The Björk-Shiley valve prosthesis. Analysis of long-term evolution.

Area of Science:

• Cardiology
• Biomedical Engineering
• Surgical Outcomes

Background:

• Björk-Shiley mechanical heart valves were implanted between 1971 and 1980.
• Long-term follow-up data is crucial for understanding device performance and patient outcomes.

Purpose of the Study:

• To review the long-term outcomes and complications of Björk-Shiley valve replacements.
• To identify risk factors associated with specific complications and mortality.

Main Methods:

• A retrospective review of 831 patients undergoing aortic, mitral, or double valve replacement.
• Cumulative follow-up of 4724 years, with survival data analyzed for 754 patients.
• Statistical analysis to correlate complications with valve type, size, and patient factors.

Main Results:

• Perivalvular leak was most frequent in aortic replacements, linked to size 19 models.
• Prosthetic stenosis and pannus formation were more common in mitral replacements.
• Thromboembolism risk was similar across valve types, but endocarditis posed the highest mortality, especially in double valve replacements.
• Double valve replacement was associated with higher overall morbidity and mortality.

Conclusions:

• Björk-Shiley valve performance varied by position, with specific complications like perivalvular leak and stenosis requiring attention.
• Endocarditis remains a critical determinant of mortality, with preoperative infection increasing risk in mitral and double valve groups.
• Double valve replacement carried a higher risk profile compared to single valve procedures.