Evolution of prosthetic heart valves

Abstract

Cardiovascular disease is the leading cause of mortality and morbidity globally. Several subtypes of cardiovascular disease require innovative surgical and interventional diagnostic and therapeutic procedures and devices which are composed of highly advanced biomaterials. The recognition and understanding of complications of these devices, many of them related to the biomaterials that comprise them, has led to iterative efforts to improve their performance and safety through biomaterials and device research and development which have been translated into better patient care.This chapter and the one following summarize key considerations in cardiovascular medical devices, including the underlying pathology of the conditions they are designed for and used to treat, relevant biomaterials of which they are fabricated, and the most important complications that need to be avoided, mitigated or managed. This chapter emphasizes biomaterials and engineering design issues relevant to cardiac valve prostheses, pacemakers and implantable cardioverter-defibrillators, implantable cardiac assist devices and artificial hearts, and miscellaneous intra-cardiac devices, including percutaneous catheter-based techniques to treat cardiovascular disease in a minimally invasive manner, such as septal defect closure devices, and left atrial occlusion devices. The following chapter discusses devices used for vascular repair and replacement (including vascular grafts and endovascular stents and stent grafts), filters to prevent pulmonary embolism, catheters and other cardiovascular devices that reside outside the heart.