Failure of a Björk-Shiley mitral valve prosthesis to open: clinical recognition
Saunders, C.R.; Rossi, N.P.; Rittenhouse, E.A.
Journal of Cardiovascular Surgery 18(6): 571-574
1977
ISSN/ISBN: 0021-9509 PMID: 599161 Document Number: 121173
Failure of a Björk-Shiley mitral valve prosthesis to open was recognized early in the postoperative period and required immediate replacement. The clinical finding was sudden, intermittent, severe hypotension associated with absent poppet sounds and simultaneous elevation in left atrial pressure. This unique and unusual hemodynamic picture was duplicated in four animal experiments. Routine monitoring of left atrial pressure is a useful postoperative adjunct that can provide early documentation of obstruction to left atrial outflow. Early recognition of the problem and immediate operative correction are mandatory.