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Ann Thorac Surg 1999;68:1096-1099
© 1999 The Society of Thoracic Surgeons

How To Do It

Orientation of tilting disc and bileaflet aortic valve substitutes for optimal hemodynamics

Joachim Laas, MDa, Peter Kleine, MDa, Michael J. Hasenkam, MDa, Hans Nygaarda

a Department of Cardiothoracic Surgery, Cardiovascular Center Bad Bevensen, Bad Bevensen, Germany

Address reprint requests to Dr Laas, Department of Cardiothoracic Surgery, Cardiovascular Center, Römstedter Str 25, 29549 Bad Bevensen, Germany

Procedures for implantation of mechanical aortic valves have to consider eccentric flow in the aortic root. We describe how to optimize orientation of tilting disc (Medtronic Hall) and bileaflet (St. Jude Medical) valves. In tilting disc valves, an asymmetric design faces an asymmetric flow. Hemodynamic performance of this valve type, regarding turbulence and pressure gradients, is close to normal physiology and superior to the bileaflet valve design. This difference is more pronounced the smaller the valve size.




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