Prosthetic Cardiac Valves — A Comparison of the Four Basic Designs

  • W. C. Roberts
  • T. L. Spray
Conference paper

Abstract

Since the first cardiac valve prosthesis was implanted in the normal anatomic position in 1960 (1), many different varieties of prostheses have been developed. In spite of the large number of types of prostheses used, none has been ideal to date. This report discusses the relative advantages and disadvantages of the various cardiac valve prostheses available today and the factors that should be taken into account in the selection of a prosthesis for a particular patient (2).

Keywords

Formalin Cage Rubber Anemia Warfarin 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Starr A, Edwards ML (1971) Mitral replacement: clinical experience with a ball-valve prosthesis. Ann Surg 154:726CrossRefGoogle Scholar
  2. 2.
    Roberts WC (1976) Choosing a substitute cardiac valve: type, size, surgeon. Am J Cardiol 38:633PubMedCrossRefGoogle Scholar
  3. 3.
    Hufnagel CA, Harvey WP (1953) The surgical correction of aortic regurgitation. Preliminary Report. Bull Georgetown Univ Med Center 6:60Google Scholar
  4. 4.
    Hufnagel CA, Harvey WP, Rabil PJ, McDermott TF (1954) Surgical correction of aortic insufficiency. Surgery 35:673PubMedGoogle Scholar
  5. 5.
    Harken DE, Soroff HS, Taylor WJ, Lefemine AA, Gupta SK, Lunzer S (1960) Partial and complete prostheses in aortic insufficiency. J Thorac Cardiovasc Surg 40:744PubMedGoogle Scholar
  6. 6.
    Harken DE, Taylor WJ, Lefemine AA, Lunzer S, Low HBC, Cohen ML,Jacobey JA (1962) Aortic valve replacement with a caged ball valve. Am J Cardiol 9:292PubMedCrossRefGoogle Scholar
  7. 7.
    Reis RL, Glancy DL, O’Brien K, Epstein SE, Morrow AG (1970) Clinical and hemodynamic assessments of fabric-covered Starr-Edwards prosthetic valves. J Thorac Cardiovasc Surg 59:84, 104PubMedGoogle Scholar
  8. 8.
    Winter TO, Reis RL, Glancy DL, Roberts WC, Epstein SE, Morrow AG (1972) Current status of the Starr-Edwards cloth-covered prosthetic cardiac valves. Circulation (Suppl) 45/46:1–14Google Scholar
  9. 9.
    Levine FH, Copeland JG, Morrow AG (1973) Prosthetic replacement of the mitral valve. Continuing assessments of the 100 patients operated upon during 1961-1965. Circulation 47:518PubMedGoogle Scholar
  10. 10.
    Bonchek LI, Starr A (1975) Ball valve prostheses: current appraisal of late results. Am J Cardiol 35:843PubMedCrossRefGoogle Scholar
  11. 11.
    Smithwick W, Kouchoukos NT, Karp RB, Pacifico AD, Kirklin JW (1975) Late stenosis of Starr-Edwards cloth-covered prostheses. Ann Thorac Surg 20:249PubMedCrossRefGoogle Scholar
  12. 12.
    Roberts WC, Morrow AG (1966) Renal hemosiderosis in patients with prosthetic aortic valves. Circulation 36:390Google Scholar
  13. 13.
    Roberts WC, Morrow AG (1972) Causes of death and other anatomic observations after cardiac valve replacement. Adv Cardiol 7:226Google Scholar
  14. 14.
    Roberts WC, Morrow AG (1967) Late postoperative pathological findings after cardiac valve replacement. Circulation (Suppl) 35/36:1-48Google Scholar
  15. 15.
    Roberts WC, Morrow AG (1967) Anatomic studies of hearts containing caged-ball prosthetic valves. Johns Hopkins Med J 121:271PubMedGoogle Scholar
  16. 16.
    Roberts WC, Morrow AG (1968) Fatal degeneration of the silicone rubber ball of the Starr-Edwards prosthetic aortic valve. Am J Cardiol 22:614PubMedCrossRefGoogle Scholar
  17. 17.
    Roberts WC, Morrow AG (1969) Late postoperative pathologic findings following cardiac valve replacement with Starr-Edwards prostheses. In: Proceedings of the Second National Conference of Prosthetic Heart Valves. Thomas, Springfield, Illinois, p 365Google Scholar
  18. 18.
    Roberts WC, Levinson GE, Morrow AG (1970) Lethal ball variance in the Starr-Edwards prosthetic mitral valve. Arch Intern Med 126:517PubMedCrossRefGoogle Scholar
  19. 19.
    Roberts WC, Bulkley BH, Morrow AG (1973) Pathologic anatomy of cardiac valve replacement: a study of 224 necropsy patients. Prog Cardiovasc Dis 15:539PubMedCrossRefGoogle Scholar
  20. 20.
    Pluth JR, Broadbent JC, Barnhorst DA, Danielson GK (1975) Aortic and mitral valve replacement with cloth-covered Braunwald-Cutter prosthesis. A three-year follow up. Ann Thorac Surg 20:239PubMedCrossRefGoogle Scholar
