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Heart. 1996 December; 76(6): 510–512.
PMCID: PMC484604

Welder identity, weld date, and the risk of outlet strut fracture in Björk-Shiley convexo-concave valves: the Dutch cohort study.


OBJECTIVE: To establish whether there is an association between subsequent fracture of the outlet strut and welder identity and the weld date of Björk-Shiley convexo-concave (BScc) valves. DESIGN: Cohort study. PATIENTS: All Dutch BScc valve recipients (n = 2266). MEAN OUTCOME MEASURES: Documented outlet strut fracture during follow up. RESULTS: Weld dates were known for 97.0% of all BScc valves (n = 2534) implanted in Dutch patients (n = 2266) and welder identity was known for 52.2%. During a mean follow up of 9.4 years, 46 fractures were documented. For 60 degrees valves welded from 1981 to 1984 the fracture rate (0.22 per 100 person-years (95% CI 0.13 to 0.34)) was higher than that for valves welded before 1981 (0.04 (95% CI 0.01-0.10)). When all fracture related risk factors were taken into account, fracture rates per welder did not show any statistically significant differences. CONCLUSIONS: Welder identity does not contribute to the risk of strut fracture. Other factors in the production of BScc valves may explain the increased risk for valves welded from 1981 to 1984.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • van der Graaf Y, de Waard F, van Herwerden LA, Defauw J. Risk of strut fracture of Björk-Shiley valves. Lancet. 1992 Feb 1;339(8788):257–261. [PubMed]
  • Hiratzka LF, Kouchoukos NT, Grunkemeier GL, Miller DC, Scully HE, Wechsler AS. Outlet strut fracture of the Björk-Shiley 60 degrees Convexo-Concave valve: current information and recommendations for patient care. J Am Coll Cardiol. 1988 May;11(5):1130–1137. [PubMed]
  • Lindblom D, Rodriguez L, Björk VO. Mechanical failure of the Björk-Shiley valve. Updated follow-up and considerations on prophylactic rereplacement. J Thorac Cardiovasc Surg. 1989 Jan;97(1):95–97. [PubMed]
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  • de Mol BA, Kallewaard M, McLellan RB, van Herwerden LA, Defauw JJ, van der Graaf Y. Single-leg strut fractures in explanted Björk-Shiley valves. Lancet. 1994 Jan 1;343(8888):9–12. [PubMed]
  • Röckelein G, Breme J, von der Emde J. Lethal blockage of a Bjørk-Shiley artificial heart valve caused by strut fracture--the metallurgical aspect. Thorac Cardiovasc Surg. 1989 Feb;37(1):47–51. [PubMed]
  • Ostermeyer J, Horstkotte D, Bennett J, Huysmans H, Lindblom D, Olin C, Orinius E, Semb G. The Björk-Shiley 70 degree convexo-concave prosthesis strut fracture problem (present state of information). Thorac Cardiovasc Surg. 1987 Apr;35(2):71–77. [PubMed]

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