Thrombosis of a Bjork-Shiley aortic valve prosthesis diagnosed by two-dimensional echocardiography

✍ Scribed by Dejan Boskovic; Leonard W. Pechacek; Zvonimir Krajcer

• Publisher: John Wiley and Sons
• Year: 1983
• Tongue: English
• Weight: 457 KB
• Volume: 11
• Category: Article
• ISSN: 0091-2751
• DOI: 10.1002/jcu.1870110303

✦ Synopsis

A number of studies have demonstrated low transvalvular gradients and near laminar flow across the Bjork-Shiley aortic valve prosthesis.',' Despite these favorable hemodynamic characteristics, thromboembolic complications associated with this prosthesis do O C C U ~. ~, ~ More than 65 cases of thrombosis of the Bjork-Shiley valve in the aortic position have been reported thus far.5 Because thrombosis of tilting disc valves typically results in acute major prosthesis dysfunction, prompt diagnosis and surgical intervention are necessary.6-8 We present a case in which thrombotic fixation of an aortic Bjork-Shiley prosthesis was identified by wide-angle, two-dimensional echocardiography , leading to emergency surgery and patient survival.

CASE REPORT

In 1978, a 20-yr-old man underwent aortic valve replacement with a No. 23 Bjork-Shiley prosthesis because of severe aortic stenosis caused by a bicuspid valve. He was placed on anticoagulant therapy but took his medication on an irregular basis. He did well until May, 1981 when he suddenly developed shortness of breath and fatigue. Because of his symptoms and the fact that his prosthetic valve sounds could not be heard, he was referred to our institution for evaluation. On admission, the patient's pulse was regular at 80 beatdmin; blood pressure was 110/70 mmHg. He was afebrile. Rales were heard at both lung bases.