SILIGURI INSTITUTE OF

TECHNOLOGY

Name:-Moina Ersad.
B-Tech ,2nd Year ,4th Semester
Department of Biomedical
Engineering.
Roll No.:-11931061009
Session:-2007-2008
Guide Teacher:-Sujan K.Samanta
Topic of Seminar:-

“ARTIFICIAL HEART
VALVES”
HEART:-
Heart is a vital part of the human
anatomy, as it functions as a pump to
circulate blood throughout the body .
It consists of four chambers , namely the
right atrium ,the right ventricle ,the left
atrium and the left ventricle.
By the pumping
action of the heart,
oxygenated blood is
circulated
throughout the
body, and the
deoxygenated blood
is circulated back to
the heart ,to regain
the oxygen that was
lost.
HEART VALVES:-
Heart valves are very important ,as
they prevent the backflow of blood
.This ensures the proper direction of
blood flow throughout the circulatory
system .Without these valves the heart
would have to work much harder to
push blood to the adjacent chambers.
There are four types of heart valves-
• Tricuspid valves
• Pulmonary valves
• Bicuspid or Mitral valves
• Aortic valves
HEART VALVE PROBLEMS:-
Heart valves are prone to disease and
malfunction ,and can be replaced by
artificial heart valves .These complications
and diseases of heart valves can prevent
the proper flow of blood throughout the
body.
They are of two types:-
• Stenosis
• Incompetence
• STENOSIS:-A stenotic heart valve
prevents the valve from opening fully
,due to stiffened valve tissue .Hence there
is more work required to push blood
through the valve.

• INCOMPETENCE:-Incompetent valves
cause inefficient blood circulation by
permitting backflow of blood in the heart.
Echocardiogram of aortic valve stenosis: calcified leaves
arrowed
TREATMENT OPTIONS
On a large scale, medication is the best
alternative ,although in some cases
defective valves have to be replaced by
prosthetic valve, in order to make the
patient lead a normal life. A lot of
research work is being done by
scientists and engineers to design a
heart valve that can withstand millions
if not billions of cardiac cycle.
Original photo of a replaced heart valve
TYPES OF PROSTHETIC HEART
VALVES
There are two main types of Prosthetic heart
valve designs:-
• Mechanical
• Bioprosthetic

The mechanical valves are excellent in terms of

durability, but have a tendency to coagulate
blood.
Bioprosthetic valves are less durable and must
be replaced periodically.
The operating principle of different types of prosthetic
heart valves
MECHANICAL HEART VALVES
• The first mechanical prosthetic heart valve was
implanted in 1952.
• Over the years 30 different mechanical designs
have originated worldwide.
• These valves have progressed from simple caged
ball valves to modern bileaflet valves.
• They emphasize on producing more central flow
and reducing blood clots.
• The common types of mechanical prosthetic
heart valves are caged ball, tilting disc, bileaflet
valve.
Different types of mechanical heart
valves
 Caged ball design:-

• The caged ball

design is one of the
early mechanical
heart valves.
• They use a small ball
that is held in place
by a welded metal
cage. It limits the
flow of fluids in a
single direction.
But there are certain disadvantages of caged ball
designs.
• Caged ball designs completely block central
flow, therefore the blood requires more energy
to flow around the central ball.
• The ball causes damage to blood cells due to
collisions.
• These damaged blood cells release clotting
ingredients. As a result, the patients are required
to take lifelong prescriptions of anticoagulants.
Tilting disc design:-
• This new class of prosthetic valves were
introduced in the mid 1960s.
• They used a tilting disc, that better mimic
the natural patterns of blood flow.
• The tilting disc valves have a polymer disc
held in place by two welded struts.
• The disc floats between two struts in such
a way, as to close when the blood begins
to move backward, and then reopens
when the blood begins to travel forward.
A tilting disc heart valve
A 3-D image of tilting disc valve
There are certain advantages of tilting disc design
over caged ball design:-
• They provide improved central flow while still
preventing backward flow.
• They reduce mechanical damage to blood cells.
Hence there is a reduced chance of blood
clotting and infection.
The main disadvantage of the tilting disc design
is:-
There is a tendency of the outlet struts to fracture,
resulting from fatigue, due to repeated ramming
of the struts by the disc.
Bileaflet valve:-

• In 1979 ,a new type of mechanical heart

valve was introduced, known as the
bileaflet valve.
• It consists of two semicircular carbon
leaflets that pivot on hinges.
• The carbon leaflet exhibit high strength
and excellent biocompatibility.
• The leaflets swing open parallel to the
direction of blood flow.
• They constitute majority of the modern
valve designs.
A bileaflet prosthetic valve
Bileaflet valve replacement
The main disadvantage of bileaflet valve is
that, they do not close completely, which
allows some backflow of blood. Since
backflow is one of the properties of
defective valves, so bileaflet valves are
still not the ideal valves.
The main advantage of these valves is that,
they provide the closest approximation to
central flow, normally achieved in a
natural heart valve.
Bioprosthetic heart valves
Bioprosthetic
valves can be
broken into
two groups:-
• Human tissue
valves
• Animal tissue
valves
Human tissue valve:-

Human tissue valves fall into two

categories:-
Homograft:-It is a valve that is
transplanted from a deceased person
to a recipient. It suffers minimum
problems of valve rejection, and
hence do not require
immunosuppressive therapy .They
are more durable.
Autograft:-They are taken from the
same patient they are implanted
into. The most common autograft
procedure is the Ross procedure,
Animal tissue valves:-

The animal tissue valves are often referred

to as heterograft or xenograft valves.
These are the animal heart tissues which
are often recovered from animals at the
time of commercial processing.
The most commonly used animal tissues
are:
• Porcine-valve tissue obtained from pig
• Bovine-pericardial tissue obtained from
cow.
A porcine valve
A Bovine valve
Heart valve replacement
Advantages of Bioprosthetic heart
valve over mechanical heart valve
• The design of the bioprosthetic
heart valve is closer to the design
of natural valve.
• The bioprosthetic valves do not
require long term anticoagulants.
• They have better haemodynamics.
• They do not cause damage to
blood cells
• They do not suffer from many of
the structural problems,
experienced by the mechanical
Conclusion:-
When one of the valves of the heart becomes
infected with disease, it can be replaced
with one of several different types of
prosthetic valves.
The prosthetic valves must meet certain
standards with regard to inertia, strength,
elasticity and electrochemical properties.
The replacement valve must also be durable
as the human body is a harsh place for
foreign objects, which can corrode or
breakdown.
References:-
• Biomaterials by Sujata Bhatt
• www.clevelandclinic.org
• www.atsmedical.com
• www.wikipedia.org
• www.yeastinfectionadvisor.com