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Thromboembolic events after aortic valve replacement with a bioprosthesis were the most frequently occurring complications in elderly patients. Whether this was valve related or dependent on other factors needed further exploration.

Five hundred patients with a median age of 73 years were followed retrospectively after aortic valve replacement with a pericardial prosthesis for occurrence of thromboembolism. Of these, 348 also underwent coronary artery bypass grafting. Twenty-five factors were investigated for their potential effect by using univariate and multivariate analysis.

Univariate analysis revealed 6 significant factors: preoperative endocarditis (P = .0001), preoperative cerebrovascular accident (P = .002), use of postoperative warfarin sodium (Coumadin, DuPont Merck; P = .006), arterial hypertension (P = .023), size of valve prosthesis of 27 mm or larger (P = .023), and …