Evaluation of disc retention of Björk-Shiley Delrin heart valves.

BACKGROUND AND AIMS OF THE STUDY: Impact wear grooves have been observed in the occluder discs of clinically explanted Björk-Shiley Delrin (BSD) heart valves due to repetitive closing impacts against the inlet strut. We examined whether this impact wear could increase the disc-to-strut gap, which could in turn affect the retention of occluder disc. MATERIALS AND METHODS: Three BSD heart valves with deep wear grooves were tested in a left ventricular assist device set-up simulating dynamic conditions that would facilitate the dislodgement. RESULTS: The disc was found to be rotating within the flange during the testing and no embolization of the occluder disc occurred in any of the BSD valves tested. The Björk retention limit and the physical retention limit were calculated for each valve. The Björk retention limit is defined as (disc well depth)-(disc-to strut gap)-(1/2 outlet strut wire diameter) and the physical retention as (disc well depth)-(disc-to strut gap). CONCLUSION: The disc retention would not be affected by the impact wear grooves as long as the disc-to-strut gap did not exceed the physical retention limit.

A working cardiac valve phantom for radiographic assessment of prosthetic heart valves.

RATIONALE AND OBJECTIVES: A working valve phantom (WVP) that both exercises the valve occluder and simulates movements of the mitral annulus is described. It was designed to develop a method for radiographic detection of a single broken leg of the two-legged Björk-Shiley convexo-concave (C/C) heart valve outlet strut. METHODS: The WVP consists of a pneumatically driven left ventricular assist device immersed in 22 cm of water. Left ventricular assist device annulus movements are generated by systolic turgor and diastolic relaxation of the aortic outflow graft within limits set by the holding fixture design. RESULTS: WVP images were comparable in attenuation, valve motion, and diagnostic sensitivity to clinical C/C valve images and were effective in assessing leaflet excursions in another valve model. Techniques developed in the WVP have proved successful in the clinical detection of C/C valves that have a single broken leg but that show normal function in all other tests. CONCLUSION: The WVP can be a useful tool for developing refined radiographic assessments of prosthetic heart valves.