Late results of valve replacement with the Bjork-Shiley valve (1973 to 1982)

T. A. Orszulak, Hartzell V Schaff, J. M. DeSmet, G. K. Danielson, J. R. Pluth, F. J. Puga

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Cardiac valve replacement with use of only the Bjork-Shiley prosthesis was performed in 1253 patients between January 1973 and December 1982. There were 828 patients having aortic valve replacement, 280 patients having mitral valve replacement, and 145 patients having double valve replacement with aortic and mitral valve prostheses. Patient outcome was stratified according to multiple variables, including valve position and valve model (spherical versus convexo-concave discs). No valve failure due to strut fracture was identified in 26 high-risk patients (mitral valve replacement with greater than or equal to 29 mm implanted in patients less than or equal to 50 years of age) followed up for a mean of 10 years postoperatively. Fifteen patients had late thrombosis of their Bjork-Shiley prosthesis (0.28 per 100 patient- years), but there was no significant difference in risk of valve thrombosis comparing the spherical and convexo-concave discs (0.27 per 100 patient- years versus 0.27 per 100 patient-years). One hundred two patients had 128 thromboembolic episodes; rates of thromboembolism after aortic valve replacement, mitral valve replacement, and double valve replacement were 2.1, 4.3, and 4.6 per 100 patient-years, respectively. Percentages of patients free from thromboemboli after aortic valve replacement, mitral valve replacement, and double valve replacement were 93% ± 1%, 86% ± 2%, and 89% ± 3% at 5 years postoperatively and 87% ± 2%, 79% ± 5%, and 77% ± 8% 10 years postoperatively. There was no significant difference in the rates of thromboemboli for spherical and convexo-concave discs for all patients and for each of the subgroups. Ten-year actuarial survival estimates for patients dismissed alive from the hospital after aortic valve replacement, mitral valve replacement, and double valve replacement with the Bjork-Shiley valve were 65% ± 4%, 63% ± 5%, and 55% ± 8%, respectively. Overall event-free survival (freedom from death, thromboembolism, anticoagulant-related bleeding, endocarditis, and reoperation) was similar for the three patient groups. Performance of the Bjork-Shiley valve as judged by late patient follow-up is similar to other mechanical valves, and modifications in disc design do not appear to have reduced the threat of late valve thrombosis and thromboemboli. Evidence does not support elective explanation of this prosthesis.

Original languageEnglish (US)
Pages (from-to)302-312
Number of pages11
JournalJournal of Thoracic and Cardiovascular Surgery
Volume105
Issue number2
StatePublished - 1993

Fingerprint

Mitral Valve
Aortic Valve
Prostheses and Implants
Thrombosis
Thromboembolism
Heart Valves
Endocarditis
Reoperation
Anticoagulants
Disease-Free Survival
Hemorrhage
Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Orszulak, T. A., Schaff, H. V., DeSmet, J. M., Danielson, G. K., Pluth, J. R., & Puga, F. J. (1993). Late results of valve replacement with the Bjork-Shiley valve (1973 to 1982). Journal of Thoracic and Cardiovascular Surgery, 105(2), 302-312.

Late results of valve replacement with the Bjork-Shiley valve (1973 to 1982). / Orszulak, T. A.; Schaff, Hartzell V; DeSmet, J. M.; Danielson, G. K.; Pluth, J. R.; Puga, F. J.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 105, No. 2, 1993, p. 302-312.

