Are all bileaflet mechanical valves equal?

Abstract

Bileaflet mechanical valves are a valuable option for patients undergoing valve replacement surgery. All of the bileaflet designs provide good hemodynamic performance with long-term durability. However, some designs may provide better hemodynamic profiles in smaller valve sizes. Furthermore, newer models may have a more favorable thromboembolic profile. Nonetheless, the risk of anticoagulant-related complications with mechanical valves must be weighed against the risks of structural deterioration and reoperation of bioprostheses. Ultimately, the choice of prosthesis should be made after careful discussion with the patient, referring cardiologist, and cardiac surgeon.

Reduced anticoagulation is safe in high-risk patients with the On-X mechanical aortic valve

“…The most common mechanical aortic prostheses today are produced by St Jude (St Jude Medical, Minneapolis, MN), Carbomedics (Sorin, Milan, Italy), ATS (ATS Medical, Minneapolis), and On-X [8]. These bileaflet mechanical valves have subtle but important design differences that influence their hemodynamics and thromboembolic profile.…”

Aortic Valve Insufficiency in the Teenager and Young Adult

“…Currently, there are four Food and Drug Administration (FDA)-approved bileaflet prostheses: St Jude (St Paul, Minnesota), Carbomedics (Sorin, Arvada, Colorado), On-X (On-X Life Technologies, Austin, Texas), and ATS Medical (Advancing the standards, Minneapolis, Minnesota). 3 Each of these valves has undergone design modifications aimed at increased effective orifice area, with less outflow obstruction in smaller valve sizes. There is now a great deal of information in the literature on the long-term performance of mechanical valves.…”

“…The On-X mechanical valve includes design modifications aimed at decreasing thrombogenicity. 3 It is currently the subject of an FDA-approved, prospective, reduced anticoagulation trial. 44,45 The trial includes two groups of patients who have undergone aortic valve replacement with an On-X valve.…”

The Intervened Heart: Cardiac Hardware in the Forensic Suite

“…Surgically implanted mechanical heart valves are quite sturdy and rarely suffer from structural failure in their current designs (8). The tradeoff, however, is that they are associated with some degree of turbulent flow and focal stasis, and thus are prone to thrombosis.…”