Nishi Y, Aoyagi S, Hirano A, Tanaka K, Yanagi I, Shimada S, Yanai T, Kosuga K, Oishi K
Nihon Kyobu Geka Gakkai Zasshi. 1989 Jun;37(6):1088-93.
In the periods between February 1973 and December 1987, 377 Björk-Shiley valve prostheses have been implanted in the aortic position in our institute. The maximum opening angle of the prosthesis have been cineradiographically measured in 30 cases. The maximum opening angle of the convexo-concave valve having an opening angle of 60 degree (CC 60) was measured as 58.8 +/- 1.9 degree and that of the monostrut valve having an opening angle of 70 degree was 69.4 +/- 2.1 degree. During this period we have experienced 6 cases of thrombosed Björk-Shiley prosthesis. They have shown restriction of the opening from 26 to 58.9 degree and restriction of the closing from 9.2 to 41.8 degree. Thrombolytic treatment was successful in case with thrombosed Björk-Shiley prosthesis which showed restriction of the opening angle on cineradiogram. 4 cases with restriction of the closing angle on cineradiogram were treated operative thrombectomy. Three of them have had uneventful reoperative course in the follow up period of 8 years. We believe that cineradiography is very useful for not only diagnosis but also decision of management for thrombosed Björk-Shiley prosthesis in the aortic position.
在1973年2月至1987年12月期间，我院377个 Björk-Shiley瓣膜假体被植入主动脉位置。对其中30例患者的假体最大开口角度进行了心血管造影测量。凸凹型开口角度为60度的瓣膜（CC 60）的最大开口角度测量值为58.8±1.9度，开口角度为70度的单支柱瓣膜的最大开口角度为69.4±2.1度。在此期间，我们遇到6例Björk-Shiley假体血栓形成的病例。这些病例显示开口受限，从26度到58.9度，关闭受限，从9.2度到41.8度。对于心血管造影显示开口角度受限的Björk-Shiley假体血栓形成病例，溶栓治疗取得成功。4例心血管造影显示关闭角度受限的病例接受了手术取栓治疗。其中3例在8年的随访期内再次手术过程顺利。我们认为，心血管造影不仅对主动脉位置的Björk-Shiley假体血栓形成的诊断非常有用，而且对治疗方案的决策也非常有用。
