The Annals of Thoracic Surgery, Vol 50, 151-154, Copyright © 1990 by The Society of Thoracic Surgeons
Development of an artificial heart valve
VO Bjork
Karolinska Hospital, Stockholm, Sweden.
When I reviewed the 21-year results with the Bjork-Shiley tilting disc
valves, I found out that to date, we still have to use these disc valves
and all mechanical heart valves with anticoagulation therapy. The highest
incidence of valve-related postoperative deaths after aortic valve
replacements in Stockholm was anticoagulation-related bleeding, which
continued at a rate of about 1% year after year. There is a need to improve
the quality of life for heart valve patients, especially for children, for
young females who want to have children, for the older generation who are
on medical treatment, and for all patients in whom long-term
anticoagulation of a perfect quality is impossible to guarantee. A series
of tests on goats has been performed, using the Bjork-Shiley Monostrut
valve used in 2,024 patients at the Karolinska Hospital in Stockholm and in
75,000 patients worldwide for up to 8 years with a modification of a
microporous surface. In the mitral position, this modified partially
microporous-surfaced Bjork- Shiley Monostrut valve has permitted goats to
live for 5 years with four normal pregnancies without anticoagulation
therapy.