Evaluation of tilting disc valves after fatigue life testing: preliminary results within a comparison program

Materials characterization of explanted mechanical heart valves and comparison to patients' clinical data

In the present study, twelve explanted mechanical heart valves (MHVs)with pyrolitic carbon tilting disc and 14 bileaflet MHVs were analyzed to investigate the effects of material properties on valve performance and patients' general health conditions. Optical and scanning electron microscopy was used to investigate material imperfections, wear patterns or damages to housing and occluder components. All analyzed tilting disc valves exhibited wear effects, particularly due to abrasion and impact to both disc and housing. Wear of pyrolitic carbon disc and housing did not influence their in vivo performance. In the bileaflet MHVs, breakaway of the pyrolitic carbon coating sometimes caused malfunctioning and required surgical retrieval of the valve. In all cases, occurrence of clinical symptoms was more likely when wear effects were located in critical areas. The study supports a correlation between the properties of the MHVs material and patients' symptoms.

Potential MR hazard to patients with metallic heart valves: the Lenz effect

The Lenz effect on the motion of metal containing moving parts of artificial heart valves has not been considered to date. In this paper the basic theory is outlined and a simple model applied to estimate worst-case forces on such valves. The results indicate a potential for forces over 100 times greater than for the more widely recognized ferromagnetic interation. Resistive pressure effects comparable to cardiac pressure differences may occur for such valves in the mitral position even at fields as low as 1.5 T. The effect will increase linearly with field strength. Additional monitoring and perhaps even exclusion of such patients may be prudent, even at 1.5 T.