Prótese de carbono de disco basculante com revestimento de material biológico em posi？？o mitral com baixa dose de anticoagulante oral: 3 anos de experiência

introduction: clinical analysis after three years of observation of the magalh？es-hp pivoting disc valve. material and methods: since 01/94, 34 patients were discharged from the hospital. all the survivors were contacted during the last three months and the average time of observation was 24.5 months (ranging from 2 to 35 months), with a total of 834 months-patient (69.5 years patient). results: the survival actuarial curve was 85.3%. there was a fatal complication unrelated to the valve (kidney insufficiency) (0.98 pcpy) (percent patient per year) and three fatal complications related to the prosthesis (thrombosis - 2.94 pcpy) (one case in another hospital, one case reoperated, and one case treated with streptokinase with initial good results and fatal pulmonary complications). there were three significant hemorrhagic episodes (2.94 pcpy), one of them fatal (0.98 pcpy), one moderate complications (0.98 pcpy), and eight cases of lesser importance (7.8 pcpy). there were nine non-fatal complications related to the valve (8.8 pcpy), heart murmurs - six cases (5.8 pcpy), small thromboembolism without sequelae - two cases (1.96 pcpy), and thrombosis - one case (0.98 pcpy) (reoperated with success, maintaining the same prosthesis with excellent evolution). conclusion: the covering of the pivoting disc valve with heterologous biological material with a minor dose of anticoagulant seems to reduce, after one year, the incidence of thrombosis (zero cases), thromboembolism (two cases with low repercussion, transitory, and without sequelae) and hemorrhagic events (two small epistaxe cases). in the first three months after the operation, occured the major incidence of thrombosis and hemorrhagic events due to deflections in the anticoagulant protocol. in this period there must be a full and effective anticoagulation to allow the least of fibrin deposit, and a thin slow cicatrization. the secure weekly average dose of phenprocoumon was 4.5 tablets (minimum of 2.5 and maximum of 7