Aortographic follow-up in patients with the Björk-Shiley aortic disc valve prosthesis.

Abstract

One hundred aortographic examinations were performed in a follow-up study of 99 long-term survivors after aortic valve replacement with the Bjork-Shiley tilting disc valve. Regurgitation of the contrast medium through the prosthesis as well as paravalvular leakage were evaluated. The regurgitation was minimal (grade I) in 57%, moderate (grade II) in 38%, marked (grade III) in 3% and very marked (grade IV) in 2%. The grade IV cases were re-operated on with closure of paravalvular leakage. The minimal or “functional” regurgitation through the valve prosthesis is an expected finding. It is due to the construction of the Bjork-Shiley valve, whereby the disc fits within its orifice leaving a minimal space between the edge of the disc and the ring. The follow-up aortography showed aneurysms in five patients, deformations of the ascending aorta in three and an iatrogenic ventricular septal defect in one patient.