Key result
In vitro, Omnicarbon valve outperforms St. Jude bileaflet by functioning normally down to PVR 1.6.
Why the study?
Mechanical heart valves designed for the left heart may exhibit aberrant behavior when placed in the pulmonary position under varying pulmonary vascular resistance conditions.
How do the St. Jude Medical bileaflet valve and MedicalCV Omnicarbon tilting disk valve behave in the pulmonary position under varying pulmonary vascular resistance in an in vitro model?
How do the St. Jude Medical bileaflet valve and MedicalCV Omnicarbon tilting disk valve behave in the pulmonary position under varying pulmonary vascular resistance in an in vitro model?
Mechanical valves designed for the left heart may exhibit aberrant leaflet behavior when used in the pulmonary position under normal or low pulmonary vascular resistance.
Suggests caution selecting bileaflet valves for pulmonary position at low PVR; leaves open optimal prosthesis choice for right-heart applications.
A study of mechanical heart valve behavior in the pulmonary position as a function of pulmonary vascular resistance is reported for the St. Jude Medical bileaflet (SJMB) valve and the MedicalCV Omnicarbon (OTD) tilting disk valve. Tests were conducted in a pulmonic mock circulatory system and impedance was varied in terms of system pulmonary vascular resistance (PVR). An impedance spectrum was found using instantaneous pulmonary artery pressure and flow rate curves. Both valves fully opened and closed at and above a nominal PVR of 3.0 mmHg/L/min. The SJMB valve was prone to leaflet bounce at closure, but otherwise completely closed, at settings above and below this nominal setting. At PVR values at and below 2.0 mmHg/L/min, the SJMB valve exhibited two types of leaflet aberrant behavior: single leaflet only closure while the other leaflet fluttered, and incomplete closure where both leaflets flutter but neither remain fully closed. The OTD valve fully opened and closed to a PVR value of 1.6 mmHg/L/min. At lower values, the valve did not close. Valves designed for the left heart can show aberrant behavior under normal conditions as pulmonary valves.
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Gohean et al. (2006) studied Mechanical heart valve behavior in the pulmonary position. St. Jude Medical bileaflet (SJMB) valve vs. MedicalCV Omnicarbon (OTD) tilting disk valve was evaluated on Valve behavior as a function of pulmonary vascular resistance (PVR). In an in vitro mock circulatory system, the St. Jude Medical bileaflet valve showed aberrant behavior at PVR ≤2.0 mmHg/L/min, while the Omnicarbon tilting disk valve functioned normally down to 1.6 mmHg/L/min.
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