Quality of Life in Patients with Mechanical Heart Valves: Influence of Anticoagulation Therapy and Valve Noise
There are two significant drawbacks with mechanical heart valves: the need for long-term anticoagulation and valve noise. To study these aspects with respect to patients’ quality of life, a follow-up was made of all patients receiving mechanical valves in our institution between 1981 and 1983. All patients were traced. Early and late mortality was 11.2%. A questionnaire was sent to the surviving patients and 281 (99%) responded. Two hundred forty-three had BJÖRK-SHILEY® 70° Convexo-Concave valves and 38 had ST. JUDE MEDICAL® valves. Mean age at follow-up was 63 years. Mean follow-up time was 2.5 years. Nine percent of patients experienced bleeding complications; 3% were major, 6% minor. This corresponds to 3.2% per patient-year. Thromboembolic complications, including TE and TIA, were experienced by 3.2% of the patients. Only 1 patient had sequelae. There were no instances of valve thrombosis. Ninety-seven percent of the patients did not feel restricted by the anticoagulation therapy; 6% felt as if they were on a special diet. The therapy was well regulated in 90% of the patients. Sixty percent of the patients used alcohol without restrictions and 25% traveled abroad without problems. Twenty-five percent of the patients were sometimes disturbed by valve noise and 8.5% were more regularly disturbed. There were no statistically significant differences between the BJORK-SHILEY and the ST. JUDE MEDICAL valves or due to age, valve location, or valve size. In order to study and compare noise of various heart valves during standardized conditions, an in vitro study was carried out. The results suggest that the anticoagulation therapy in the majority of patients was well regulated and associated with a low incidence of complications. In spite of advanced age, most patients lived active lives and were not restricted. Some patients were occasionally disturbed by the valve noise, and this problem deserves further attention.
KeywordsHeart Valve Anticoagulation Therapy Thromboembolic Complication Mechanical Valve Mechanical Heart Valve
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