Excellence and durability: A normally functioning Björk-Shiley flat-disc prosthesis 42 years post implantation

Mechanical heart valves have been used worldwide for more than 60 years. While the composition and design of the valves, and the surgical techniques employed to implant them, have changed and advanced over that time, some of the earlier mechanical heart valves showed such great durability that they are still functioning in patients today. One of the most often-used and long-lasting mechanical prostheses was the Björk-Shiley heart valve. While many versions of this valve were used during its 25 years of production, the most durable was the Björk-Shiley flat-disc valve. This valve was first implanted in 1971 and was the first successful tilting-disc valve. Here, the complex medical history is reported of an elderly patient with a well-functioning Björk-Shiley flat-disc valve in the aortic position that was placed over 42 years ago. The history of mechanical heart valves - in particular the Björk-Shiley heart valve, including the flat-disc mechanical valve - is also briefly reviewed

Left ventricular noncompaction: a diagnostically challenging cardiomyopathy

Diagnosing left ventricular noncompaction (LVNC) cardiomyopathy is a challenge for the medical community because the condition shares morphologic features of hypertrophic and dilated cardiomyopathies. The uncertainty surrounding the diagnosis of LVNC is related to the lack of a perfect diagnostic tool, such as a reproducible genetic marker. The diagnosis requires expertise in the broad spectrum of overlapping cardiomyopathies. The demarcation between LVNC and normal phenotypic variations is often indistinct. Echocardiography, used in routine clinical practice to identify the typical morphologic features of LVNC, can be overly sensitive and lack specificity with the presently defined measurements and ratios used to diagnose LVNC. The available diagnostic criteria show a propensity toward overdiagnosing LVNC. The complex clinical sequelae of atrial and ventricular arrhythmias, heart failure, thromboembolic events and sudden death associated with LVNC make a valid and reproducible diagnosis critical. The trend to using a morphologic/pathophysiologic, instead of a solely morphologic, approach holds promise in the quest for an accurate, reliable diagnosis of LVNC. We must understand the distinction between morphological findings and morphological findings with pathophysiology. Our future understanding of LVNC depends on an integration of cardiac morphology, physiology, pathophysiology and evolving genetics

Chapter 7: Fundamentals and applications of echocardiographic methods and systems in the electrophysiology laboratory

ISBN: 978097901648

The first operation for apical hypertrophic cardiomyopathy-Dr Dwight McGoon, 1972

The first operation for apical hypertrophic cardiomyopathy (ApHCM) was performed on September 7, 1972 by Dr Dwight McGoon at Mayo Clinic on a 16-year-old boy who was thought to have a cardiac neoplasm