Art Valves

Different types of valve art

Before starting with echocardiographic evaluation of a valve prosthesis it is necessary to be aware of the different types of valve prostheses. There is a difference in the kind and in the type and diameter. Thus, each manufacturer has its own characteristics. And there is a difference in whether the prosthesis is biologically or mechanically created.

Click here for normal mechanical prosthesis

Click here for normal biological prostheses

Mechanical prosthetic valves

Advantages and disadvantages of mechanical and bioprosthetic
	Mechanical	Biological
Advantages	Durable	No anticoagulation needed Less obstruction of the blood flow No Leakage Inaudible Hemodialysis Less risk of infection in the ring or edge flap No pannus (tissue ingrowth)
Disadvantages	Anticoagulation needed Any obstruction of the blood flow Leakage (leakage backflow after valve closure, closure backflow flap for closure. Audible (ticks). Hemodialysis (blood cells break down by colliding with mechanical valve. Infection in ring or rim valve (endocarditis). Pannus (tissue ingrowth)	Degeneration is 10-15 years
NB: For all valve prostheses is indicated in some cases endocarditis prophylaxis.1

Types of mechanical prosthetic valves

Valve profile in different types of mechanical prosthetic valves

Features of the different prosthetic

Type of prosthetic valve1	Brand	Obstruction	Leakage
Ball in Cage	Starr-Edwards	many	little
Tilting disc	Bjork-Shiley Medtronic Hall Sorin	Little	Many
Bileaflet	St. Jude Medical Sorin-Bicarbon Carbomedics	Little	Many
Homograft	(Donor Valve)	No	No
Unstented bioprosthesis	Medtronic Freestyle	No	No
Stented bioprosthesis	Carpentier-Edwards Hancock Medtronic Intact	Many	No

References

1 R.B.A, van den Brink ‘Kunstkleppen' in "Praktische echocardiografie",Hamer, J.P.M, Pieper P.G, et al, 2e druk, 2009, Houten, Bohn Stafleu van Loghum, DOI: 10.1007/978-90-313-7565-3_9, Print ISBN: 978-90-313-6235-6

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