The Annals of Thoracic Surgery, Vol 32, 120-126, Copyright © 1981 by The Society of Thoracic Surgeons
Medium-term follow-up of the Ionescu-Shiley heterograft valve
RM Becker, L Sandor, M Tindel and RW Frater
Utilizing a questionnaire specifically designed to uncover potential
thromboembolic episodes, we personally interviewed 97 patients who
underwent valve replacement with the Ionescu-Shiley valve between January,
1977, and June, 1980. In both the aortic and mitral positions, the
attrition rate after the first year was low; cumulative survival at 3 to 4
years was 78% (aortic) and 61% (mitral). None of the deaths were attributed
to primary valve failure. Patients with aortic prostheses, none of whom
were anticoagulated, had a cumulative thromboembolism-free rate of 94% at 3
to 4 years. Patients with mitral prostheses had a thromboembolism-free rate
of 71% at 3 to 4 years with 80% of the episodes occurring in patients in
atrial fibrillation. Most emboli produced only transient symptoms, and only
1 patient has residual impairment. The Ionescu-Shiley valve performs well
in the early years after valve replacement. Anticoagulation should be
strongly considered for patients with mitral prostheses who are in atrial
fibrillation.
