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Ann Thorac Surg 1985;40:234-240
© 1985 The Society of Thoracic Surgeons

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Articles

Hemodynamic Evaluation of the Integral Monostrut Björk-Shiley Prosthesis in the Aortic Position

From the Cardiac Surgery and Cardiopulmonary Function Units, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

^* Address reprint requests to Dr. Aris, Cardiac Surgery Unit, Hospital de la Santa Creu i Sant Pau, Av San Antonio M. Claret 167, 08025 Barcelona, Spain

Between May, 1983, and November, 1984, the new integral monostrut Björk-Shiley prosthesis was used for aortic valve replacement in 62 patients. The prosthesis is machined from a solid piece of cobalt alloy and has no welded joints. The traditional U-shaped outlet strut has been replaced by a projecting metal finger that holds the disc in place. The disc opens to 70 degrees and is convexoconcave.

Successful transseptal heart catheterization was performed in 23 patients an average of 6 months following operation to evaluate the hemodynamic performance of the prosthesis. The mean peak-to-peak gradient was 7.73 ± 7.49 mm Hg (± standard deviation). In five valves it was 0, and in only three was it higher than 15 mm Hg. Significant peak gradients were directly related to the valve index (valve area/body surface area). Mean systolic gradient at rest was 12.7 ± 6.27 mm Hg and did not increase after exercise. Effective orifice areas were adequate, and the discharge coefficient ranged from 0.77 for the 21-mm prosthesis to 0.48 for the 29-mm prosthesis. Minimal regurgitation, which was washed out on the next systole, was observed with all sizes of the prosthesis. Disc opening was maximal (70 degrees) in all but one of the observed instances.

Longer clinical follow-up is required, but the new integral monostrut Björk-Shiley prosthesis, with its important design changes and excellent hemodynamic performance, appears to be a promising aortic valve substitute.

This article has been cited by other articles:

				A. Aris, A. Igual, J. M. Padro, R. Burgos, J. L. Vallejo, J. M. Rabasa, R. Llorens, and J. Casares The Spanish Monostrut Study Group: A Ten-Year Experience With 8,599 Implants Ann. Thorac. Surg., July 1, 1996; 62(1): 40 - 47. [Abstract] [Full Text]

				L. I. Thulin, W. H. Bain, H. H. Huysmans, G. van Ingen, I. Prieto, F. Basile, D. A. Lindblom, and C. L. Olin Heart Valve Replacement with the Bjork-Shiley Monostrut Valve: Early Results of a Multicenter Clinical Investigation Ann. Thorac. Surg., February 1, 1988; 45(2): 164 - 170. [Abstract] [PDF]