Use of aspirin as the sole antiplatelet agent following prosthetic valve replacement in rheumatic heart disease.

Aspirin was administered as the sole antiplatelet agent in 147 patients following valve replacement, who were at low risk for thromboembolism. Of these, 67 underwent mitral valve replacement (MVR), 61 aortic valve replacement (AVR) and 19 combined aortic and mitral valve replacement (DVR). The mean follow up period was 6.63 years (range 1-14 years). The incidence of thromboembolic episodes (TEE) in patients following MVR, AVR, and DVR was 0.41, 0.80 and nil respectively. The TEE free survival at the first year follow-up was 98.4%, 99.3% and 100% in patients following MVR, AVR and DVR respectively. Fatal intracranial haemorrhage was not encountered. Valve thrombosis in this patient population was not seen. In conclusion, aspirin as the sole antiplatelet agent appears to be safe and effective following prosthetic valve replacement in selected patients. Further studies involving larger number of patients are necessary to confirm these results.