  21. 21.
    Roberts WC, Morrow AG (1966) Mechanism of acute left arterial thrombosis after mitral valve replacement. Pathologic findings indicating obstruction to left atrial emptying. Am J Cardiol 18:497PubMedCrossRefGoogle Scholar
  22. 22.
    Roberts WC, Lambird PA, Gott VL, Morrow AG (1966) Fatal aortic regurgitation following replacement of the mitral and aortic valves. A mechanical complication of double valve replacement. J Thorac Cardiovasc Surg 52:189PubMedGoogle Scholar
  23. 23.
    Roberts WC, Morrow AG (1967) Causes of early postoperative death following cardiac valve replacement. Clinico-pathologic correlations in 64 patients studied at necropsy. J Thorac Cardiovasc Surg 54:422PubMedGoogle Scholar
  24. 24.
    Seningen RP, Bulkley BH, Roberts WC (1974) Prosthetic aortic stenosis. A method to prevent its occurrence by measurement of aortic size from preoperative aortogram. Circulation 49:921PubMedGoogle Scholar
  25. 25.
    Baxter RH, Bain WH, Rankin RJ, Turner MA, Escarous AE, Thomson RM, Lorimer AR, Lawrie DV (1975) Tricuspid valve replacement: a five-year appraisal. Thorax 30:158PubMedCrossRefGoogle Scholar
  26. 26.
    Horsley HT, Rappoport, WJ, Vigoda PS. Vogel JHK (1970) Fatal malfunction of Edwards low-profile mitral valves. Circulation (Suppl) 41/42:11–39Google Scholar
  27. 27.
    Gunstensen J (1971) Acute dysfunction of Starr-Edwards mitral prostheses. Thorax 26:163PubMedCrossRefGoogle Scholar
  28. 28.
    Olin C (1970) Evaluation of the Kay-Shiley disc valve prosthesis in the aortic position. Clinical and haemodynamic results, and experimental comparison with other prosthetic aortic valves. Scand J Thorac Cardiovasc Surg (Suppl) 7:1Google Scholar
  29. 29.
    Shepherd RL, Glancy DL, Reis RL, Epstein SE, Morrow AG (1973) Hemodynamic function of the Kay-Shiley prosthetic cardiac valve. Observations after mitral or tricuspid valve replacement. Chest 63:323PubMedCrossRefGoogle Scholar
  30. 30.
    Roberts WC, Fishbein MC, Golden A (1975) Cardiac pathology after valve replacement by disc prosthesis. A study of 61 necropsy patients. Am J Cardiol 35:740PubMedCrossRefGoogle Scholar
  31. 31.
    Fernandez J, Morse D, Spagna P, Lemole G, Gooch A, Yang SS, Maranhao V (1976) Results of mitral valve replacement with the Beall prosthesis in 209 patients. J Thorac Cardiovasc Surg 71:218Google Scholar
  32. 32.
    Hammer WJ, Hearne MJ, Roberts WC (1976) Cocking of a poppet disc prosthesis in the aortic position. A cause of intermittent aortic regurgitation. J Thorac Cardiovasc Surg 71:259PubMedGoogle Scholar
  33. 33.
    Beall AC Jr, Morris GC Jr, Howell JF Jr, Guinn GA, Noon GP, Reul GJ Jr, Greenberg JJ, Ankeney JL (1973) Clinical experience with an improved mitral valve prosthesis. Ann Thorac Surg 15:601PubMedCrossRefGoogle Scholar
  34. 34.
    Nathan MJ (1973) Strut fracture. A late complication of Beall mitral valve replacement. Ann Thorac Surg 16:610PubMedCrossRefGoogle Scholar
  35. 35.
    Cooley DA, Sandiford FM, Wukasch DC, Reul GJ (1975) Mitral valve replacement with a new prosthesis. Experience with 366 patients. J Cardiovasc Surg Spec. No: 378Google Scholar
  36. 36.
    Böök K (1974) Mitral valve replacement with the Björk-Shiley tilting disc valve. A clinical and haemodynamic study in patients with isolated mitral valve lesions. Scand J Thorac Cardiovasc Surg (Suppl) 12:1Google Scholar
  37. 37.
    Björk VO, Henze A, Holmgren A (1974) Five years’ experience with the Björk-Shiley tilting disc valve in isolated aortic valvular disease. J Thorac Cardiovasc Surg 68:393PubMedGoogle Scholar
  38. 38.
    Roberts WC, Hammer WJ (1976) Cardiac pathology after valve replacement with a tilting disc prosthesis (Björk-Shiley type): A study of 46 necropsy patients and 49 Björk-Shiley prostheses. Am J Cardiol 37:1024PubMedCrossRefGoogle Scholar
  39. 39.
    Ben-Zvi J, Hildner FJ, Chandraratna PA, Samet P (1974) Thrombosis on Björk-Shiley aortic valve prosthesis. Clinical arteriographic, echocardiographic and therapeutic observations in seven cases. Am J Cardiol 34:538PubMedCrossRefGoogle Scholar
  40. 40.
    Björk VO, Böök K, Holmgren A (1974) The Björk-Shiley mitral valve prosthesis. A comparative study with different prosthesis orientations. Ann Thorac Surg 18:379PubMedCrossRefGoogle Scholar
  41. 41.
    Ross DN (1962) Homograft replacement of the aortic valve. Lancet 11:487CrossRefGoogle Scholar
  42. 42.
    Barratt-Boyes BG, Lowe JB, Cole DS, Kelly DT(1965) Homograft valve replacement for aortic valve disease. Thorax 20:495PubMedCrossRefGoogle Scholar
  43. 43.
    Angell WW, Shumway NE, Kosek JC (1972) A five-year study of viable aortic valve homo-grafts. J Thorac Cardiovasc Surg 64:329PubMedGoogle Scholar
  44. 44.
    Moore CH, Martelli V, Al-Janabi N, Ross DN (1975) Analysis of homograft valve failure in 311 patients followed up to 10 years. Ann Thorac Surg 20:274PubMedCrossRefGoogle Scholar
  45. 45.
    Yarbrough JW, Roberts WC, Reis RL (1973) Structural alterations in tissue cardiac valves implanted in patients and in calves. J Thorac Cardiovasc Surg 65:364PubMedGoogle Scholar
  46. 46.
    Ionescu UI, Pakrashi BC, Mary DAS, Bartek IT, Wooler GH (1974) Replacement of heart valves with frame-mounted tissue grafts. Thorax 29:56PubMedCrossRefGoogle Scholar
  47. 47.
    Nuno-Conceicao A, Puig LB, Verginelli G, Iryia K, Bittencourt D, Zerbini EJ, (1975) Homologous dura mater cardiac valves. Structural aspects of eight implanted valves. J Thorac Cardiovasc Surg 70:499Google Scholar
  48. 48.
    Mary DAS, Pakrashi, BC, Catchpole RW, Ionescu MI (1975) Tissue valves in the mitral position. Five years experience. Br Heart J 37:1123PubMedCrossRefGoogle Scholar
  49. 49.
    Olsen EGJ, Al-Janabi N, Salamao CS, Ross DN (1975) Fascia lata valves: a clinicopathological study. Thorax 30:528PubMedCrossRefGoogle Scholar
  50. 50.
    Horowitz MS, Goodman DJ, Fogarty TJ, Harrison DC (1974) Mitral valve replacement with the glutaraldehyde-preserved porcine heterograft. Clinical, hemodynamic, and pathological correlations J Thorac Cardiovasc Surg 67:885Google Scholar
  51. 51.
    Mcintosh CL, Michaelis LL, Morrow AG, Itscoitz SB, Redwood DR, Epstein SE (1975) Atrioventricular valve replacement with the Hancock porcine xenograft: a five year clinical experience. Surgery 78:768PubMedGoogle Scholar
  52. 52.
    Pipkin RD, Buch WS, Fogarty TJ (1976) Evaluation of aortic valve replacement with a porcine xenograft without long-term anticoagulation. J Thorac Cardiovasc Surg 71:179PubMedGoogle Scholar
  53. 53.
    Zuhdi N, Hawley W, Voehl V, Hancock W, Carey J, Greer A (1974) Porcine aortic valves as replacement for human heart valves. Ann Thorac Surg 17:479PubMedCrossRefGoogle Scholar
  54. 54.
    Johnson AD, Daily PO, Peterson KL, LeWinter M, DiDonna GT, Blair G, Niwayama G (1975) Functional evaluation of the porcine heterograft in the mitral position. Circulation (Suppl) 50/51:1-40Google Scholar
  55. 55.
    Reis RL, Hancock WD, Yarbrough JW. Glancy DL, Morrow AG (1971) The flexible stent. A new concept in the fabrication of tissue heart valve prostheses. J Thorac Cardiovasc Surg 62:683PubMedGoogle Scholar
  56. 56.
    Spray TL, Roberts WC (1977) Structural changes in porcine xenografts used as substitute cardiac valves. Gross and histologic observations in 5 lglutaraldehyde-preserved Hancock valves in 41 patients. Am J Cardiol 40:319PubMedCrossRefGoogle Scholar
  57. 57.
    Rhoades GR, Mcintosh CL (1977) Evaluation of hemolysis folowing replacement of atrioventricular valves with porcine xenograft (Hancock) valves. J Thorac Cardiovasc Surg 73:312Google Scholar
  58. 58.
    Roberts WC, Perloff JK, Constantino T (1971) Severe valvular aortic stenosis in patients over 65 years of age. A clinicopathologic study. Am J Cardiol 27:497PubMedCrossRefGoogle Scholar
  59. 59.
    Roberts WC, Perloff JK (1972) Mitral valvular disease. A clinicopathologic survey of the conditions causing the mitral valve to function abnormally, Ann Intern Med 77:939Google Scholar
  60. 60.
    Roberts WC, Dangel JC, Bulkey BH (1973) Nonrheumatic valvular cardiac disease: a clinicopathologic survey of 27 different conditions causing valvular dysfunction. Cardiovasc Clin 5:333PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1980

Authors and Affiliations

  • W. C. Roberts
  • T. L. Spray

There are no affiliations available

Personalised recommendations