The Journal of Thoracic and Cardiovascular Surgery
Volume 140, Issue 3 , Pages 611-616 , September 2010

Intermittent regurgitation caused by incomplete leaflet closure of the Medtronic ADVANTAGE bileaflet heart valve: Analysis of the underlying mechanism

Received 7 April 2009 ,Revised 28 August 2009 ,Accepted 1 November 2009.

References 

  1. Eichinger WB, Wagner I, Bleiziffer S, von Canal F, Lange R. Occasional single-beat regurgitation observed with the new Medtronic ADVANTAGE bileaflet heart valve. J Thorac Cardiovasc Surg. 2006;131:730–731
  2. Eichinger WB, Wagner IM, Bleiziffer S, von Canal F, Gunzinger R, Ruzicka DJ, et al. Occasional single beat regurgitation observed with the Medtronic Advantage bileaflet heart valve. Ann Thorac Surg. 2006;82:537–541
  3. Haaverstad R, Vitale N, Tromsdal A, Hegbom K, Karevold A. Intermittent incomplete closure of Medtronic Advantage aortic valve leaflets causes unnecessary reoperation. J Thorac Cardiovasc Surg. 2007;134:791–792
  4. Saxena R, Lemmon J, Ellis J, Yoganathan A. An in vitro assessment by means of laser Doppler velocimetry of the Medtronic Advantage bileaflet mechanical heart valve hinge flow. J Thorac Cardiovasc Surg. 2003;126:90–98
  5. Chambers J, Cross J, Deverall P, Sowton E. Echocardiographic description of the CarboMedics bileaflet prosthetic heart valve. J Am Coll Cardiol. 1993;21:398–405
  6. Donnerstein RL, Scott WA, Vasu A, Copeland JG. Acoustic analysis of the closing sounds of bileaflet prosthetic valves in a sheep model. J Thorac Cardiovasc Surg. 1991;101:1060–1068
  7. Bottio T, Casarotto D, Thiene G, Caprili L, Angelini A, Gerosa G. Leaflet escape in a new bileaflet mechanical valve: TRI technologies. Circulation. 2003;107:2303–2306
  8. Mosterd A, Shahin GM, van Boven WJ, Jaarsma W, Graafland AD, van Swieten HA. Images in cardiovascular medicine. Leaflet fracture of a St. Jude mechanical bileaflet valve. Circulation. 2005;111:e280–e281
  9. Blot WJ, Ibrahim MA, Ivey TD, Acheson DE, Brookmeyer R, Weyman A, et al. Twenty-five-year experience with the Bjork-Shiley convexoconcave heart valve: a continuing clinical concern. Circulation. 2005;111:2850–2857
  10. Hansen L, Danne M, Hoffmann B, Riess FC. Structural valve failure with every beat regurgitation observed using the Medtronic Advantage aortic valve. J Thorac Cardiovasc Surg. 2007;134:1344–1345
  11. Galli CA, Muratori M, Montorsi P, Barili F, Polvani G, Pepi M. Cyclic intermittent aortic regurgitation of a mechanical bileaflet aortic valve prosthesis: diagnosis and clinical implications. J Am Soc Echocardiogr. 2007;20:1315.e5–1315.e8
  12. Shu MC, Gross JM, O'Rourke KK, Yoganathan AP. An integrated macro/micro approach to evaluating pivot flow within the Medtronic ADVANTAGE bileaflet mechanical heart valve. J Heart Valve Dis. 2003;12:503–512
  13. Shu MC, O'Rourke KK, Coppin CM, Lemmon JD. Flow characterization of the ADVANTAGE and St. Jude Medical bileaflet mechanical heart valves. J Heart Valve Dis. 2004;13:814–822
  14. Rakow N, Nelson D, McClay C, Rose R, Leuer L, Boldt C, et al. Chronic, preclinical assessment of the Medtronic Advantage aortic valve prosthesis. J Heart Valve Dis. 2002;11:851–856
  15. Kleine P, Scherer M, Abdel-Rahman U, Klesius AA, Ackermann H, Moritz A. Effect of mechanical aortic valve orientation on coronary artery flow: comparison of tilting disc versus bileaflet prostheses in pigs. J Thorac Cardiovasc Surg. 2002;124:925–932
