The closing behavior of Medtronic Hall mechanical heart valves.

Abstract

The rapid deceleration of mechanical heart valve leaflets or discs at closure, and their rebound after impact between the leaflets or discs and housing may produce conditions that favor cavitation inception. Precision measurements of the disc closing velocity using a laser sweeping technique (LST) were made on two Medtronic Hall (Med Hall) mitral valve models, the 29 mm Standard and D-16 Med Hall valves. The experiment was carried out in a pulsatile mock flow loop (PFL) by installing the tested valve in the mitral position of the PFL. Tests were conducted under physiologic pressures at heart rates of 70, 90, and 120 beats/min with flow rates of 5, 6, and 7.5 l/min, respectively. For each valve tested, the experimental series was carried out to include both a flexible mounting and a rigid mounting mechanism. The time history of the disc closing velocity during the last 3 degrees before final closure was measured. Results show that the disc approached the valve housing at a near constant velocity of approximately 1.3, 1.5, and 2.0 m/sec for the Med Hall Standard valve, and 1.9, 2.5, and 2.6 m/sec for the Med Hall D-16 valve at 70, 90, and 120 beats/min, respectively. After impact, the valve of disc rebounded with velocities that depended on the mounting modalities and heart rates. In the rigid mounting, the disc rebound velocities of the Med Hall Standard and D-16 valves were about 60%-70% and 70%-80% of their respective approaching velocities. For the flexible mounting, the rebound velocities were 15%-25% and 20%-30% of their respective approaching velocities. The results demonstrate that a slight modification in the seat stop geometry of Med Hall valves can significantly affect disc closure behavior.