Montero C G, Mula N, Brugos R, Tellez G, Figuera D
Cardiovascular Surgery, Clinica Puerta de Hierro, Madrid, Spain.
Ann Thorac Surg. 1989 Dec;48(6):824-8. doi: 10.1016/0003-4975(89)90678-4.
Thrombotic obstruction of the Björk-Shiley prosthetic valve is a catastrophic complication, often leading to a fatal outcome. Worldwide experience with the Björk-Shiley valve supports the need for long-term anticoagulation to prevent entrapment of the disc. Replacement of the malfunctioning device is associated with a high mortality, and therefore a more expeditious method is desirable. It is our experience that simple thrombectomy may suffice in most occasions, even for the mitral position, and especially when done through a bicameral approach in order to visualize both supravalvular and infravalvular regions. The philosophy and results with thrombectomy and disc rotation in 12 cases of thrombotic occlusion of the Björk-Shiley valve are described. It is suggested that this method may be preferable to replacement of the thrombosed prosthetic valve in select patients.
比约克-希利人工瓣膜的血栓性梗阻是一种灾难性并发症，常导致致命后果。全球对比约克-希利瓣膜的使用经验支持长期抗凝以防止瓣盘卡瓣的必要性。更换出现故障的装置死亡率很高，因此需要一种更迅速的方法。我们的经验是，在大多数情况下，即使是二尖瓣位置，单纯血栓切除术可能就足够了，尤其是通过双腔入路进行以便观察瓣上和瓣下区域时。本文描述了12例比约克-希利瓣膜血栓性闭塞患者进行血栓切除术和瓣盘旋转的理念及结果。建议在部分患者中，这种方法可能比更换血栓形成的人工瓣膜更可取。
