Technique of implantation of the Medtronic-Hall valve and other modern tilting-disc prostheses.
Modern tilting-disc prostheses (Medtronic-Hall, Björk-Shiley Monostrut, and Omniscience) have distinctive mechanical characteristics, including wide-angle disc opening, that require special care about the implantation technique. Proper sizing, suturing, and orientation of the prosthesis are essential if problems of nonstructural valve dysfunction are to be avoided. A number of complications of this type, reported recently, appear to be related to a mismatch between the size of the disc and that of the cavities, whether ventricular or aortic. Based on an institutional experience of over 2,000 Medtronic-Hall valve replacements, described are the technical details of the implantation, centered on the sizing and orientation of the prostheses, including the technique of continuous suture used in mitral valve replacement.
Antunes
M J
MJ
Division of Cardiothoracic Surgery, Hospital of the University of Coimbra, Portugal.
D001021:Aortic Valve / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008943:Mitral Valve / Q000601:surgery*; D011474:Prosthesis Design; D012399:Rotation; D013499:Surface Properties; D013536:Suture Techniques