The Bjork–Shiley mechanical heart valve (Shiley Corp, Irvine, CA) was one of the earliest tilting disc valve prosthesis used for the replacement of diseased cardiac valves. This valve was implanted in a large number of patients in the 1970s and early 1980s. A change in the valve design in the early 1980s led to a high rate of fracture and disc escape and a high patient mortality. As a result, the manufacturer of this valve stopped the production of the valve. We recently treated a patient with a Bjork–Shiley mitral valve prosthesis implanted more than 40 years ago. An 83-year-old man with cardiomyopathy, permanent atrial fibrillation, and a biventricular pacemaker with threatened skin erosion of the pacemaker pocket underwent revision of the pacemaker pocket with transfer of the pacemaker generator to a sub-pectoral position. He had undergone a mitral valve replacement with a Bjork– Shiley tilting disc valve in 1970 (Fig 1). In preparation for surgery, an intravenous heparin infusion was started and warfarin was withheld until international normalized ratio level reached 2. The Bjork–Shiley tilting disc valve was a low profile mechanical valve with a Delrin disc held in a tantalum housing by two metal struts. The valve was introduced in clinical practice in 1969 [1]. The initial Delrin disc was subsequently replaced with a pyrolytic carbon disc. This valve provided significant advantage over the bulky Starr–Edwards cage ball valve with a lower transvalvular gradient [2]. A change in the design of the valve led to a high failure rate of this valve and its disappearance from