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Fate of thrombectomized Björk-Shiley valves. A long-term cinefluoroscopic, echocardiographic, and hemodynamic
Insights
Thrombectomy effectively treats thrombosis in Björk-Shiley heart valves, showing no operative mortality or late deaths. This procedure ensures excellent long-term valve function and patient survival.
Area of Science:
- Cardiology
- Cardiac Surgery
- Biomedical Engineering
Background:
- Thrombosis of prosthetic heart valves, specifically Björk-Shiley valves, presents a significant clinical challenge.
- Implanted Björk-Shiley valves are susceptible to thrombotic events, necessitating effective treatment strategies.
Purpose of the Study:
- To evaluate the efficacy and safety of thrombectomy for treating thrombosis in Björk-Shiley mechanical heart valves.
- To assess the early and long-term outcomes, including mortality, embolism, and valve function, following thrombectomy.
Main Methods:
- A retrospective review of 14 patients who underwent thrombectomy for Björk-Shiley valve thrombosis (mitral and aortic positions).
- Follow-up included clinical assessment, cinefluoroscopy, echocardiography, cardiac catheterization, and angiocardiography.
Main Results:
- No operative mortality or perioperative embolism was observed in the 14 patients.
- Excellent long-term results with no late mortality over an average follow-up of 23.5 months.
- Serial evaluations demonstrated no rethrombosis or valve dysfunction; cardiac catheterization showed normalized intracardiac pressures in most patients.
Conclusions:
- Thrombectomy is a safe and effective treatment for thrombosed Björk-Shiley valves.
- The procedure offers excellent early and long-term patient survival and preserves valve function.
Abstract:
Fourteen patients underwent thrombectomy for thrombosis of implanted Björk-Shiley valves (13 in the mitral and one in the aortic position) between January, 1975, and July, 1984. There was no operative mortality or perioperative embolism. Over a follow-up period of 1 to 96 months (average 23.5 months), there was no late mortality. Serial evaluation of valve function by cinefluoroscopy and echocardiography has shown no evidence of rethrombosis or valve dysfunction in any of the patients. Cardiac catheterization and angiocardiography done in 10 patients at various intervals (1 month to 6 years) postoperatively have shown normal valve function in all and normalization of elevated preoperative intracardiac pressures in the majority. Our experience suggests that thrombectomy of thrombosed Björk-Shiley valves provides excellent early and long-term results in terms of patient survival and valve function.