Valve prostheses. Medical search. Frequent questions

METHODS: Demographic, procedural, and in-hospital outcome data on patients who underwent TAVR from 2007 to 2011 were obtained from the U.K. TAVI (United Kingdom Transcatheter Aortic Valve Implantation) registry. (ox.ac.uk)
This document is applicable to heart valve substitutes intended for implantation and provides general requirements. (iso.org)
This document is applicable to newly developed and modified heart valve substitutes and to the accessory devices, packaging, and labelling required for their implantation and for determining the appropriate size of the heart valve substitute to be implanted. (iso.org)
ISO 5840-1 does not provide requirements specific to homografts, tissue engineered heart valves (e.g. valves intended to regenerate in vivo ), and heart valve substitutes designed for implantation in circulatory support devices. (iso.org)
Accurate assessment of the patient's annular size and indexing the effective orifice area (EOA) of the prosthesis to patient's BSA at the time of prosthesis implantation are important steps to preventing future PPM. (ochsner.org)
Endobronchial-valve treatment for advanced heterogeneous emphysema induced modest improvements in lung function, exercise tolerance, and symptoms at the cost of more frequent exacerbations of COPD, pneumonia, and hemoptysis after implantation. (nih.gov)
This guideline lists the 13 parameters you must address when applying to add a Trans-Aortic Valve Implantation (TAVI) device to the Prostheses List. (health.gov.au)
Introdução: Uma nova alternativa de tratamento foi desenvolvida, o Implante por Cateter de Bioprótese Valvar Aórtica (TAVI, em inglês, Transcatheter Aortic Valve Implantation), indicado para os pacientes portadores de estenose aórtica grave com várias comorbidades, considerados inoperáveis pelo tratamento cirúrgico convencional. (usp.br)
Introduction: A new treatment alternative has been developed, the Transcatheter Aortic Valve Implantation (TAVI), indicated for patients with severe aortic stenosis with various comorbidities deemed inoperable by conventional surgical treatment. (usp.br)
Transcatheter aortic valve implantation (TAVI) is a well-recognized and established therapy for severe aortic stenosis, with expanding indications toward younger patients with low surgical risk profile. (frontiersin.org)
Transcatheter aortic valve implantation (TAVI) has been widely recognized as a safe and effective treatment for aortic stenosis (AS) in patients who cannot undergo surgical aortic valve replacement (SAVR) or are at high or intermediate surgical risk ( 1 - 4 ). (frontiersin.org)
Implantation of prosthetic cardiac valves to treat hemodynamically significant aortic or mitral valve disease has become increasingly common. (medscape.com)

