Document Detail


Late thrombotic malfunction of the Björk-Shiley tilting disc valve in the tricuspid position. Principles for recognition and management.
MedLine Citation:
PMID:  7375889     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Among 52 consecutive patients surviving tricuspid valve replacement with the Björk-Shiley tilting disc valve, follow-up extends between 1/2-9 years, mean 4.9 years. Four patients suffered thrombotic obstruction of their tricuspid prosthesis on 8 occasions, an incidence of 3.2%/year. Ebstein's anomaly and deficient anticoagulation were identified as likely contributory factors, but the complication remained unexplained in 2/8 instances. Thrombotic malfunction of the tricuspid prosthesis seems to constitute a relatively benign clinical entity with mild manifestations and diagnostic possibilities by non-invasive methods. Relief by means of thrombolytic treatment in the form of streptokinase (Kabikinase) (4) or replacement of the clotted prosthesis (4) involved neither disabling complications nor mortality. Our clinical observations and experimental studies suggest that thrombolytic therapy is effective, provided that prosthetic malfunction is due to a recent red clot, whereas encapsulation of the prosthetic disc by organized white-grey pannus necessitates re-operation. Streptokinase treatment should be attempted before surgery, but it is hardly meaningful to proceed for more than 24 hours. Restored prosthetic function within this time limit indicates the likely resolution of a red clot.
Authors:
A Péterffy; A Henze; G F Savidge; C Landou; V O Björk
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scandinavian journal of thoracic and cardiovascular surgery     Volume:  14     ISSN:  0036-5580     ISO Abbreviation:  Scand J Thorac Cardiovasc Surg     Publication Date:  1980  
Date Detail:
Created Date:  1980-07-26     Completed Date:  1980-07-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0121343     Medline TA:  Scand J Thorac Cardiovasc Surg     Country:  SWEDEN    
Other Details:
Languages:  eng     Pagination:  33-41     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Angiocardiography
Cineradiography
Follow-Up Studies
Heart Valve Prosthesis / adverse effects*
Humans
Prognosis
Streptokinase / adverse effects,  therapeutic use
Thromboembolism / drug therapy,  etiology*,  radiography
Time Factors
Tricuspid Valve / radiography,  surgery*
Chemical
Reg. No./Substance:
EC 3.4.-/Streptokinase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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