A CASE OF THROMBOTIC VALVE 14 YEARS AFTER BJÖRK-SHILEY MITRAL VALVE PROSTHESIS

Abstract

Reported herein is a patient with valvular dysfunctions due to thorombosis developed 14 years after mitral valve prosthesis with Bjork-Shiley valve, who could be rescued by emergency operation. A 44-year-old woman was admitted to the hospital because of hemorrhagic gastric ulcer. There was a history of mitral valve prosthesis with Bjork-Shiley valve for mitral insufficiency in 1976, and subsequent anti-coagulation therapy on an ambulant basis, after admission her symptoms of heart failure were aggravated. She was diagnosed as dysfunction of the artificial valve and underwent an emergency operation for reconstruction of the valve with 29 mm of St. Jude Medical valve. The findings at the operation revealed that a newly formed thrombosis at the minor-strut area had been inhibiting the motility of the valve.After the operation, her condition was improved and she was discharged at Day 20 of illness. This case was thus identified as having causative factors of nutritive infusion and administration of hemostatic agent upon suspending the anticoagulation therapy due to hemorrhagic gastric ulcer after 14 years of the term with no complaint of heart failure. It was also diagnosed as dysfunction of artificial valve decisively induced by a newly formed thrombosis which was assumed to becaused by the increased blood coagulation.