Comparative hydrodynamic performance study of 28 commercially available prosthetic heart valves

It is always a question how the results from the simulation model can be correlated and utilized for clinical situations. At the National Cardiovascular Center, Osaka, Japan, the selection among tissue valves was switched from porcine to pericardial xenografts in 1980 on the basis of both our in-vitro test data and clinical hemodynamic data. Fig.5 shows the comparable pressure gradients and calculated EOAs of porcine (Hancock) and bovine xenografts (I-S). The solid lines were obtained from the postoperative catheterization data, while the dotted lines were obtained from our in-vitro test data. Clinical and simulation data showed high resemblance to one another. From these results obtained from our in-vitro testing we now feel more confident in selecting better prosthetic valves for clinical use. Among newly developed valves, bileaflet mechanical valves indicated good hydrodynamics in the mitral position, while newly developed bovine pericardial valves exhibited good performance both in the mitral and aortic positions. According to our other in-vitro data, these two types of valves belonged to a group with the smallest resistance under the steady flow condition. Regurgitant volume in xenografts, however, was smaller than in disc valves. Therefore, the difference in EOAs in the aortic position would be attributed to those reasons mentioned above. On the basis of our simulation data, we would prefer to use newly-developed bovine pericardial xenografts in clinical patients as long as other factors required such as antithrombogenicity and durability are satisfactory.