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Heart & vascular pathology

Valvular disease

Prosthetic valves

Last author update: 1 December 2014

Last staff update: 31 December 2020

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PubMed Search: Prosthetic valves [title] valvular heart disease

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Table of Contents

Cite this page: Amita R. Prosthetic valves. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/heartprostheticvalves.html. Accessed December 18th, 2024.

Definition / general

Prosthetic cardiac devices improve survival and greatly increase the quality of life in most patients

Radiology images

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Starr-Edwards mechanical valve

Bjork-Shiley concavo-convex valve

St Jude Medical bileaflet prosthesis

Prosthetic aortic valve

Aortic prosthetic valve before & after IV heparin

Case reports

30 year old woman with prosthetic heart valve thrombosis, anticoagulation and pregnancy (Neth Heart J 2007;15:306)
47 year old woman with mitral valve sparing procedures and prosthetic heart valve failure (Can J Cardiol 2009;25:e86)
65 year old man and 59 and 60 year old women with thrombolytics and left sided prosthetic valve thrombosis (Tex Heart Inst J 1998;25:130)

Treatment

The American Heart Association / American College of Cardiology (AHA/ACC) task force recommends bioprostheses for those over 65 undergoing aortic valve replacement (see table below)
For younger patients undergoing aortic valve replacement, a modern bileaflet mechanical valve appears to be optimal

Complications

Common prosthesis associated complications are:
- Thrombosis, thromboembolism
- Infection on annulus or biological tissues
- Structural or nonstructural dysfunction
All mechanical prostheses have an absolute requirement for anticoagulant treatment
Thromboembolism has been reported to occur at a higher rate with Starr-Edwards versus Bjork-Shiley valves
Bileaflet prostheses such as the St. Jude valve appear to have the lowest risk of thromboembolism
Rates of thromboembolism are higher following mitral valve replacement than following aortic valve replacement

Gross description

Mechanical prostheses
- Ball valves
- Disc valves
- Bileaflet valves
Biological prosthetic valves
- An autologous or autogeneous valve
- Autograft valve
- Homograft (or allograft) valve
- Heterograft (or xenograft) valve
- Bovine pericardial valves
See Heart 2002;87:583 for a full description of these valves
Gross findings to be recorded from an explanted prosthetic valve: see table below

Diagrams / tables

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