Risk of strut fracture of Björk-Shiley valves

Graaf, Yolanda van der; Waard, F. de; Herwerden, Lex A. van; Defauw, Jo J.A.M.

doi:10.1016/0140-6736(92)91328-6

Cited by 95 publications

(55 citation statements)

References 11 publications

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“…The cohorts have involved patients in Sweden, 11 several European countries and Canada, 12 the Netherlands, [13][14][15] the United Kingdom, 8 and the United States. 5 In addition, cohorts of Canadian, 16 German, 17 Norwegian, 18 Italian, 19 Swiss, 20 and Japanese 21 BSCC patients have also been identified, but the numbers of patients and of OSFs in these studies individually and collectively have been small.…”

Section: Resultsmentioning

confidence: 99%

“…6 The major patient characteristic thus far identified as a risk factor for OSF is the age of the patient (in some studies, age at implantation was the variable assessed). 5,6,13,22 The risk of OSF decreases by Ϸ5% with each increasing year of age. The trend in risk with the current age of the patient is shown in Table 3 with data from the Dutch/UK/US combined cohorts, for which Ͻ3% of the fractures occurred among persons aged 65 and older at the time of the OSF.…”

Section: Risk Factors For Osfmentioning

confidence: 99%

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Twenty-Five–Year Experience With the Björk-Shiley Convexoconcave Heart Valve

et al. 2005

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Section: Resultsmentioning

confidence: 99%

Section: Risk Factors For Osfmentioning

confidence: 99%

Twenty-Five–Year Experience With the Björk-Shiley Convexoconcave Heart Valve

et al. 2005

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“…To this end, we use the one-dimensional Green's function that can be expressed as the solution of the inhomogeneous second-order differential equation (2) with , which satisfies the radiation condition as . This solution is given by (3) Extracting the behavior of the term for in (1) and substituting the proper value of then results in (4) where denotes the wave admittance of the medium surrounding the wire. The yet unknown signals and represent two independent homogeneous solutions of the differential equation (2).…”

Section: A Open Loopmentioning

confidence: 99%

“…In the U.S., between 30 000 and 40 000 patients use such a device. An epidemiological study in 1992 [1] found 42 strut fractures during mean follow-up of 6.6 years, while a nondestructive evaluation of 24 representative explanted valves [2] showed single-leg fractures in seven and fatigue changes in two of them. Fig.…”

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confidence: 99%

On the feasibility of detecting flaws in artificial heart valves

Lepelaars

Ooijen

Tijhuis

2000

IEEE Trans. Microwave Theory Techn.

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Abstract-In this paper, we investigate the feasibility of detecting defects in certain artificial heart valves by determining the electromagnetic behavior of some simple models with the aid of thin-wire integral equations. The idea is to use the stationary current that occurs at late times after the excitation of a closed loop as a discriminator. This current exhibits an exponential decay when a resistive load is included that is representative of fatigue or a partial fracture. The decay rate is indicative of the severity of the defect. For a wire with an opening, which is representative of a complete fracture, the late-time current is completely absent. As a simplified model of remote detection by a small loop antenna that could be introduced via a catheter, we consider the coupling between two parallel circular wires. In all cases, the dispersive environment of the valve is taken to be homogeneous and filled with blood since this medium exhibits a representative dispersion.

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“…1 Epidemiological studies have been successful in determining individual risk factors for valve fracture, long-term survival, and operative mortality. [2][3][4][5] Great efforts have been made to achieve adherence to the published decision guidelines in the Netherlands. In 1992, the Dutch BScc Follow-up Study, a retrospective cohort study, identified 4 risk factors for outlet strut fracture that were relatively easy to determine in the BScc patient: opening angle, valve size, mitral position, and young age.…”

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confidence: 99%

Decision Guidelines for Prophylactic Replacement of Björk-Shiley Convexo-Concave Heart Valves

2004

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Background-Because of risk of outlet strut fracture, prophylactic replacement should be considered for Björk-Shiley convexo-concave (BScc) valve recipients. We assessed the effects of epidemiological and decision-analytic guidelines on actual BScc valve replacement. Methods and Results-We performed a retrospective cohort study including all 2263 Dutch BScc patients with a mean follow-up of 11.3 years (range, 0 to 23 years). Outcomes were outlet strut fracture, mortality, and BScc valve replacement. For the surviving patients in 1992 (nϭ1330), we calculated the expected differences in life expectancy (LE) with and without BScc valve replacement according to decision guidelines developed in 1992. Differences in LE were compared with actual replacements. During 8 years of follow-up, there were 494 deaths (40%), and 11 patients had suffered outlet strut fracture. Of 1330 patients, 96 (10%) had undergone BScc valve replacement, particularly in years after introduction of initial and updated guidelines. One hundred seventeen patients (9%) had an estimated gain in LE after BScc valve replacement. These patients were more likely to undergo replacement than patients with an estimated loss of LE (hazard ratio, 6.6; 95% CI, 4.4 to 10; PϽ0.0001). A loss in LE after reoperation was predicted for 8 of 11 patients who experienced outlet strut fracture after guidelines were available. Conclusions-Valve replacement for BScc heart valve patients was largely in concordance with guidelines in the Netherlands. Individualized guidelines that are based on high-quality epidemiological data and are updated and implemented rigorously can influence clinical practice in complex decision problems.

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Risk of strut fracture of Björk-Shiley valves

Cited by 95 publications

References 11 publications

Twenty-Five–Year Experience With the Björk-Shiley Convexoconcave Heart Valve

Twenty-Five–Year Experience With the Björk-Shiley Convexoconcave Heart Valve

On the feasibility of detecting flaws in artificial heart valves

Decision Guidelines for Prophylactic Replacement of Björk-Shiley Convexo-Concave Heart Valves

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