Aortic valve replacement with the Jyros bileaflet prosthetic valve; early echocardiographic and radiological...

The Jyros bileaflet prosthetic heart valve has a unique hinge mechanism permitting rotation of the leaflets within the valve ring. Thirty patients undergoing aortic valve replacement with a Jyros valve were assessed clinically, echocardiographically and radiologically. Rotation of the valve in vivo was assessed, as well as the hemodynamic characteristics of the valve at rest and after exercise, and functional capacity of the valve recipients. Measured transvalvar gradients were comparable with other bileaflet valves at rest and after exercise, as were calculated effective orifice areas. Initially only four prostheses (13%) showed any evidence of rotating, but this improved to 14 of 23 investigated (60.9%) after exercise; rotation appears to be more common in smaller valves. There were no operative or early deaths, but one patient died at 11 months from a type A ascending aortic dissection. During a total of 28.5 patient-years of follow up (range 2-24 months) valve related complication has not been reported. All survivors are in good clinical condition. Preliminary results with the Jyros valve compare well with other bileaflet devices for aortic valve replacement; the hemodynamic performance of the valve does not appear to be affected by rotation or non-rotation.