In patients with prosthetic heart valves non-cardiac surgery may require temporary discontinuation of oral anticoagulation. (bmj.com)
In the presented patient, unusually fulminant and finally fatal thrombosis of a mechanical mitral valve prosthesis developed within only 48 hours after non-cardiac surgery despite heparin treatment. (bmj.com)
Additionally, cine images depicted a mechanical failure of the artificial pulmonic valve, with the two flaps fixed in the open position throughout the cardiac cycle, caused by thrombus adherent to the left prosthetic valve leaflet. (massgeneral.org)
Because this was an unsuspected finding, and cardiac ultrasound was non-diagnostic (acoustic windows were limited), cine fluoroscopy was performed, confirming that the prosthetic pulmonic valve was fixed in the open position. (massgeneral.org)
ECG-gated CTA multiphase thick MPR and volume rendered (upper right) reformats illustrates fixed position of the leaflets of the artificial pulmonic valve leaflets, with no significant motion throughout the cardiac cycle. (massgeneral.org)
The excellent spatial resolution of CT coupled with the ability to acquire dynamic images with ECG gating, and ability to reconstruct images in any plane, makes cardiac CT the test of choice for detecting thrombus formation and evaluating mechanical valve dysfunction with the lowest radiation dose possible. (massgeneral.org)
Prothesis-patient mismatch (PPM) occurs when there is a mismatch between the effective orifice area (EOA) of the prosthetic valve and the required cardiac output to meet the need of the patient's body surface area (BSA). (ochsner.org)
As one of the highest-volume surgical programs in the country, Nancy & Bill Thompson Heart Valve Center's expert cardiac surgery team is well-versed in the full array of aortic valve surgical options, including complex surgical procedures not available at other centers. (hoag.org)
With advances in modern surgical techniques, cardiac surgeons now have multiple methods to replace the aortic valve using innovative new prosthetic options. (hoag.org)
Materials and Methods: A total of 140 patients with 10 different types of mechanical aortic valves, who underwent dualsource cardiac CT, were included. (elsevierpure.com)
Conclusion: Dual-source cardiac CT accurately measures opening and closing angles in most types of mechanical aortic valves, compared with the manufacturers' values. (elsevierpure.com)
Get answers from Dr. Doug Johnston, Chief of Cardiac Surgery at Northwestern Medicine in Chicago, Illinois, who has performed thousands of heart valve surgeries and successfully treated many patients in our community including Kim Clemens and James Wright. (heart-valve-surgery.com)
Bicuspid aortic valve (BAV) is the most common congenital cardiac malformation, affecting 1-2% of the population, and is the cause of a significant proportion of aortic valve disease in young adults ( 9 ). (frontiersin.org)
In a laboratory with experienced personnel, Doppler-derived aortic valve gradients are accurate and reproducible and correlate well with those obtained during cardiac catheterization. (medscape.com)
Prosthetic material used for cardiac valve repair, such as annuloplasty rings and chords. (dentalcare.com)
Cardiac transplant with valve regurgitation due to a structurally abnormal valve. (dentalcare.com)

This report dramatically shows that despite improvements in prosthetic heart valve design and in the management of anticoagulation, thrombosis remains one of the most dangerous complications after valve replacement with a mechanical prosthesis. (bmj.com)
The incidence of mechanical valve failure has ranged from 8% - 18% in multiple studies, with most failures secondary to thrombosis formation. (massgeneral.org)
However, in tran- due to mechanical valve thrombosis is continued despite medical treatment. (who.int)
In this paper, we report a rare case of myocardial infarction, which occurred as a result of a coronary embolism in a patient with prosthetic mitral valve thrombosis. (who.int)
Mechanical valve thrombosis and the patient presented with non-ST prosthetic valve was non-obstructive causes embolism rarely. (who.int)
Bioprosthetic valves (see the image below) used in heart valve replacement generally offer functional properties (eg, hemodynamics, resistance to thrombosis) that are more similar to those of native valves. (medscape.com)
Complications observed were two cases of obstructive prosthesis thrombosis, a cerebrovascular stroke coming from microthrombosis, an infective endocarditis and a hemorrhagic accident under vitamin K antagonists. (bvsalud.org)

Objectives: The aim of this study was to compare the incidence and prognostic significance of prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR) according to racial groups. (northwestern.edu)
Does patient-prosthesis mismatch after aortic valve replacement affect survival and quality of life in elderly patients? (unige.it)
Background To evaluate the impact of patient-prosthesis mismatch (PPM) on survival, functional status, and quality of life (QoL) after aortic valve replacement (AVR) with small prosthesis size in elderly patients. (unige.it)
Patient Prosthesis Mismatch: What Should You Know? (heart-valve-surgery.com)
Patient Prosthesis Mismatch: How To Avoid It? (heart-valve-surgery.com)
What is patient prosthesis mismatch? (heart-valve-surgery.com)

Although the risk of valve related thromboembolic complications may generally be only slightly increased during the short perioperative period, in the presence of certain risk factors, replacement of oral anticoagulation with heparin is recommended. (bmj.com)
To evaluate the outcome of pregnancy in women with mechanical heart valve prostheses in relation to the anticoagulant treatment used in the first trimester and the incidence of thrombotic and bleeding complications. (qxmd.com)
Hemorrhagic complications necessitating hospitalization occurred in 15% of patients with mechanical valves and 7% of patients with bioprostheses (P = .01). (elsevierpure.com)
Replacement of diseased valves with prosthetic heart valves reduces the morbidity and mortality associated with native valvular disease, but it comes at the expense of risking complications related to the implanted prosthetic device. (medscape.com)
The objective of this study was to describe the clinical and etiological particularities of mechanical valve prostheses complications. (bvsalud.org)

