[Current status of cardiac valve prosthesis]

Area of Science:

• Cardiovascular Surgery
• Biomaterials Science
• Medical Device Engineering

Context:

• Cardiac valve replacement is a key treatment for valvular heart disease, with over two decades of clinical application.
• Current prostheses include mechanical valves (pyrolytic carbon) and biological valves (tanned porcine or bovine tissue).
• Both mechanical and biological valves present unavoidable complications, impacting long-term patient outcomes.

Purpose:

• To review the current state of cardiac valve prostheses.
• To highlight the limitations and complications associated with existing mechanical and biological valves.
• To emphasize the need for improved prosthesis design and patient selection criteria.

Summary:

• Mechanical valves, such as tilting disc or bi-leaflet designs made of pyrolytic carbon, are widely used.
• Biological valves, typically porcine aortic or bovine pericardial, are treated with glutaraldehyde tanning.
• Complications include thrombus formation, embolism, infection, hemolysis, and valve sound for mechanical valves, and valve failure and infection for biological valves.

Impact:

• Current cardiac valve prostheses necessitate careful selection based on individual patient medical, social, and geographical factors.
• There is a continued need for the development of ideal prostheses that minimize late complications.
• Advancements in materials science and structural design are essential for future cardiac valve prosthesis innovation.