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Related Experiment Videos

Valve replacement with the ATS open pivot bileaflet prosthesis

S Westaby1, G Van Nooten, H Sharif

  • 1Oxford Heart Centre, John Radeliffe Hospital, UK.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|January 1, 1996
PubMed
Summary

The ATS open pivot bileaflet valve demonstrates excellent hemodynamics and a low thromboembolism rate. This study supports reduced anticoagulant levels for patients with aortic valve replacements in sinus rhythm.

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Area of Science:

  • Cardiovascular Surgery
  • Biomaterials Science
  • Medical Device Engineering

Background:

  • Bileaflet mechanical valves are widely used for heart valve replacement.
  • Optimizing hemodynamic performance and minimizing thromboembolic events are critical for prosthetic valve design.

Purpose of the Study:

  • To evaluate the hemodynamic performance and thromboembolic risk of the ATS open pivot bileaflet valve.
  • To assess the valve's safety and efficacy in various cardiac positions.

Main Methods:

  • Prospective study of 200 patients undergoing valve replacement with the ATS valve.
  • Hemodynamic assessment using transesophageal and transthoracic echocardiography.
  • Clinical follow-up for 12 months to 3 years to monitor for thromboembolic events and other complications.

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Main Results:

  • The ATS valve exhibited hemodynamic gradients equivalent to or better than other bileaflet valves.
  • A very low rate of thromboembolic events was observed.
  • No valve-related deaths occurred; complications included two reoperations for dehiscence and one case of prosthesis thrombosis resolved with thrombolysis.

Conclusions:

  • The ATS open pivot bileaflet valve possesses excellent hemodynamic characteristics and a low thromboembolic rate.
  • The valve's design, featuring a convex self-washing hinge mechanism, may contribute to its favorable profile.
  • Reduced anticoagulant intensity (INR 1.5-2.0) is suggested for aortic valve replacement patients in sinus rhythm, and the valve shows promise in the tricuspid position.