Selection of valve prosthesis, reoperation and late result--surgical technique of reoperation with Bj?rk-Shiley prosthesis

Late result of Bj?rk-Shiley prosthesis selected in the aortic and mitral position for valve replacement was reviewed on 222 cases in our 10 years clinical experience. Late survival was 93.8% (5 yrs), 83% (10 yrs) in the aortic position, 94% (5 yrs) and 80% (10 yrs) in the mitral position. Valve-related complication by Bj?rk-Shiley prosthesis was very low in incidence as compared with that published by other institution with respects to thromboembolism, prosthetic valve endocarditis, reoperation, anticoagulation-related bleeding. Inflammatory aortic valve disease which developed valve detachment in the aortic position with Bj?rk-Shiley valve was treated with double-suture technique in the aortic annulus and fixation of the graft with the inside of sinus of Valsalva, en-bloc reconstruction with composite graft using Bj?rk-Shiley valve inside of the sinus Valsalva without touch to coronary ostium. The other surgical procedure was translocation method using Bj?rk-Shiley prosthesis. Our clinical results suggest that Bj?rk-Shiley prosthesis is still recommended in the aortic and mitral positions from low incidence of valve-related complication and good late survival.