Research output: Contribution to journalArticle

Orszulak, TA, Schaff, HV, DeSmet, JM, Danielson, GK, Pluth, JR & Puga, FJ 1993, 'Late results of valve replacement with the Bjork-Shiley valve (1973 to 1982)', Journal of Thoracic and Cardiovascular Surgery, vol. 105, no. 2, pp. 302-312.
Orszulak, T. A. ; Schaff, Hartzell V ; DeSmet, J. M. ; Danielson, G. K. ; Pluth, J. R. ; Puga, F. J. / Late results of valve replacement with the Bjork-Shiley valve (1973 to 1982). In: Journal of Thoracic and Cardiovascular Surgery. 1993 ; Vol. 105, No. 2. pp. 302-312.
@article{e4847807366a4760b984317e531f8603,
title = "Late results of valve replacement with the Bjork-Shiley valve (1973 to 1982)",
abstract = "Cardiac valve replacement with use of only the Bjork-Shiley prosthesis was performed in 1253 patients between January 1973 and December 1982. There were 828 patients having aortic valve replacement, 280 patients having mitral valve replacement, and 145 patients having double valve replacement with aortic and mitral valve prostheses. Patient outcome was stratified according to multiple variables, including valve position and valve model (spherical versus convexo-concave discs). No valve failure due to strut fracture was identified in 26 high-risk patients (mitral valve replacement with greater than or equal to 29 mm implanted in patients less than or equal to 50 years of age) followed up for a mean of 10 years postoperatively. Fifteen patients had late thrombosis of their Bjork-Shiley prosthesis (0.28 per 100 patient- years), but there was no significant difference in risk of valve thrombosis comparing the spherical and convexo-concave discs (0.27 per 100 patient- years versus 0.27 per 100 patient-years). One hundred two patients had 128 thromboembolic episodes; rates of thromboembolism after aortic valve replacement, mitral valve replacement, and double valve replacement were 2.1, 4.3, and 4.6 per 100 patient-years, respectively. Percentages of patients free from thromboemboli after aortic valve replacement, mitral valve replacement, and double valve replacement were 93{\%} ± 1{\%}, 86{\%} ± 2{\%}, and 89{\%} ± 3{\%} at 5 years postoperatively and 87{\%} ± 2{\%}, 79{\%} ± 5{\%}, and 77{\%} ± 8{\%} 10 years postoperatively. There was no significant difference in the rates of thromboemboli for spherical and convexo-concave discs for all patients and for each of the subgroups. Ten-year actuarial survival estimates for patients dismissed alive from the hospital after aortic valve replacement, mitral valve replacement, and double valve replacement with the Bjork-Shiley valve were 65{\%} ± 4{\%}, 63{\%} ± 5{\%}, and 55{\%} ± 8{\%}, respectively. Overall event-free survival (freedom from death, thromboembolism, anticoagulant-related bleeding, endocarditis, and reoperation) was similar for the three patient groups. Performance of the Bjork-Shiley valve as judged by late patient follow-up is similar to other mechanical valves, and modifications in disc design do not appear to have reduced the threat of late valve thrombosis and thromboemboli. Evidence does not support elective explanation of this prosthesis.",
author = "Orszulak, {T. A.} and Schaff, {Hartzell V} and DeSmet, {J. M.} and Danielson, {G. K.} and Pluth, {J. R.} and Puga, {F. J.}",
year = "1993",
language = "English (US)",
volume = "105",
pages = "302--312",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - Late results of valve replacement with the Bjork-Shiley valve (1973 to 1982)

AU - Orszulak, T. A.

AU - Schaff, Hartzell V

AU - DeSmet, J. M.

AU - Danielson, G. K.

AU - Pluth, J. R.

AU - Puga, F. J.