  16. Reiss N, Seifert D, Koertke H, Hoffmann-Koch A, Kleikamp G, Bairaktaris A, et al. Initial experience with the medtronic ADVANTAGE valve prosthesis in the mitral position—clinical outcome and analysis of complications. Thorac Cardiovasc Surg. 2007;55:149–155
  17. Bakhtiary F, Abolmaali N, Dzemali O, Wittlinger T, Doss M, Moritz A, et al. Impact of mechanical and biological aortic valve replacement on coronary perfusion: a prospective, randomized study. J Heart Valve Dis. 2006;15:5–11
  18. Guenzinger R, Eichinger WB, Botzenhardt F, Bleiziffer S, Wagner I, Bauernschmitt R, et al. Rest and exercise performance of the Medtronic Advantage bileaflet valve in the aortic position. Ann Thorac Surg. 2005;80:1319–1326
  19. Haaverstad R, Vitale N, Karevold A, Cappabianca G, Tromsdal A, Olsen PS, et al. Clinical and echocardiographic assessment of the Medtronic Advantage aortic valve prosthesis: the Scandinavian multicentre, prospective study. Heart. 2007;93:500–505
  20. Kleine P, Klesius AA, Scherer M, Abdel-Rahman U, Moritz A. Initial in vivo results of the new Medtronic Advantage(TM) bileaflet valve in aortic position and comparison to the SJM. Cardiovasc Surg. 2002;10:494–499
  21. Koertke H, Seifert D, Drewek-Platena S, Koerfer R. Hemodynamic performance of the Medtronic ADVANTAGE prosthetic heart valve in the aortic position: echocardiographic evaluation at one year. J Heart Valve Dis. 2003;12:348–353
  22. Korfer R, Svennevig JL, Mohr FW, Leguerrier A, Menicanti L, Olsen PS, et al. The worldwide mid-term experience with the Medtronic ADVANTAGE bileaflet mechanical heart valve. J Heart Valve Dis. 2006;15:404–413
  23. Guenzinger R, Eichinger WB, Botzenhardt F, Bleiziffer S, Wagner I, Bauernschmitt R, et al. A prospective randomized comparison of the Medtronic Advantage Supra and St. Jude Medical Regent mechanical heart valves in the aortic position: is there an additional benefit of supra-annular valve positioning?. J Thorac Cardiovasc Surg. 2008;136:462–471Epub 2008 May 12
  24. Bottio T, Tarzia V, Rizzoli G, Gerosa G. In vitro testing of three totally supra-annular bileaflet mechanical valves: hydrodynamics in the Sheffield pulse duplicator. J Heart Valve Dis. 2008;17:222–226
  25. Autschbach R, Walther T, Falk V, Kostelka M, Rosler A, Langebartels G, et al. Prospectively randomized comparison of different mechanical aortic valves. Circulation. 2000;102(19 Suppl. 3):III1–III4
  26. Rizzoli G, Guglielmi C, Toscano G, Pistorio V, Vendramin I, Bottio T, et al. Reoperations for acute prosthetic thrombosis and pannus: an assessment of rates, relationship and risk. Eur J Cardiothorac Surg. 1999;16:74–80

 Funding: In vitro measurements were performed by Medtronic Inc, Minneapolis, Minnesota.

 Disclosures: Walter Echinger reports consulting/lecture fees and grant support from Medtronic and St. Jude. Andrea Hutter reports lecture fees and grant support from Edwards. Rudiger Lange reports consulting fees and grant support from Medtronic and Edwards.

 The German Heart Center is part of the investigating institutions in the ADVANTAGE trial initiated by Medtronic Inc.

PII: S0022-5223(09)01427-5

doi: 10.1016/j.jtcvs.2009.11.001

The Journal of Thoracic and Cardiovascular Surgery
Volume 140, Issue 3 , Pages 611-616 , September 2010