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Mechanical prostheses: old and new

R B Karp, M E Sand

    Cardiovascular Clinics
    |January 1, 1993
    PubMed
    Summary
    This summary is machine-generated.

    Modern mechanical heart valves offer improved durability and performance, with proper use leading to good patient outcomes. Current options reflect market consolidation due to regulatory and economic factors.

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    Area of Science:

    • Cardiovascular Surgery
    • Biomedical Engineering
    • Prosthetic Devices

    Background:

    • Over 50 mechanical heart valves have been developed since the 1950s, with only four currently available in the U.S. market.
    • The evolution of these devices has been driven by the need for improved durability, hemodynamic performance, and reduced complications.
    • Market consolidation is attributed to regulatory hurdles, product liability concerns, and intellectual property rights.

    Purpose of the Study:

    • To review the evolution of mechanical heart valves.
    • To discuss modes of valve failure and clinical expectations.
    • To evaluate current prostheses, implantation considerations, surveillance, and anticoagulation strategies.

    Main Methods:

    • Literature review of mechanical heart valve development and performance.

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  • Analysis of clinical outcomes associated with different valve generations.
  • Discussion of specific valve characteristics and their suitability for various patient populations.

    • Main Results:

    • Current mechanical valves demonstrate ease of implantation, enhanced durability, and good hemodynamic function.
    • Proper anticoagulation is crucial for reducing thromboembolism and thrombosis.
    • The St. Jude Medical (SJM) valve is highlighted for its suitability in pediatric patients and specific mitral valve replacements due to its low profile and hinge mechanism.

    Conclusions:

    • Good clinical results are achievable with current mechanical heart valves when used and monitored appropriately.
    • The choice of valves has narrowed, impacting surgical options.
    • Ongoing evaluation of new prostheses and optimization of implantation and anticoagulation remain critical.