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The three main types of artificial heart valves are mechanical, biological (bioprosthetic/tissue), and tissue-engineered valves. In the US, UK and the European Union, the most common type of artificial heart valve is the bioprosthetic valve. Mechanical valves are more commonly used in Asia and Latin America.
Decellularized tricuspid biological heart valve. Biological scaffolds can be created from human donor tissue or from animals; however, animal tissue is often more popular since it is more widely accessible and more plentiful. [10] Xenograft, from a donor of a different species from the recipient, heart valves can be from either pigs, cows, or ...
The valve is excised 4–5 mm from the annulus, leaving intact the attached chordae unless they are calcified or otherwise diseased. The valve is replaced by a mechanical or bioprosthetic valve. The replacement valve is sewn into the annulus with interrupted or horizontal mattress sutures with the pledgets on the atrial side. [17]
Valve sparing aortic root replacement (VSARR) is an alternative procedure to the composite aortic valve graft (CAGVR, Bentall procedure). A notable benefit of VSARR is the reduced need for anticoagulation, as the patient's own aortic valve is spared and does not need to be replaced with a mechanical or bioprosthetic valve. [11]
Conventional mechanical valves used for replacement require anti-coagulation therapy which decreases quality of life. [4] Xenogeneic biological values require glutaraldehyde treatment to decrease the immune response to the foreign valve. [12] Still these valves eventually calcify and durability of the valve is decreased.
Tissue valves deteriorate more rapidly in young patients and during pregnancy, but they are preferable for women who wish to have children because pregnancy increases the risk of blood clots. Typically, a mechanical valve is considered for patients under 60 years old, while a tissue valve is considered for patients over the age of 65 years. [13]
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The physico-chemical and biological properties of the natural porcine aortic valve have been profoundly altered by various interventions in order to adapt it for therapeutic means. In this way, the porcine valve has lost all its primordial characteristics except its shape which remains unchanged and unchangeable.