Clinical experience with the first 100 ATS heart valve implants

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Clinical Medicine

Background:

• Mechanical heart valves are crucial for treating valvular heart disease.
• The ATS mechanical bileaflet valve is a newer option requiring evaluation.
• Assessing valve performance and patient outcomes is essential for clinical adoption.

Purpose of the Study:

• To evaluate the clinical performance and hemodynamic characteristics of the new ATS mechanical bileaflet valve.
• To assess patient functional status and survival rates after implantation.
• To compare the valve's performance with existing mechanical valves.

Main Methods:

• Prospective study of 100 patients (119 valves implanted: 61 aortic, 50 mitral, 8 tricuspid) between May 1992 and March 1994.
• Follow-up ranged from 5 to 27 months, assessing New York Heart Association functional class, complications, and survival.
• In vitro hydrodynamic evaluation using a pulse duplicator system and clinical hemodynamic assessment (echocardiography, transesophageal, transthoracic).

Main Results:

• Significant improvement in New York Heart Association functional class from mean 3+ to 1.3 postoperatively.
• Excellent hemodynamic performance with favorable gradients and no significant regurgitation.
• Low complication rates: 98% actuarial survival, one embolic event, one valve thrombosis successfully treated.

Conclusions:

• The ATS mechanical bileaflet valve offers excellent hemodynamic function and clinical outcomes.
• The valve is well-tolerated, with improved patient functional status and high survival rates.
• Its performance is comparable or superior to other mechanical valves, with minimal noise during closure.