What question did this study set out to answer?

To identify clinical characteristics, predisposing factors, and optimal therapeutic strategies for late thrombotic obstruction of Björk–Shiley tilting disc valves in the tricuspid position.

January 1, 1980Scandinavian Journal of Thoracic and Cardiovascular Surgery

Late Thrombotic Malfunction of the Björk–Shiley Tilting Disc Valve in the Tricuspid Position.Principles for Recognition and Management

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Why the study?

Does thrombolytic therapy or surgery safely resolve thrombotic obstruction in patients with Björk-Shiley tricuspid valves?

Population

52 consecutive patients surviving tricuspid valve replacement with the Björk-Shiley tilting disc valve

Design

Cohort

Follow-up

mean 4.9 years (range 0.5-9 years)

Authors

ÁPÁrpád PéterffyUniversity of Debrecen AHAxel HenzeUppsala University GSGeoffrey F. SavidgeLeiden University

Discussion

Member takes

Implication

May support initial thrombolysis for Björk-Shiley tricuspid thrombosis; extends Level 3 data but leaves optimal strategy open.

Key Points

To identify clinical characteristics, predisposing factors, and optimal therapeutic strategies for late thrombotic obstruction of Björk–Shiley tilting disc valves in the tricuspid position.
Followed 52 consecutive patients surviving tricuspid valve replacement with Björk–Shiley tilting disc valves over a duration of 0.5 to 9 years (mean 4.9 years).
Evaluated diagnostic findings and therapeutic outcomes among patients managed with either thrombolytic therapy (streptokinase) or surgical valve replacement.
Thrombotic obstruction occurred in 4 patients across 8 distinct episodes, representing an incidence rate of 3.2% per patient-year.
Deficient anticoagulation and Ebstein's anomaly were identified as primary predisposing factors, though 2 of 8 episodes remained unexplained.
Treatment with streptokinase (n=4) or reoperation (n=4) produced complete functional relief with zero mortality and no disabling complications, with thrombolysis proving effective specifically for fresh red clots within a 24-hour window.

Structured PICO

Does thrombolytic therapy or surgery safely resolve thrombotic obstruction in patients with Björk-Shiley tricuspid valves?

Population

52 consecutive patients surviving tricuspid valve replacement with the Björk-Shiley tilting disc valve

Intervention

Thrombolytic treatment (streptokinase) or surgical replacement of the clotted prosthesis

Outcome

Incidence of thrombotic obstruction and treatment outcomes (complications and mortality)hard clinical

Thrombolytic therapy with streptokinase is an effective initial treatment for recent thrombotic obstruction of Björk-Shiley tricuspid valves, with surgery reserved for organized pannus or failure after 24 hours.

Cite This Study

Péterffy et al. (1980) studied this question.

synapsesocial.com/papers/6a75609ecc7f6f86c703335c https://doi.org/10.3109/14017438009109852

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Late Thrombotic Malfunction of the Björk–Shiley Tilting Disc Valve in the Tricuspid Position.Principles for Recognition and Management

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Late Thrombotic Malfunction of the Björk–Shiley Tilting Disc Valve in the Tricuspid Position.Principles for Recognition and Management

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider