Cardiac Valve Replacement with the Björk-Shiley Prosthesis in Young Patients

Abstract

Between 1971 and 1974, 26 valve replacements with the Björk-Shiley tilting disc valve prosthesis were performed in 23 children between 4 and 16 years of age. Mitral valve replacement was carried out in 11 patients, aortic valve replacement in 9 and double replacement in the other 3 patients. Several of the patients presented associated lesions which were also corrected at the same intervention, One patient died during the postoperative period; the remaining 22 all showed significant clinical remission. No incidents of thromboembolism or complications of any other nature were observed during follow-up periods of 6 to 26 months. It is our belief that the Björk-Shiley valve represents an improvement over other prostheses currently used for the surgical correction of valve disease in children.

Valve replacement in children

“…These authors commented that a number of early reports had shown that those children taking aspirin or no medications had both few embolic complications and no episodes of bleeding. Notably Rufilinchas and colleagues [42] observed no bleeding or thromboembolic complications in 22 children who underwent valve replacement of Bj6rk-Shiley valves without the use of warfarin. We at Great Ormond Street have not been as brave as this, first because thromboembolic episodes tend to be time related and are thus likely to occur during longer follow-up periods, and second because the evidence for antithrombotic effects of aspirin and of dipyridamole is not wholly convincing and has recently been challenged [43].…”