Fluoroscopic cine imaging of the artificial aortic and pulmonic valves confirms normal motion of the aortic valve leaflets, and fixed position of the pulmonic valve leaflets. (massgeneral.org)
For decades, India relied on imports of expensive artificial valve replacements to meet domestic need, but many families whose children developed RHD were also among the poorest in India, and could not afford even the heavily discounted price tags of imported valves, which hovered around $1,200 each. (globalhealth.care)
The Chitra valve project sought to address this significant public health challenge by creating an affordable, high quality artificial heart valve for India. (globalhealth.care)
From the perspective of the Indian public, the device may have fulfilled its purpose by crashing prices for most artificial heart valves. (globalhealth.care)
First, as a Class III medical device, price becomes less important relative to quality, and the bileaflet artificial valve models--though much more expensive--have marginally better performance in many use cases. (globalhealth.care)
An artificial heart valve is a one-way valve implanted into a person's heart to replace a heart valve that is not functioning properly (valvular heart disease). (wikipedia.org)
Artificial heart valves can be separated into three broad classes: mechanical heart valves, bioprosthetic tissue valves and engineered tissue valves. (wikipedia.org)
While some dysfunctional valves can be treated with drugs or repaired, others need to be replaced with an artificial valve. (wikipedia.org)
The three main types of artificial heart valves are mechanical, biological (bioprosthetic/tissue), and tissue-engineered valves. (wikipedia.org)
In the US, UK and the European Union, the most common type of artificial heart valve is the bioprosthetic valve. (wikipedia.org)
The first artificial heart valve was the caged ball valve, a type of ball check valve, in which a ball is housed inside a cage. (wikipedia.org)
During aortic valve replacement surgery, the damaged valve is removed and replaced with an artificial valve called a prosthetic valve. (hoag.org)
Do you have an artificial heart valve? (dentalcare.com)
Overview of Limb Prosthetics A limb prosthesis is an artificial limb that replaces a missing body part. (msdmanuals.com)
They may use a prosthesis (an artificial breast) in their bra that gives them a natural shape, or they may choose to use nothing at all. (medlineplus.gov)

Patients with heart valve prosthesis (HVP) and Staphylococcus aureus bacteremia (SAB) are at risk for endocarditis. (lu.se)
Objectives: A rapid-growing mycobacteria biological prosthetic valve (BPV) endocarditis related to prosthetic manufacturing process is described in Brazil.Methods: From 1999 to 2008, thirty-nine patients underwent BPV replacement due to culture-negative suspected endocarditis. (unifesp.br)
There are many potential causes of heart valve damage, such as birth defects, age related changes, and effects from other disorders, such as rheumatic fever and infections causing endocarditis. (wikipedia.org)
A history of fever should raise the possibility of prosthetic valve endocarditis (PVE). (medscape.com)

Rodríguez-Caulo and colleagues report a retrospective multicenter study on almost 1,500 patients aged 50-65 who underwent aortic valve replacement with mechanical or biological prosthesis. (ctsnet.org)
We compared late results of contemporary bioprostheses and bileaflet mechanical prostheses in patients who underwent aortic valve replacement between 50 and 70 years old. (elsevierpure.com)
01). Conclusion: In this study, patients aged 50 to 70 years who underwent aortic valve replacement with mechanical valves had a survival advantage relative to matched patients who received bioprostheses. (elsevierpure.com)
Methods Between January 2005 and December 2013, 152 patients with pure aortic stenosis, aged at least 75 years, underwent AVR, with a 19 or 21mm prosthetic heart valve. (unige.it)
In a retrospective cohort analysis of 4253 patients who underwent primary isolated aortic-valve replacement, 15-year survival and stroke rates were equivalent with bioprosthetic and mechanical valves. (medscape.com)
At some point in the remote past, there was this 70-year-old gentleman who underwent a mitral-valve repair. (medscape.com)

however, reoperation was more frequent among those with a biological prosthesis. (ctsnet.org)
01). Freedoms from reoperation at 10 years were 98% for mechanical valves and 91% for bioprostheses (P = .06). (elsevierpure.com)
Distinction of thrombus from pannus on obstructed prosthetic valves is essential because thrombolytic therapy has emerged as an alternative to reoperation. (nih.gov)
The reoperation rate was 12.1% in the bioprosthetic valve group at 15 years and 6.9% in the mechanical valve group, while major bleeding occurred in 6.6% of bioprosthesis patients and in 13.0% of the mechanical-valve group. (medscape.com)

