Prophylactic replacement of Björk-Shiley convexo-concave valves at risk of strut fracture. Björk-Shiley Study Group

The Journal of Thoracic and Cardiovascular Surgery
M KallewaardY van der Graaf

Abstract

Prophylactic replacement of Björk-Shiley convexo-concave valves (Shiley, Inc., Irvine, Calif.) has been advised for selected groups of patients. If prophylactic replacement is considered, risks of postoperative morbidity and mortality have to be weighed against benefits of replacement. Here we report the results of prophylactic replacement of Björk-Shiley convexo-concave valves at risk of strut fracture in The Netherlands. We reviewed medical records of 36 patients undergoing prophylactic replacement of their Björk-Shiley convexo-concave valves before August 1995. Replacement was judged to be prophylactic if the risk of strut fracture outweighed that of death from reoperation, or the patient wished to have the valve replaced although it was not recommended. The procedure was also considered to be prophylactic if a concomitant pathologic condition, not likely to require cardiac surgery in the near future, was present or if preoperative examination revealed an unexpected cardiac pathologic condition. Twenty-two 70-degree and 16 60-degree Björk-Shiley convexo-concave valves and one spherical valve were replaced (25 aortic and 14 mitral, including three double-valve replacements). Early mortality was 2.8% (1/36) (exact 95% confiden...Continue Reading

References

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Citations

Oct 22, 2003·Journal of Clinical Epidemiology·M J van GorpY van der Graaf
Jan 19, 2000·Medical Decision Making : an International Journal of the Society for Medical Decision Making·E W SteyerbergJ D Habbema
May 7, 2003·Circulation·Tomaso BottioGino Gerosa
Jan 24, 2009·Journal of Biomedical Materials Research. Part B, Applied Biomaterials·Hongbo ZhangRobert Guidoin

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