Outlet strut fracture of the Bjork-Shiley 60 degrees Convexo-Concave valve: current information and recommendations for patient care

Shiley Incorporated, Cincinnati, Ohio.

Mechanical failure of artificial heart valves can be a catastrophic event. The problem of outlet strut fracture of the Bjork-Shiley 60 degrees Convexo-Concave tilting disc prosthesis has received much attention in the medical literature and generated both concern and confusion among patients and physicians. Analysis of current data from the manufacturer, as well as a review of the medical literature, suggests that the overall risk of outlet strut fracture is low and that elective explantation of a well functioning Bjork-Shiley 60 degrees Convexo-Concave valve prosthesis is not warranted. Diagnostic features of outlet strut fracture can be seen with overpenetrated chest X-ray films so that diagnosis can be established promptly. Early operation to replace the fractured prosthesis is essential for patient survival.

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