title: Heart valve replacement with the pivoting disc prosthesis: appraisal of results and description of a new all-carbon model.
abstract: The Lillehei-Kaster pivoting disc (LKPD) valve has a free-floating pyrolite carbon disc suspended within a unibody titanium housing. A brief history of its development beginning in 1964 illustrates the origin of the concepts of central flow, lifetime durability, laminar flow, and low profile with lightness of weight. Clinical evidence indicating that this prosthesis has lifetime wearability is confirmed by complete freedom from mechanical failure in widespread clinical usage. Postoperative studies for abnormal hemolysis disclosed a striking improvement over lateral flow prostheses. The hemodynamic performance has been evaluated in both early and late postoperative studies and showed excellent results in all but the smallest sizes in the aortic position. The incidence of thromboembolism was found to be very low. In a total of 1610 patients at risk, the overall incidence of embolism was only 1.1 percent, and fatal embolism occurred in only one patient. These results with use of the LKPD valve have confirmed substantial progress in resolving the problems of prosthesis-related complications. Performance parameters still in need of improvement have also been identified, and these considerations have been incorporated into the design of a new all-carbon prosthesis with bioengineering refinements to meet these needs.
mesh_terms: D001021:Aortic Valve; D001792:Blood Platelets; D002244:Carbon; D005069:Evaluation Studies as Topic; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000266:history; D006439:Hemodynamics; D006461:Hemolysis; D049673:History, 20th Century; D006358:Hot Temperature; D006801:Humans; D007962:Leukocytes; D008943:Mitral Valve; D013923:Thromboembolism / Q000209:etiology
chemical_list: D002244:Carbon