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Spectral signature of the opening sound of the bjork shiley convexoconcave valve as a potential indicator of strut fracture


, : Spectral signature of the opening sound of the bjork shiley convexoconcave valve as a potential indicator of strut fracture. American Journal of Noninvasive Cardiology 1(6): 369-372

The Bjork-Shiley cardiac-valve prosthesis with a 60.degree. opening convexoconcave disc (BSCC) has failed by fracture at the base of the outlet (short) strut in 206 patients as of March, 1987. There are approximately 25,000 29- to 33-mm and 57,600 21- to 27-mm valves implanted worldwide although 57% of fractures were among 9,4000 29- to 33-mm valves manufactured between February 1981 and June 1982. Once mechanical failure of a valve occurs, reoperation is required within hours. It would be useful, therefore, to identify fracture of a strut before complete failure of the valve occurs. For this purpose, we evaluated in vitro the potential of spectral analysis of the prosthetic valve sound as a noninvasive indicator of strut fracture. An intact 29-mm BSCC valve and a normally functioning 29-mm BSCC valve with a through-and-through fracture of the outlet structure at one welding point were examined in the mitral position of a pulse duplicator (pressure 120/80 mm Hg, rate 70/min). Clear differences of the opening sound were observed. The dominant frequency of the opening sound of the intact valve was 234 Hz and the valve with a fractured strut was 78 Hz. A correlation between the frequency spectrum of the opening sound of the two valves was poor (correlation coefficient of 0.22), indicating a marked difference of the spectral signature. These in vitro observations suggest that frequency analysis of the opening sound of BSCC valves has the potential for a noninvasive identification of subclinical strut fracture.

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Related references

Lemke B.; Rathmann J.; Wiebe V.; Witzel U., 1991: Strut fracture of the bjork shiley 60 degrees convexoconcave valve 5 years after implantation metallurgic analysis of the outlet strut. Zeitschrift fuer Kardiologie 80(8): 537-540

Gonzalez Lavin L.; Mcgrath L.B.; Fernandez J.; Quinlan W.C., 1986: Strut fracture and other events following valve replacement with the 60 degree convexoconcave bjork shiley prosthesis. American Heart Association Monograph (124): II-337

Mok C K.; Lee J.W T.; Kong S M.; Hui K.K K., 1985: Experience with outlet strut fracture of the bjork shiley convexoconcave mitral valve prosthesis. Within a period of 15 months, we encountered five patients with outlet strut fracture of the Bjork-Shiley convexoconcave mitral valve prosthesis. All of the patients had acute failure of the left side of the heart and pulmonary edema. The diagnosi...

Gonzalez Lavin L.; Mcgrath L.B.; Grunkemeier G.; Fernandez J.; Lewis B.; Quinlan W., 1987: Strut fracture and other events after valve replacement with the 60 degree convexoconcave bjork shiley prosthesis. Circulation 76(3 PART 2): III-137-III-140

Mok, C.K.; Lee, J.W.; Kong, S.M.; Hui, K.K., 1985: Experience with outlet strut fracture of the Björk-Shiley convexoconcave mitral valve prosthesis. Within a period of 15 months, we encountered five patients with outlet strut fracture of the Björk-Shiley convexoconcave mitral valve prosthesis. All of the patients had acute failure of the left side of the heart and pulmonary edema. The diagnos...

Gonzalez-Lavin, L.; McGrath, L.B.; Grunkemeier, G.; Fernandez, J.; Lewis, B.; Quinlan, W., 1987: Strut fracture and other events after valve replacement with the 60 degree convexoconcave Björk-Shiley prosthesis. A total of 688 patients received 808 Björk-Shiley prostheses during a 5 year span. Cumulative duration of follow-up totaled 1175.4 patient-years (1368 valve-years). Linearized rates in percent per patient-year for valve-related events (95% confid...

Goovaerts, J.; D.G.est, H., 1986: Outlet strut fracture of the 27 mm convexoconcave Björk-Shiley mitral valve prosthesis. Report of 2 cases. Two patients with outlet strut fracture of the convexoconcave Björk-Shiley mitral valve prosthesis are described and all published cases are reviewed. The pertinent clinical, diagnostic and therapeutic features are discussed. Prompt recognition o...

Goovaerts J.; D.G.est H., 1986: Outlet strut fracture of the 27 millimeter convexoconcave bjork shiley mitral valve prosthesis report of 2 cases. Acta Cardiologica 41(4): 305-312

Khalil, Y.; Sethia, B.; Quin, R.O.; Bain, W.H., 1985: Disc and strut embolisation after minor strut fracture in a Björk-Shiley mitral valve prosthesis. Thorax 40(2): 158-159

Khalil Y.; Sethia B.; Quin R.O.; Bain W.H., 1985: Disc and strut embolization after minor strut fracture in a bjork shiley mitral valve prosthesis. Thorax 40(2): 158-159