Krotin Mirjana, Krotin Jelisaveta Milenković, Zdravković Marija
Clinical Hospital Center Beianijska kosa, Department of Cardiology, Belgrade, Serbia.
Vojnosanit Pregl. 2010 Aug;67(8):685-7. doi: 10.2298/vsp1008685k.
The Björk-Shiley Delrin (BSD) tilting disc heart valve was first clinically used in 1969. A triple BSD valve replacement has not been quite common, because of high postoperative risk and complications, but there have been several cases with different postoperative course. The first implantation of artificial valve in Yugoslavia was done by Prof. Isidor Papo, in 1965.
We presented patient with more than 30 years of successful triple (aortic, mitral and tricuspid) BSD valve functioning. This is a rare case of a triple BSD valve long-term functioning and, as far as we know, the case of the longest period of successful functioning of the triple BSD valves. In March 1977, a 34-year-old female with severe congestive heart failure of the New York Heart Association (NYHA) functional class IV was admitted to the Military Medical Academy, Belgrade, for triple valve (aortic, mitral and tricuspid) surgery with BSD mechanical valves. Complicated surgery was done well. Sixteen months later the patient was diagnosed with infective endocarditis caused by Enterobacter spp. that was isolated from blood cultures. The patient was successfully cured. After that the patient had no cardiovascular symptoms and regular physical and echocardiographic examinations used to reveal satisfactory cardiovascular function. The patient died more than 30 years after the surgery due to a terminal phase of uterine carcinoma.
Although BSD valves were withdrawn from clinical use long time ago, there are still some rare cases of their successful functioning, mostly due to the precise surgical technique and regular follow-up by the cardiologists.
Björk-Shiley Delrin(BSD)倾斜盘式心脏瓣膜于1969年首次临床应用。由于术后风险高和并发症多,三联BSD瓣膜置换术并不常见,但也有几例术后病程不同的病例。1965年,伊西多尔·帕波教授在南斯拉夫完成了首例人工瓣膜植入手术。
我们介绍了一位患者,其三联(主动脉瓣、二尖瓣和三尖瓣)BSD瓣膜成功运行了30多年。这是三联BSD瓣膜长期运行的罕见病例,据我们所知,也是三联BSD瓣膜成功运行时间最长的病例。1977年3月,一名纽约心脏协会(NYHA)心功能IV级的重度充血性心力衰竭34岁女性入住贝尔格莱德军事医学院,接受三联瓣膜(主动脉瓣、二尖瓣和三尖瓣)BSD机械瓣膜置换手术。复杂的手术进行得很顺利。16个月后,患者被诊断为阴沟肠杆菌引起的感染性心内膜炎,该病菌从血培养中分离出来。患者成功治愈。此后,患者无心血管症状,定期体格检查和超声心动图检查显示心血管功能良好。患者在手术后30多年因子宫癌晚期去世。
尽管BSD瓣膜早已退出临床使用,但仍有一些罕见的成功运行病例,这主要归功于精确的手术技术和心脏病专家的定期随访。