Fernandez J, Samuel A, Yang S S, Gooch A, Maranhao V, Lemole G M, Goldberg H
Chest. 1976 Jul;70(1):12-6. doi: 10.1378/chest.70.1.12.
Seven cases of massive thrombosis of an aortic Bjork-Shiley prosthesis were encountered among 433 valvular implants. Four patients died before treatment could be instituted, and three underwent repeat surgery successfully. Anticoagulation therapy was probably well maintained in four, and poorly maintained in three patients. These cases illustrated the need for a high index of suspicion and prompt recognition of this complication in patients with Bjork-Shiley prostheses. The diagnosis of massive thrombosis should be suspected with the rapid onset of (1) signs of congestive heart failure, (2) absence or attenuation of valvular clicks, (3) aortic regurgitation, or (4) hemolytic anemia. Salvage of these patients requires emergency replacement of the thrombosed prosthesis or removal of the thrombus.
在433例瓣膜植入手术中，发现7例主动脉瓣Bjork-Shiley人工瓣膜发生大量血栓形成。4例患者在能够进行治疗之前死亡，3例患者再次手术成功。4例患者的抗凝治疗可能维持良好，3例患者维持不佳。这些病例表明，对于植入Bjork-Shiley人工瓣膜的患者，需要高度怀疑并及时识别这种并发症。出现以下情况时应怀疑发生大量血栓形成：（1）充血性心力衰竭的体征迅速出现；（2）瓣膜喀喇音消失或减弱；（3）主动脉瓣反流；（4）溶血性贫血。挽救这些患者需要紧急更换血栓形成的人工瓣膜或清除血栓。
