Heart
Valvular heart disease
Prosthetic valves

Author: R. Amita, M.D. (see Authors page)

Revised: 19 March 2018, last major update December 2014

Copyright: (c) 2014-2018, PathologyOutlines.com, Inc.

PubMed Search: Prosthetic valves [title] valvular heart disease

Cite this page: Amita, R. Prosthetic valves. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/heartprostheticvalves.html. Accessed April 22nd, 2018.
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

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Bjork-Shiley concavo-convex valve

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St Jude Medical bileaflet prosthesis

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Prosthetic aortic valve

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Aortic prosthetic valve before & after IV heparin

Case reports
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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Prosthetic cardiovascular devices

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AHA/ACC recommendations

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Gross examination of prosthetic heart devices

Gross images

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Mitral valve prosthesis
shows significant pannus
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Mechanical mitral valve prosthesis

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Synthetic chordae tendinae

Microscopic (histologic) images

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Valve sewing cuff, atrial
endocardium, native
mitral leaflet tissue
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Synthetic chorda surrounded by tissue fibrosis

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Segment of coronary artery