A functioning Björk-Shiley aortic valve after 36 years without anticoagulation

Area of Science:

• Cardiology
• Biomedical Engineering
• Mechanical Heart Valves

Background:

• Clinical guidelines mandate lifelong oral anticoagulation after mechanical heart valve prosthesis implantation.
• Rare instances of patients not receiving anticoagulation or therapy withdrawal occur.
• Mechanical heart valves are crucial for managing valvular heart disease.

Purpose of the Study:

• To report an exceptionally durable mechanical aortic valve prosthesis.
• To investigate the long-term function of a Björk-Shiley valve in a patient without anticoagulation.
• To contribute to understanding mechanical valve longevity and management.

Main Methods:

• Case report of a patient with a Björk-Shiley mechanical aortic valve prosthesis.
• Review of patient's medical history regarding anticoagulation and antiplatelet therapy.
• Echocardiographic assessment of prosthetic valve function (gradient and insufficiency).

Main Results:

• The Björk-Shiley mechanical aortic valve prosthesis functioned for 49 years post-implantation.
• The patient received no anticoagulation or antiplatelet therapy for the initial 36 years.
• No thromboembolic or valve-related adverse events were observed.
• Excellent valve function was confirmed by echocardiography (mean gradient 13 mmHg, no insufficiency).

Conclusions:

• This case demonstrates exceptional durability of a mechanical aortic valve prosthesis.
• The findings challenge the absolute necessity of lifelong anticoagulation in all mechanical valve recipients.
• Further research is warranted to explore factors contributing to such long-term, complication-free mechanical valve function without anticoagulation.