The Annals of Thoracic Surgery, Vol 32, 50-57, Copyright © 1981 by The Society of Thoracic Surgeons
Clinical and hemodynamic evaluation of the 19 mm Bjork-Shiley aortic valve prosthesis
HV Schaff, AM Borkon, C Hughes, S Achuff, JS Donahoo, TJ Gardner, L Watkins Jr, VL Gott, AG Morrow and RK Brawley
Between November, 1973, and March, 1980, 43 patients underwent isolated
aortic valve replacement with 19 mm Bjork-Shiley prostheses at the Johns
Hopkins Hospital. There were 4 male and 39 female patients ranging from 12
to 75 years old (mean, 54.5 years). Average weight was 62 +/- 2 kg and
average body surface area, 1.64 +/- 0.3 m2. Five patients died within
thirty days of operation; however, since 1975, hospital mortality has been
5.9%. The 38 survivors have been followed up for as long as 85 months
(mean, 40 months). There were 4 late deaths, and actuarial survival in
patients discharged from the hospital was 81% at five years. All long-term
survivors were in New York Heart Association Functional Class I (29
patients) or Class II (5 patients). Preoperative and postoperative
echocardiograms in 17 patients demonstrated significant decreases in mean
left ventricular wall thickness (12.9 +/- 1.8 mm vs 10.3 +/- 1.4 mm; p less
than 0.001) and in left ventricular mass (262 +/- 95 gm vs 188 +/- 50 gm; p
less than 0.02). Postoperative cardiac catheterization data were obtained
from an additional 24 patients undergoing aortic valve replacement with the
19 mm Bjork-Shiley prosthesis at the National Heart Institute. Average peak
systolic gradient at rest was 16 mm Hg (range, 0 to 45 mm Hg) and was found
to be directly related to body surface area (r = 0.60, p less than 0.002).
Average effective valve orifice area was 1.06 cm2 (range, 0.63 to 2.02
cm2). For patients with small aortic roots, aortic valve replacement with
the 19 mm Bjork-Shiley valve is a satisfactory and, perhaps, preferable
alternative to aortic annuloplasty to accommodate larger sized prostheses.
