Echocardiographic study of malfunction of the Bjork-Shiley prosthetic heart valve in the mitral position.

This report presents an echocardiographic study of four cases of malfunction of the Bjork-Shiley prosthetic heart valve in the mitral position. The malfunction was proved in all patients by cardiac catheterization, observation at cardiac surgery or findings at postmortem examination. Two distinctive motion patterns of the malfunctioning valves were detected in the echocardiogram. One was a rounded and slowed pattern of opening and closure that correlated with the presence of abnormal clotting on the prosthesis (two patients). The other was an unusual "hump" during the opening phase that correlated with significant perivalve leak (two patients). These patterns along with other observations appears to be valuable in recognizing mitral valve Bjork-Shiley prosthetic malfunction with echocardiography.