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. 1985 May;53(5):510–514. doi: 10.1136/hrt.53.5.510

Mechanism of late failure of the Alvarez disc valve prosthesis.

J L Gibbs, G A Davies, A Schofield, G A Wharton, D A Watson, L M Gerlis
PMCID: PMC481801  PMID: 3994864

Abstract

An Alvarez disc valve prosthesis had been implanted in the mitral and tricuspid positions in 15 patients between 1964 and 1967 in this hospital. Of these 15 patients, only three survived longer than 10 years, all three dying unexpectedly between 16 and 18 years postoperatively. Two deaths were a direct result of disruption of the Alvarez prosthesis. The third patient was not examined at necropsy, but in retrospect the history was highly suggestive of valve malfunction. Cross sectional and pulsed Doppler echocardiography made valuable contributions to the diagnosis in both cases of valve disruption and, when available, should be part of the primary investigation of suspected prosthetic heart valve failure. The Alvarez valve prosthesis is liable to erosive wear which may cause late detachment of the disc from the valve ring with abrupt and catastrophic haemodynamic consequences.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Clark R. E., Swanson W. M., Kardos J. L., Hagen R. W., Beauchamp R. A. Durability of prosthetic heart valves. Ann Thorac Surg. 1978 Oct;26(4):323–335. doi: 10.1016/s0003-4975(10)62898-6. [DOI] [PubMed] [Google Scholar]
  2. Cooper D. K., Sturridge M. F. Acute massive mitral regurgitation from prosthetic valve dysfunction. Br Heart J. 1976 Jul;38(7):701–705. doi: 10.1136/hrt.38.7.701. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Edmunds L. H., Jr, Wooler G. H., Watson D. A. Clinical experience with the Alvarez and Starr-Edwards prosthetic mitral valves. J Thorac Cardiovasc Surg. 1966 Feb;51(2):185–194. [PubMed] [Google Scholar]
  4. Harrison E. C., Roschke E. J., Matsuno M., Allen J. W. Double opening sound related to dysfunction in a caged disc mitral valve prosthesis. Am J Cardiol. 1974 Feb;33(2):300–303. doi: 10.1016/0002-9149(74)90294-x. [DOI] [PubMed] [Google Scholar]
  5. Hildner F. J., Robinson M. J. Complications of Beall valve prosthesis. Am J Cardiol. 1972 Dec;30(8):922–922. doi: 10.1016/0002-9149(72)90027-6. [DOI] [PubMed] [Google Scholar]
  6. Holen J., Simonsen S., Frøysaker T. An ultrasound Doppler technique for the noninvasive determination of the pressure gradient in the Björk-Shiley mitral valve. Circulation. 1979 Mar;59(3):436–442. doi: 10.1161/01.cir.59.3.436. [DOI] [PubMed] [Google Scholar]
  7. Hylen J. C. Mechanical malfunction and thrombosis of prosthetic heart valves. Am J Cardiol. 1972 Sep;30(4):396–404. doi: 10.1016/0002-9149(72)90571-1. [DOI] [PubMed] [Google Scholar]
  8. Ibarra F., Gutierrez A., Martinez F., Carreras L., Lopez C., Alonso-Lej F. Fracture of the outlet strut of a Björk-Shiley mitral prosthesis: emergency operation with survival. J Thorac Cardiovasc Surg. 1984 Feb;87(2):315–318. [PubMed] [Google Scholar]
  9. Johnson M. L., Holmes J. H., Paton B. C. Echocardiographic determination of mitral disc valve excursion. Circulation. 1973 Jun;47(6):1274–1280. doi: 10.1161/01.cir.47.6.1274. [DOI] [PubMed] [Google Scholar]
  10. Jost R. G., McKnight R. C., Roper C. L. Failure of Beal mitral valve prosthesis. Clinical and radiographic features. J Thorac Cardiovasc Surg. 1975 Jul;70(1):163–165. [PubMed] [Google Scholar]
  11. Joyce L. D., Emery R. W., Nicoloff D. M. Ball variance and fracture of mitral valve prosthesis causing recurrent thromboemboli. J Thorac Cardiovasc Surg. 1978 Feb;75(2):309–312. [PubMed] [Google Scholar]
  12. Larrieu A. J., Puglia E., Allen P. Strut fracture and disc embolization of a Björk-Shiley mitral valve prosthesis: localization of embolized disc by computerized axial tomography. Ann Thorac Surg. 1982 Aug;34(2):192–195. doi: 10.1016/s0003-4975(10)60883-1. [DOI] [PubMed] [Google Scholar]
  13. MELROSE D. G., BENTALL H. H., MCMILLAN I. K., FLEGE J. B., ALVAREZDIAZ F. R., NAHAS R. A., FAUTLEY R., CARSON J. THE EVOLUTION OF A MITRAL-VALVE PROSTHESIS. Lancet. 1964 Sep 19;2(7360):623–624. doi: 10.1016/s0140-6736(64)90514-8. [DOI] [PubMed] [Google Scholar]
  14. Mashhour Y. A., Garcia J. B., Ionescu M., Wooler G. H. Mitral valve replacement with Alvarez prosthesis: long-term results. Thorax. 1969 May;24(3):287–290. doi: 10.1136/thx.24.3.287. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. McEnany M. T., Wheeler E. O., Austen W. G. Survival following fracture of strut from mitral prosthesis with disc translocation. J Thorac Cardiovasc Surg. 1979 Jul;78(1):136–139. [PubMed] [Google Scholar]
  16. Norenberg D. D., Evans R. W., Gundersen A. E., Abellera R. M. Fracture and embolization of a Björk-Shiley disc. Fatal failure of a prosthetic mitral valve. J Thorac Cardiovasc Surg. 1977 Dec;74(6):925–927. [PubMed] [Google Scholar]
  17. Paton B. C., Pine M. B. Aortic valve replacement with the De Bakey valve. J Thorac Cardiovasc Surg. 1976 Oct;72(4):652–656. [PubMed] [Google Scholar]
  18. Sacks S. H., Northeast A. D., Watkins J. Late strut fracture in a Björk-Shiley valve prosthesis (current series). Br Heart J. 1984 May;51(5):578–580. doi: 10.1136/hrt.51.5.578. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Sethia B., Quin R. O., Bain W. H. Disc embolisation after minor strut fracture in a Björk-Shiley mitral valve prosthesis. Thorax. 1983 May;38(5):390–391. doi: 10.1136/thx.38.5.390. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Silver M. D. Wear in Björk-Shiley heart valve prostheses recovered at necropsy or operation. J Thorac Cardiovasc Surg. 1980 May;79(5):693–699. [PubMed] [Google Scholar]
  21. Veyrat C., Cholot N., Abitbol G., Kalmanson D. Non-invasive diagnosis and assessment of aortic valve disease and evaluation of aortic prosthesis function using echo pulsed Doppler velocimetry. Br Heart J. 1980 Apr;43(4):393–413. doi: 10.1136/hrt.43.4.393. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Veyrat C., Ollagnier J., Fremont D., Savier C. H., Philippe B., Naouri R., Chiche P. Jugular pulse and flow velocity anomalies: a diagnostic clue to an obstructive tricuspid prosthetic dysfunction. Eur J Cardiol. 1981;12(3-4):195–205. [PubMed] [Google Scholar]
  23. Winters W. L., Jr, Gimenez J., Soloff L. A. Clinical application of ultrasound in the analysis of prosthetic ball value function. Am J Cardiol. 1967 Jan;19(1):97–107. doi: 10.1016/0002-9149(67)90267-6. [DOI] [PubMed] [Google Scholar]

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