Mechanical Heart Valve Replacement Devices

By Adam Pick, Patient & Author of "The Patient's Guide To Heart Valve Surgery"

The Most Durable Heart Valve Replacements... Mechanical Heart Valves

If you were recently diagnosed with a severe valvular disorder, in which your heart valve can not be
repaired, common patient questions are:

Which type of heart valve replacement is best for me?

A mechanical heart valve? Or, a tissue valve?

So you know, a medical device that is implanted into the heart of a patient with valve disease, like aortic
stenosis or mitral regurgitation, is called an artificial heart valve. You may also know that a heart has
four valves -- an aortic valve, a mitral valve, a pulmonary valve and a tricuspid valve. When one of these
valves malfunction, it can cause the heart to enlarge and lead to other complications, including
congestive heart failure.

Mechanical heart valves and biological heart valves are two different types of prosthetic heart valve
replacements which mimic the functions of a human valve.

What is A Mechanical Heart Valve?

A mechanical heart valve is made from materials that do not include any form of biological tissue (pig,
cow, horse). Instead, very strong materials -- such as titanium and carbon -- are used in a mechanical
heart valve that make them incredibly strong and durable. Some reports suggest that the mechanical
valves available today are able to last indefinitely. Recently, an accelerated wear tester suggested that
one mechanical heart valve could last over 50,000 years.
However, a key consideration for patients is that mechanical valves require continuous use of blood
thinners, also known as anticoagulants, such as Coumadin. Patients on Coumadin therapy need to be
monitored regularly with a PT (Prothrombin) blood test. These blood tests help ensure that the patient’s
INR (International normalised ratio) is acceptable. For example if the INR level is 5, this indicates an
elevated chance of bleeding, whereas an INR level of .5 indicates the possibility of a blood clot.

The three major kinds of mechanical heart valve replacements are the tilting-disc mechanical valve, the
bileaflet mechanical valve, and the original caged-ball mechanical valve.

The ‘Caged-Ball' Mechanical Valve

The caged-ball design was the first mechanical valve implanted. It houses a silicone elastomer ball within
a metal cage. Whenever the blood pressure within the heart’s chamber exceeds the pressure outside of
the heart’s chamber, the ball pushes against the cage allowing the blood to flow. After heart contracts,
the pressure drops and the ball goes back to the valve’s base to form a seal.

The ‘Tilting-Disc’ Mechanical Valve

Shortly after the caged-ball design, the tilting-disc mechanical valve replacement was created. The first
tilting-disc valve that was clinically available was the ‘Bjork-Shiley’ valve. This valve was introduced in
1969 and there have been some noteworthy design changes since then.

A tilting-disc valve has a single, circular occluder that is controlled with a metal strut. These valves have
metal rings covered by an ePTFE fabric. In order to hold the valve in place, sutures are stitched into the
ePTFE fabric. The ring has two supports that hold a flexible disc that will open-and-close as blood is
pumped through the valve.

The ‘Bileaflet’ Mechanical Valve

A bileaflet mechanical valve consists of two leaflets that are semicircular and rotate around struts that
are attached to the housing of the valve. In 1979, the bileaflet valve design was introduced. Some
reports suggest that bileaflet mechanical valves povide more natural bloodflow compared to the
aforementioned mechanical heart valves.

Advantages Of Mechanical Heart Valves

The main advantage of mechanical heart valve replacements is durability.

Mechanical heart valves are made from very durable materials including titanium, carbon compounds
and teflon. While the average tissue valve (porcine, bovine, equine) is estimated to last between 10-15
years, reports suggest that mechanical valves can last 30 years or more after implant. That said, for
some younger patients, a mechanical heart valve can be a suitable replacement for the diseased valve.

Disadvantages of Mechanical Heart Valves

There are a few disadvantages, or considerations, that should be noted about mechanical heart valves.

First, to reduce the risk of clotting, patients are required to use blood thinners (e.g. Coumadin, Warfarin)
for the balance of their lives.

Second, due to the mechanical nature of the valve, some patients can hear their valves "click" while
opening-and-closing in their hearts.

Third, with the ongoing interest and use of transcatheter valve replacements, it is not possible to replace
a mechanical valve should complications occur years after implant.

Selecting a heart valve replacement is a very important decision for the patient, their family and friends.
I encourage you to research this choice given your age, health history, lifestyle and risk factors.

To further understand the advantages and disadvantages of mechanical heart valves AND become
familiar with mechanical heart valve manufacturing brands, please click here.

Heart Valve Disorders

 Aortic Stenosis

Aortic Regurgitation

Mitral Regurgitation

Mitral Valve Prolapse

Mitral Stenosis

Bicuspid Aortic Valve

Pulmonary Valve Stenosis

Leaky Heart Valve

Calcified Heart Valve

Atrial Fibrillation

Heart Valve Procedures

Aortic Valve Repair

Aortic Valve Replacement

Mitral Valve Repair

Mitral Valve Replacement

Ross Procedure

Robotic Mitral Valve Repair

David Procedure

Maze Procedure

Percutaneous Aortic Valve

Mechanical Heart Valve

Heart Valve Replacement Artificial Heart Valve