Why Select a Mechanical Valve?

For more than 30 years, mechanical heart valves have successfully provided patients who have undergone valve replacement surgery with the ability to lead healthy, active, productive lives. Today, 20 to 30% of all patients diagnosed with heart valve disease receive a mechanical valve. Surgeons regularly select mechanical valves for mitral valve surgery or aortic valve surgery based on a number of inherent benefits including valve durability and exceptional hemodynamic performance.

Once your physician has determined that your diseased heart valve needs replacement or repair, the decision regarding your heart valve choice will depend on important factors regarding your condition as well as valve performance considerations.

Patient Factors:

  • Your specific valve disease and how far the valve disease has progressed
  • Other medical conditions you may have
  • Your ability to tolerate anticoagulation therapy 
  • Your age and other lifestyle considerations such as child-bearing

Physicians will evaluate specific mechanical heart valve options based on five primary performance characteristics, each with important considerations on clinical outcomes:

5 performance characteristics for valve selection
Performance Characteristics of Valve Selection
  • Thromboresistance (resistant to forming blood clots)
  • Hemodynamics (efficient blood flow through the valve sufficient to meet your body’s needs)
  • Durability (how long the valve lasts)
  • Quality of life (valve noise, ability to tolerate/desire, reoperation considerations, age)
  • Implantability (ease of implant for the surgeon)

Thromboresistance

Is the valve design resistant to thrombus (blood clot) formation? Thrombogenicity (tendency to produce a thrombus) in mechanical heart valves is rooted in the potential for blood to stagnate in recesses or cavities areas where blood may collect. Stagnant blood can form small clots that may hamper valve function or blood circulation and is the primary reason that patients with mechanical valves take anticoagulants (blood thinners) and maintain a regimen of anticoagulation therapy.

Hemodynamics (efficient flow of blood through the valve)

Will the valve provide the hemodynamic performance necessary for physiologic needs? Size and construction of types of mechanical heart valves can make a difference on the effective orifice area (opening) to promote optimal blood flow. Your surgeon will choose the mechanical valve with the most effective orifice (opening) to annulus (structure of the heart valve opening) ratio for physiologic function.

Durability

How long will the valve last? What materials are used to make the valve and how biocompatible and durable are they?  Does the valve have proven durability?  Most mechanical heart valves made from solid pyrolytic carbon and other materials have been proven to provide excellent biocompatibility and durability.

Quality of Life

Are there aspects of the valve — such as valve noise — that may inhibit quality of life for the patient? Certainly, a noisy heart valve may interfere with everyday quality of life including annoyance, sleep disturbance, inability to concentrate and even social embarrassment. Your surgeon will consider this and other factors such as desire and ability to tolerate anticoagulation therapy and/or reoperation.

Implantability

Is the valve easy to implant? Mechanical heart valves include specific features to make them easier for surgeons to implant. Examples include: easy suturing cuffs, physical attributes that make valves easier to seat, structure to provide ease of rotation and suture guides.