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Clinical and hemodynamic study of tilting disc heart valve: Single-center study
Amber Malhotra1, Sanjay R Pawar2, Anubhav Srivastava2
1Gandhi Medical College, Bhopal, Madhya Pradesh, India amgitmalhotra2001@rediffmail.com.
Insights
The TTK Chitra heart valve demonstrates comparable hemodynamics and outcomes to other prosthetic valves. This study highlights its safety and efficacy in patients undergoing valve replacement surgery.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Clinical Echocardiography
Background:
- The TTK Chitra artificial heart valve is a widely utilized prosthetic in India.
- Comparative studies are essential to assess the performance of indigenous medical devices against global standards.
Purpose of the Study:
- To evaluate the hemodynamic performance of the TTK Chitra heart valve.
- To assess complications, event-free survival, and the role of echocardiography in follow-up.
- To compare the TTK Chitra valve with other commonly used prosthetic valves.
Main Methods:
- A cohort of 200 patients underwent 249 valve replacements (mitral, aortic, and double valve).
- Total patient follow-up was 451 patient-years.
- Color Doppler echocardiography was employed for patient follow-up.
Main Results:
- Late mortality was 3.98% per patient-year; valve thrombosis occurred in 0.36% of mitral valve replacement patients.
- Embolic complications were observed in 2.74% (aortic), 1.95% (double), and 1.08% (mitral) of patients.
- Four-year freedom from valve-related mortality/morbidity was 86% (mitral), 56% (double), and 89% (aortic); hemodynamic parameters were comparable to other valves.
Conclusions:
- The TTK Chitra heart valve exhibits performance comparable to other widely used prosthetic valves regarding hemodynamics, complications, and survival.
- Hemodynamic gradients offer a more reproducible metric for prosthetic valve follow-up compared to effective orifice area.
Background:
The TTK Chitra heart valve has been developed and widely used in India. This study aimed to evaluate its hemodynamics, complications, and event-free survival in comparison with other commonly used prosthetic valves. The role of color Doppler echocardiography in the follow-up of patients with prosthetic valves was also studied.
Patients And Methods:
Two hundred patients underwent 249 valve replacements (122 mitral, 29 aortic, 49 both). Total follow-up was 451 patient-years.
Results:
There were 18 late deaths (3.98% ± 0.92% per patient-year). One mitral valve replacement patient (0.36% ± 0.36% per patient-year) developed valve thrombosis. Two aortic valve replacement patients (2.74% ± 1.91% per patient-year), 2 double-valve replacement patients (1.95% ± 1.36% per patient-year) and 3 mitral valve replacement patients (1.08% ± 0.62% per patient-year) developed embolic complications. Freedom from all valve related mortality and morbidity at 4 years was 86% ± 4% for mitral valve replacement, 56% ± 10% for double-valve replacement, and 89% ± 6% for aortic valve replacement. The average peak gradient, mean gradient, and average peak velocity for the aortic and mitral positions were found to be comparable to those of other commonly used valves.
Conclusion:
The performance of this valve in terms of hemodynamic complications, mortality, and morbidity is comparable to other valves in common use. Hemodynamic gradients are more reproducible than effective orifice area, hence more beneficial for follow-up.
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