{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T22:17:49Z","timestamp":1770589069445,"version":"3.49.0"},"reference-count":22,"publisher":"IMR Press","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HSF"],"abstract":"<jats:p>&lt;p&gt;&lt;b&gt;Background:&lt;\/b&gt; We performed the first quadruple valve replacement with mechanical valves, combined with the correction of complex congenital heart disease on November 17, 1999. We report here the 11-year follow-up study.&lt;\/p&gt;&lt;p&gt;&lt;b&gt;Methods:&lt;\/b&gt; A 47-year-old man with subacute rheumatic endocarditis, a ventricular septal defect, and an obstruction of the right ventricular outflow tract required replacement of the aortic, mitral, tricuspid, and pulmonary valves; repair of the ventricular septal defect; and relief of the obstruction of the right ventricular outflow tract. The surgery was done on November 17, 1999, after careful systemic preparation of the patient. Warfarin therapy with a target international normalized ratio (INR) range of 1.5 to 2.0 was used. Follow-up included monitoring the INR, recording the incidences of thromboembolic and bleeding events, electrocardiography, radiography, and echocardiography evaluations.&lt;\/p&gt;&lt;p&gt;&lt;b&gt;Results:&lt;\/b&gt; The patient's INR was maintained between 1.5 and 2.0. All 4 mechanical prosthetic heart valves worked well. He is in generally good health without any thromboembolic or bleeding complications.&lt;\/p&gt;&lt;p&gt;&lt;b&gt;Conclusions:&lt;\/b&gt; Long-term management is challenging for patients who have experienced quadruple valve replacement with mechanical valves; however, promising results could mean that replacement of all 4 heart valves in 1 operation is feasible in patients with quadruple valve disease, and an INR of 1.5 to 2.0 could be appropriate for Chinese patients with undergoing valve replacement with mechanical valves.&lt;\/p&gt;<\/jats:p>","DOI":"10.1532\/hsf98.20111124","type":"journal-article","created":{"date-parts":[[2012,6,15]],"date-time":"2012-06-15T22:54:46Z","timestamp":1339800886000},"page":"145","source":"Crossref","is-referenced-by-count":8,"title":["Quadruple Valve Replacement with Mechanical Valves: An 11-Year Follow-up Study"],"prefix":"10.31083","volume":"15","author":[{"given":"Yukun","family":"Cao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunhu","family":"Gu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guocheng","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiqiang","family":"Yu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongbing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dinghua","family":"Yi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16242","published-online":{"date-parts":[[2012,6,14]]},"reference":[{"key":"1","doi-asserted-by":"crossref","first-page":"2172","DOI":"10.1016\/j.athoracsur.2006.01.072","article-title":"Short- and long-term results of triple valve surgery in the modern era","volume":"81","author":"B. 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