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Thrombosis of Björk-Shiley aortic valve prostheses
Insights
Massive thrombosis can occur with Björk-Shiley aortic valves despite low reported rates. Cineradiography can detect disk immobilization, aiding early diagnosis of this potentially fatal complication.
Area of Science:
- Cardiovascular Surgery
- Medical Imaging
- Biomedical Engineering
Background:
- Björk-Shiley aortic valve prostheses are associated with thromboembolic complications.
- Massive thrombosis, though reportedly minimal, poses a significant fatal risk.
Observation:
- The authors observed massive thrombosis in three patients with Björk-Shiley aortic valves.
- In all cases, the prosthetic disk exhibited relative radiolucency.
- Prosthetic valves manufactured after late 1975 incorporate a tantalum foil hoop.
Findings:
- Cineradiography is identified as the most rapid and accurate method for visualizing the prosthetic disk, especially in valves with tantalum foil.
- A method for calculating the valve opening angle from cineradiographs is presented.
- Serial cineradiography may detect early signs of thrombosis and disk immobilization.
Implications:
- Early detection of Björk-Shiley aortic valve thrombosis is crucial for patient survival.
- Cineradiography offers a valuable tool for monitoring valve function and detecting complications.
- Further research into serial cineradiographic monitoring could improve patient outcomes.
Abstract:
Though thromboembolic complications are reportedly minimal in patients with Björk-Shiley aortic valve prostheses, massive thrombosis remains a major and often fatal problem. The authors observed massive thrombosis in 3 patients, only one of whom survived. In all three instances, the disk of the prosthesis was relatively radiolucent. With valves manufactured after late 1975, which contain a tantalum foil hoop, cineradiography is the most rapid and accurate method of showing the disk. A simple method of calculating the valve opening angle from the cineradiograph is described. It is suggested that serial cineradiographs might be useful in detecting lesser degrees of thrombosis and partial immobilization of the disk.