Pharmacologic Control of Thromboembolic Complications of Cardiac-Valve Replacement

Publisher Website
Google Scholar
Abstract
Either dipyridamole, a vasodilator known to reduce platelate adhesiveness and aggregation, or a placebo was given in a daily dose of 400 mg as a random, blind trial to 70 patients who had undergone prosthetic cardiac-valve replacement. Patients in both groups were given anticoagulation with warfarin sodium. Of 36 patients in the placebo group followed for 557 months systemic arterial embolism occurred in 17 per cent. Twenty-seven patients in the dipyridamole group followed for 393 months gave no clinical evidence of arterial embolism. Dipyridamole was discontinued shortly after surgery in seven patients, and these were followed for 110 months. In two of them cerebral emboli developed six months after treatment was discontinued. It is tentatively concluded that the addition of dipyridamole to a program of anticoagulation reduces the frequency of postoperative arterial emboli originating on prosthetic cardiac valves in patients who can tolerate the drug.