The Annals of Thoracic Surgery, Vol 32, 138-145, Copyright © 1981 by The Society of Thoracic Surgeons
Ten-year follow-up in aortic valve replacement using the Bjork-Shiley prosthesis
D Cheung, RJ Flemma, DC Mullen, D Lepley Jr, AJ Anderson and E Weirauch
An in-depth statistical analysis of early and late results of aortic valve
replacement using the Bjork-Shiley tilting-disc prosthesis is presented.
Our experience with this prosthesis indicates that replacement carries a
low surgical risk, a low incidence of complications (embolization,
infection, or hemorrhage due to long-term use of anticoagulants), and good
long-term survival. Coexisting coronary artery disease increases surgical
mortality significantly, and simultaneous, complete revascularization is
essential. Patients undergoing isolated aortic valve replacement did
significantly better than those requiring other simultaneous procedures or
those who had had previous operations. Earlier operation is imperative
since progress of aortic valve disease is unpredictable by duration of
symptoms, and patients in New York Heart Association Functional Class II
have a low surgical risk and a greatly increased survival. It would appear
from this study that additional criteria, such as increasing ventricular
dilatation and hypertrophy determined by echocardiographic studies and
gated nuclear studies showing deterioration of ejection fraction on
exercise, should be used to help determine time of surgical intervention
rather than symptomatology alone.
