Orientation of tilting disc and bileaflet aortic valve substitutes for optimal hemodynamics

Procedures for implantation of mechanical aortic valves have to consider eccentric flow in the aortic root. We describe how to optimize orientation of tilting disc (Medtronic Hall) and bileaflet (St. Jude Medical) valves. In tilting disc valves, an asymmetric design faces an asymmetric flow. Hemodynamic performance of this valve type, regarding turbulence and pressure gradients, is close to normal physiology and superior to the bileaflet valve design. This difference is more pronounced the smaller the valve size.