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Ann Thorac Surg 1989;47:436-440
© 1989 The Society of Thoracic Surgeons

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Articles

Björk-Shiley strut fracture and disc escape: Literature review and a method of disc retrieval

Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, the Netherlands

Accepted for publication September 30, 1988.

^_* Address reprint requests to Dr Hendel, Department of Cardiothoracic Surgery, The Prince Henry Hospital, Little Bay, Sydney, 2036, Australia.

Embolization of a prosthetic valve poppet is a rare but life-threatening event. It was reported sporadically before the introduction of the Björk-Shiley 70-degree convexoconcave prosthesis in 1980. Since that time, there have been a large number of reported mechanical failures with disc escape. The rate for the 29-mm to 33-mm mitral valves is estimated as 5.2%. In 29 of 35 patients (including the 2 presented here) in whom the site of disc lodgment could be determined, the disc was in the descending or abdominal aorta. Fifteen of these patients died. Six survivors had the disc removed at the same operation and 6 at a later operation. In 2 patients, the disc was not removed. In 2 patients in whom the disc was not removed initially, it was thought to contribute to post-operative complications. Two more cases of structural failure of the Björk-Shiley convexoconcave prosthesis are presented. A transpericardial approach to the descending aorta on bypass is described. It allows easy removal of the disc and eliminates the need for a second operation.

This article has been cited by other articles:

				S. K. Lochridge Bjork-Shiley strut fracture and disc escape Ann. Thorac. Surg., January 1, 1990; 49(1): 166 - 166. [PDF]