PY - 1993

Y1 - 1993

N2 - Cardiac valve replacement with use of only the Bjork-Shiley prosthesis was performed in 1253 patients between January 1973 and December 1982. There were 828 patients having aortic valve replacement, 280 patients having mitral valve replacement, and 145 patients having double valve replacement with aortic and mitral valve prostheses. Patient outcome was stratified according to multiple variables, including valve position and valve model (spherical versus convexo-concave discs). No valve failure due to strut fracture was identified in 26 high-risk patients (mitral valve replacement with greater than or equal to 29 mm implanted in patients less than or equal to 50 years of age) followed up for a mean of 10 years postoperatively. Fifteen patients had late thrombosis of their Bjork-Shiley prosthesis (0.28 per 100 patient- years), but there was no significant difference in risk of valve thrombosis comparing the spherical and convexo-concave discs (0.27 per 100 patient- years versus 0.27 per 100 patient-years). One hundred two patients had 128 thromboembolic episodes; rates of thromboembolism after aortic valve replacement, mitral valve replacement, and double valve replacement were 2.1, 4.3, and 4.6 per 100 patient-years, respectively. Percentages of patients free from thromboemboli after aortic valve replacement, mitral valve replacement, and double valve replacement were 93% ± 1%, 86% ± 2%, and 89% ± 3% at 5 years postoperatively and 87% ± 2%, 79% ± 5%, and 77% ± 8% 10 years postoperatively. There was no significant difference in the rates of thromboemboli for spherical and convexo-concave discs for all patients and for each of the subgroups. Ten-year actuarial survival estimates for patients dismissed alive from the hospital after aortic valve replacement, mitral valve replacement, and double valve replacement with the Bjork-Shiley valve were 65% ± 4%, 63% ± 5%, and 55% ± 8%, respectively. Overall event-free survival (freedom from death, thromboembolism, anticoagulant-related bleeding, endocarditis, and reoperation) was similar for the three patient groups. Performance of the Bjork-Shiley valve as judged by late patient follow-up is similar to other mechanical valves, and modifications in disc design do not appear to have reduced the threat of late valve thrombosis and thromboemboli. Evidence does not support elective explanation of this prosthesis.

AB - Cardiac valve replacement with use of only the Bjork-Shiley prosthesis was performed in 1253 patients between January 1973 and December 1982. There were 828 patients having aortic valve replacement, 280 patients having mitral valve replacement, and 145 patients having double valve replacement with aortic and mitral valve prostheses. Patient outcome was stratified according to multiple variables, including valve position and valve model (spherical versus convexo-concave discs). No valve failure due to strut fracture was identified in 26 high-risk patients (mitral valve replacement with greater than or equal to 29 mm implanted in patients less than or equal to 50 years of age) followed up for a mean of 10 years postoperatively. Fifteen patients had late thrombosis of their Bjork-Shiley prosthesis (0.28 per 100 patient- years), but there was no significant difference in risk of valve thrombosis comparing the spherical and convexo-concave discs (0.27 per 100 patient- years versus 0.27 per 100 patient-years). One hundred two patients had 128 thromboembolic episodes; rates of thromboembolism after aortic valve replacement, mitral valve replacement, and double valve replacement were 2.1, 4.3, and 4.6 per 100 patient-years, respectively. Percentages of patients free from thromboemboli after aortic valve replacement, mitral valve replacement, and double valve replacement were 93% ± 1%, 86% ± 2%, and 89% ± 3% at 5 years postoperatively and 87% ± 2%, 79% ± 5%, and 77% ± 8% 10 years postoperatively. There was no significant difference in the rates of thromboemboli for spherical and convexo-concave discs for all patients and for each of the subgroups. Ten-year actuarial survival estimates for patients dismissed alive from the hospital after aortic valve replacement, mitral valve replacement, and double valve replacement with the Bjork-Shiley valve were 65% ± 4%, 63% ± 5%, and 55% ± 8%, respectively. Overall event-free survival (freedom from death, thromboembolism, anticoagulant-related bleeding, endocarditis, and reoperation) was similar for the three patient groups. Performance of the Bjork-Shiley valve as judged by late patient follow-up is similar to other mechanical valves, and modifications in disc design do not appear to have reduced the threat of late valve thrombosis and thromboemboli. Evidence does not support elective explanation of this prosthesis.

UR - http://www.scopus.com/inward/record.url?scp=0027511459&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027511459&partnerID=8YFLogxK

M3 - Article

VL - 105

SP - 302

EP - 312

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 2

ER -