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ANTICOAGULATION NECESSARY WITH ST. JUDE VALVE PROSTHESIS.

Because of the St. Jude valve's superior flow characteristics, it was hoped that embolic events would be rare enough to render anticoagulation unnecessary. However, this report on 785 patients who received 815 St. Jude valves between 1979 and 1984 demonstrates that, in the absence of warfarin, although the rate of embolic events with this prosthesis is lower than that with other nonbiologic prostheses, it is not as low as the rate with porcine valves. Among 610 patients evaluable at follow-up, the rate of thromboembolism per patient-year was 2.6 percent among 518 patients taking warfarin, 9.2 percent among 24 patients taking antiplatelet agents but not warfarin, and 15.6 percent among 41 taking neither anticoagulants nor antiplatelet agents.

The complication rates in patients who did not take warfarin are based on small numbers of subjects, but they suggest that patients who are at high risk for bleeding complications with anticoagulant therapy should be given porcine valves.

— THL

Published in Journal Watch General Medicine January 24, 1989

Citation(s):

Myers ML et al. Jude valve prosthesis: analysis of the clinical results in 815 implants and the need for systemic anticoagulation. J Am Coll Cardiol 1989 Jan 13 57-62.

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• The St Jude received in 1995
  Frank McKown, United methodist church, 26 Mar 2009 10:55 AM EST
  In nov 1995 I had a st jude valve replacement. To this day it works to perfection. I have been... [more]
• st jude vavle/anticoag/status post surg
  Brian Wallace, Naval Hospital Pensacola, 17 Aug 2009 12:58 PM EST
  82 y/o female, pacemaker, st jude valve, CVA r hemi with dysphagia, coumadin per S.S. All this occured 3/93. D/C'd... [more]