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J Thorac Cardiovasc Surg 2001;122:8-9
© 2001 The American Association for Thoracic Surgery

Editorials

In search of the ideal valve replacement device

From The Children's Hospital, Boston, Mass.

Received for publication March 7, 2001. Accepted for publication March 20, 2001. Address for reprints: John E. Mayer, MD, The Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115 (E-mail: john.meyer@tch.harvard.edu).

See related article on page 129.

The search for an ideal cardiac valve replacement began in the earliest days of cardiac surgery, and the commandments describing the essential characteristics of an ideal valve replacement device were outlined by Dwight Harken ¹ in the 1950s. These characteristics include durability, absence of thrombogenicity, resistance to the ability to provide normal hemodynamics, absence of damage to blood elements, and technical practicality of insertion in a physiologic position in the circulation. Additional desirable characteristics include resistance to infection and lack of immunogenicity. If valves are to be used in children, the capacity for growth must be included as well. Many prosthetic and bioprosthetic valves provide good hemodynamic performance with low gradients and insignificant regurgitation. However, no prosthetic valve will be able to meet the nonthrombogenicity criterion because a nonthrombogenic, blood-compatible surface . . . [Full Text of this Article]

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