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Björk-Shiley valve malfunction by prolapsed sutures
The Journal of Cardiovascular Surgery
|November 1, 1986
Summary
Long sutures caused severe aortic regurgitation after aortic valve replacement in three patients. Trimming sutures at reoperation resolved the issue, suggesting improved surgical techniques may prevent this complication.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
Background:
- Aortic valve replacement (AVR) is a common procedure to treat aortic valve disease.
- Björk-Shiley prostheses are mechanical heart valves used in AVR.
Observation:
- Three patients developed severe aortic regurgitation within six months post-AVR.
- The complication was linked to Björk-Shiley prosthesis implantation.
Findings:
- Long sutures prolapsing across the prosthesis annulus were identified as the cause.
- Suture knots unraveling and protruding may lead to regurgitation.
- Reoperation involving suture trimming or tucking effectively eliminated aortic regurgitation.
Implications:
- Proper suture management during AVR is crucial for preventing prosthesis-related complications.
- Everting the sewing skirt during initial AVR may mitigate the risk of suture prolapse.
- This finding can inform surgical best practices for aortic valve replacement procedures.
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