Unraveling cavitation in mechanical heart valves

Mechanical heart valves (MHVs) are widely used in cardiac patients due to their durability and ability to restore blood flow. However, MHV patients often face unnoticed structural valve deterioration, neurological events, and cognitive decline over time. A key but underrecognized contributor to these complications is cavitation, a biomechanical phenomenon involving the formation and collapse of vapor bubbles during valve closure. Although extensively studied, the clinical implications of cavitation remain largely unexamined. This review explores the mechanisms, hemodynamics, diagnostic challenges, and clinical ramifications of cavitation in MHVs. By integrating insights from engineering, in vitro modeling, and clinical research, emphasizes the necessity of a multidisciplinary approach to identify and address risks associated with cavitation. Advanced diagnostic technologies such as transcranial Doppler, four-dimensional flow magnetic resonance imaging, and computational fluid dynamics present promising opportunities for early detection and risk evaluation. In addition, the review discusses innovative materials and valve designs that could help reduce cavitation. Ultimately, acknowledging cavitation as a significant clinical event is vital for enhancing prosthetic valve performance, prolonging device lifespan, and improving patient outcomes.