ACUTE THROMBOTIC OBSTRUCTION WITH BJORK-SHILEY VALVES - DIAGNOSTIC AND SURGICAL CONSIDERATIONS

  • 1 January 1978
    • journal article
    • research article
    • Vol. 75  (3) , 321-330
Abstract
Patients (8) have had thrombotic obstruction of a prosthetic valve since 1971, 6 mitral valves and 2 aortic. All 8 patients had a Bjork-Shiley valve. During the same period 159 Bjork-Shiley valves were placed, 85 in the mitral and 74 in the aortic area. This represents a valve thrombotic occlusive incidence of 4.4% in this series, 5.9% of mitral and 2.7% of aortic prostheses. Among the 6 patients with mitral prostheses only 1 survived. The 2 patients with occluded aortic valves survived. The onset of symptoms was very abrupt in most patients and progressed very rapidly. Acute pulmonary edema was observed in 5 patients. Anticoagulation was considered inadequate in all patients. Aspirin or dipyridamole was being used in 7 patients at the time of thrombosis. A high frequency of thrombotic occlusion of Bjork-Shiley valves in the absence of full anticoagulation with warfarin derivatives was indicated. The urgent need for surgery once valve thrombosis is suspected was emphasized.