Thrombectomy of the Björk-Shiley prosthetic valve revisited: long-term results.

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.