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Ann Thorac Surg 2004;78:384-385
© 2004 The Society of Thoracic Surgeons

Correspondence

Long-term durability of three mechanical valves: Reply

Yuji Naito, MD, Masato Nakajima, MD, Hidenori Inoue, MD, Narutoshi Hibino, MD, Eiki Mizutani, MD, Koji Tsuchiya, MD

Department of Cardiovascular Surgery, Yamanashi Central Hospital, 1-1-1, Fujimi, Kofu-shi, Yamanashi 400-0027, Japan

e-mail: ujinaito{at}aol.com

To the Editor:

We appreciate the interest of De Smet and associates in our case report describing unexpected long-term durability of a Smeloff-Cutter ball-valve prosthesis [1]. Their report on the greater durability of mechanical valves was noteworthy.

We discussed possible causes for the longer durability of ball valves in the aortic position in our case study. Nevertheless, little is known about the variables that affect the durability of ball valves in different positions; this is especially there for Smeloff-Cutter valves. The putative reasons for their extremely prolonged durability are as follows: First, a larger size of valve may reduce the risk of pannus and thrombus formation. Rizzoli and co-workers [2] indicated that large prosthetic size (>27 mm) is associated with reduced risk of thrombosis and pannus formation in the mitral and tricuspid positions. Second, younger age at the initial operation may cause a high cardiac-output status, which could prevent valvular thrombosis.

Considering such factors, we could not help suggesting that the prolonged durability of Smeloff-Cutter valves in the mitral and tricuspid positions is mainly due to structural superiority for an antithrombotic effect. In contrast with the Starr-Edwards ball-valve prosthesis, which is currently available, the Smeloff-Cutter valve is no longer in production.

References

  1. Naito Y., Nakajima M., Inoue H., Hibino N., Mizutani E., Tsuchiya K. Unexpected durability of Smeloff-Cutter aortic ball valve prosthesis. Ann Thorac Surg 2003;75:1633-1635.[Abstract/Free Full Text]
  2. Rizzoli G., Guglielmi C., Toscano G., et al. Reoperations for acute prosthetic thrombosis and pannus: an assessment of rates, relationship and risk. Eur J Cardio-thorac Surg 1999;16:74-80.[Abstract/Free Full Text]




This Article
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