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J Thorac Cardiovasc Surg 2006;131:1419
© 2006 The American Association for Thoracic Surgery

Letter to the Editor

Tubular heart valves

Ann Arbor, Mich

To the Editor:

Cox and associates ¹ recently presented in vitro testing results on the 3F Aortic Bioprosthesis. Unfortunately, Cox and colleagues chose not to give authorship to any of the engineers who performed this work, nor even give them the courtesy of an acknowledgement. Due to the lack of input from these engineers, of whom I am one, the article contains several technical and interpretive errors that should be corrected. They are as follows:

• The text gives the impression that a laser micrometer was used to measure aortic chamber compliance during flow testing. Those measurements were actually made on valveless chambers in a separate test system before flow testing.

• The paper states, "Five milliliters of corn starch was ... injected into the flow loop to act as an acoustic scattering agent." This is nonsensical since laser-based flow visualization does not employ acoustic scatter in any way. The statement refers to a technique used during in vitro Doppler studies and is presumably a "copy and paste" error.

• Wear testing of the valve was not conducted at 700 to 900 Hz as implied. The test rate was 700 to 900 rpm, which is about 12 to 15 Hz.

• Wear testing was not conducted on valve sizes 19-, 21-, 23-, 25-, and 27-mm valves, 2 of each size, as stated. Testing was conducted on 19-, 25-, and 29-mm valves, 10 of each size.

• The authors state, "This nonturbulent flow was characteristic of ... all valve sizes ...." Since flow visualization testing was only conducted on 19-mm valves, this is conjecture being stated as fact.

• The authors state, "The distribution of stress on the leaflets of the 3F Aortic Bioprosthesis shows the greatest degree of stress to be in the belly of the valve leaflets, with less stress at the commissural posts (Figure 6)." This statement is actually in direct contradiction to Figure 6. The figure clearly shows the largest stresses to be along the leaflet edge and at the commissural attachment point.

These corrections are not intended to be petty or esoteric. As the clinical use of the 3F aortic valve continues to grow, it is important to have accurate literature reports of how the valve has been tested, as well as sound technical analyses of its performance features. Rather than relying on ill-conceived theories of "tubular" geometry or "form follows function," the valve's excellent performance can be attributed to more straightforward design features (ie, the leaflet design, the small, unobstructive sewing ring, the lack of rigid supports structures, and the mechanical durability of pericardium). An intellectually and scientifically rigorous paper with a description of these features and how they translate to the observed performance would have been much more useful.

	References

Top References

 

1. Cox JL, Ad N, Myers K, Gharib M, Quijano RC. Tubular heart valves. a new tissue prosthesis design—preclinical evaluation of the 3F aortic bioprosthesis. J Thorac Cardiovasc Surg 2005;130:520-527.[Abstract/Free Full Text]
   

This article has been cited by other articles:

				J. L. Cox and R.C. Quijano Tubular heart valves J. Thorac. Cardiovasc. Surg., March 1, 2007; 133(3): 845 - 846. [Full Text] [PDF]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Biancucci, B. Search for Related Content PubMed PubMed Citation Articles by Biancucci, B. Related Collections Valve disease