Trileaflet Mechanical Valves: What Is Already Known? A Systematic Review

Abstract

Background: Trileaflet mechanical valves were introduced in the late 90’s. Despite promising results, none have made it past preclinical testing. Ample in vitro, in vivo and computational testing have already been done. Methods: This systematic review is intended to summarize all available preclinical and clinical testing regarding trileaflet mechanical valves. A literature search of Pubmed, Embase and Web of Science (Core Collection) (from inception to August 2023) was performed using a search string that was well defined and not modified during the study. An extensive overview of the search terms used in each database can be found in the appendix. 24 publications were included in this review. Results: This systematic review serves as an overview evaluating the rationale behind a trileaflet mechanical valve as well as the computational, in vitro and in vivo testing. We aim to summarize all available knowledge on trileaflet mechanical valves. Conclusions: A trileaflet mechanical valve is a promising concept, with equal or even superior hemodynamics compared to conventional bileaflet valves based on computational, in vivo and in vitro data. First in men trials are warranted to elude the true potential of this design.