Reoperation for dysfunction of the Björk-Shiley mitral disc prosthesis

Summary Of 193 patients with Bjork-Shiley mitral valve prostheses, replacement was necessary in 8 (4.1 per cent). The reasons for reoperation were: detachment (4), thrombosis (1), technical error (1), and late disc entrapment (2). Five of these patients died (62.5 per cent), the death being directly related to the need for urgent operation because of low cardiac output. We recommend avoiding the use of the larger sized Bjork-Shiley prostheses, since striking of the disc against the ventricle wall, probably consequent to postoperative decrease in heart size, may appear even 1 year after implantation of the prostheses. An early diagnosis and early reoperation offer these patients a much more favorable prognosis.