Strut fracture in a Bjork-Shiley aortic valve prosthesis

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Pathology

Background:

• Mechanical prosthetic heart valves are used to replace damaged native valves.
• Strut fracture is a known, life-threatening complication associated with certain mechanical heart valve models.
• Previous incidents involved DeBakey, Beall, and Cooley-Cutter valves.

Observation:

• A 35-year-old male patient experienced sudden death 16 months post-implantation.
• The patient had a 60-degree Bjork-Shiley Convexo-Concave heart valve prosthesis in the aortic position.
• Autopsy revealed fractured welded attachments of the valve's outlet strut.

Findings:

• The fractured outlet strut attachments of the Bjork-Shiley valve were identified as the cause of failure.
• The valve's tilting disc was discovered dislodged in the patient's abdominal aorta.
• This case highlights a fatal strut fracture in the Bjork-Shiley Convexo-Concave model.

Implications:

• Strut fracture in mechanical heart valves poses a significant risk of mortality.
• This case underscores the critical need for ongoing surveillance and potential design improvements for prosthetic heart valves.
• Further research into the long-term durability and failure mechanisms of mechanical heart valves is warranted.