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Wada-Cutter heart valve: overall experience at the Sapporo Medical College
1Department of Thoracic and Cardiovascular Surgery, Sapporo Medical College Japan.
Insights
The Wada-Cutter cardiac valve replacement resulted in a high 40.3% mortality rate due to thrombosis and mechanical failure. This valve
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Prosthetic Heart Valves
Background:
- The Wada-Cutter valve was an early prosthetic device used for cardiac valve replacement.
- Its unique design garnered attention and influenced later valve technologies.
Purpose of the Study:
- To evaluate the clinical outcomes and complications associated with the Wada-Cutter valve.
- To assess the historical significance and design concepts of the Wada-Cutter valve.
Main Methods:
- Retrospective analysis of 124 cardiac valve replacement surgeries using the Wada-Cutter valve between 1966 and 1974.
- Documentation of patient demographics, surgical procedures, mortality rates, and postoperative complications.
Main Results:
- A cumulative mortality rate of 40.3% was observed.
- High incidences of valve thrombosis (9 patients), thromboembolism (4 patients), and mechanical valve failure (5 patients) were reported.
- Clinical use was discontinued in 1974 due to poor outcomes.
Conclusions:
- The Wada-Cutter valve, despite its innovative design, led to significant complications and high mortality.
- The valve's limitations, particularly thrombosis and mechanical failure, precluded its long-term clinical use.
- Potential improvements with alternative materials like Pyrolite carbon were noted.
Abstract:
We performed cardiac valve replacement using the Wada-Cutter valve in 124 patients during the 9 years between 1966 and 1974: aortic valve replacement in 48, mitral valve replacement in 56, tricuspid valve replacement in 9, and multiple valve replacement in 11. Sixteen patients died within 30 days after operation, and 34 died in the late postoperative period, with a cumulative mortality rate of 40.3%. Postoperative complications included valve thrombosis in 9 patients, thromboembolism in 4, and mechanical valve failure in 5. The Wada-Cutter valve, first described at the Annual Meeting of The Society of Thoracic Surgeons on January 27, 1967, in a discussion on the paper by Cooley and colleagues on mitral valve replacement with a discoid valve, attracted attention for its unique design. Four of the Wada-Cutter valves were incorporated in Liotia's total artificial heart, which was implanted clinically for the first time in Cooley's second-stage heart transplantation. It may not only claim to be the origin of today's most popular tilting-disc heart valves but also has some original concepts with regard to bileaflet and tricuspid tilting-disc heart valves. However, at that time, cardiac valve replacement with this prosthesis resulted in a high incidence of thrombosis without systemic anticoagulation and in mechanical valve failure due to hinge wear of the Teflon occluder. For these reasons, its clinical use was discontinued in 1974. If Pyrolite carbon had been adopted in construction of the valve when it first became available, the valve design could have been useful even today.