Twenty patients received a stentless valve and 13 a stented valve. (uea.ac.uk)
Newer generationmechanical valves have shown less PPM than older generation, and stentless bioprosthesis have less PPM than stented prosthesis.Long-termclinical outcome of PPMis associatedwith adverse cardiovascular events especially in the presence of pre-existing left ventricle dysfunction or with concomitant procedure such as coronary artery bypass graft surgery. (ochsner.org)
Sutureless valves, stentless valves and valved conduits are not included. (iso.org)
Three of these options include: homograft aortic valves (from a human donor), mechanical aortic valve replacement, and stentless aortic valve replacement. (hoag.org)

Nancy & Bill Thompson Heart Valve Center is one of a handful of clinics nationwide dedicated to state-of-the-art screening, diagnosis, and treatment of valvular heart disease. (hoag.org)

Some of the provisions of ISO 5840-1 can be applied to valves made from human tissue that is rendered non-viable. (iso.org)
While most patients undergo pulmonary valve replacement with a tissue valve, the more durable mechanical valve can also be used, which necessitates permanent systemic anticoagulation. (massgeneral.org)
What Is So Unique About Heart Valve Replacements Made From Horse Tissue? (heart-valve-surgery.com)
Medtronic's tissue valve expertise benefits from more than 40 years of experience, research, and skill, allowing us to provide the world with not only choice, but with advanced features that make a difference in patients' lives. (medtronic.com)
Our third generation of tissue valve technology brings you AOA ® tissue treatment, the Physiologic Fixation™ process, and now, the Cinch ® Implant System - demonstrating our commitment to innovation. (medtronic.com)
The latest addition to Medtronic's tissue valve portfolio, 3f ® Aortic Bioprosthesis, is the only pericardial tissue valve designed to function like a native human aortic valve. (medtronic.com)
Age, calcium metabolism and glutaraldehyde pretreatment all contribute to the failure of tissue valves. (medtronic.com)
AOA treatment is Medtronic's biochemical approach to mitigating calcification in the wall and leaflets of tissue valves. (medtronic.com)
1,2,3 The Physiologic Fixation process, used in Medtronic's third generation tissue valves, was developed to address the problem of structural valve deterioration caused by mechanical stress and is designed to maintain native collagen structure and porcine aortic root and leaflet geometry. (medtronic.com)

The left ventricle pumps blood to the aorta through the aortic valve. (wikipedia.org)
Bentall with Bioprosthesis is a replacement of the aortic valve, root, and the entire ascending aorta, utilizing a graft. (hoag.org)

Anticoagulation in pregnant women with mechanical heart valve prostheses. (qxmd.com)
Caged ball valves are strongly associated with blood clot formation, so people who have one required a high degree of anticoagulation, usually with a target INR of 3.0-4.5. (wikipedia.org)
Duration of symptoms, anticoagulation status and qualitative and quantitative ultrasound intensity of the mass obstructing a mechanical prosthetic valve can help differentiate pannus formation from thrombus and may therefore be of value in refining the selection of patients for thrombolytic therapy of prosthetic valve obstruction. (nih.gov)
Conclusion: These clinical cases highlight the difficulties related to the monitoring of long-term anticoagulation in patients with mechanical valve prosthesis in our context. (bvsalud.org)

After being oxygenated, blood passes to the left atrium, where is it pumped through the mitral valve to the left ventricle. (wikipedia.org)

As bicuspid aortic valve (BAV) affects ~1-2% of the population, it may be speculated that an increasing number of patients with degenerated BAV may eventually need TAVI during the course of the disease. (frontiersin.org)
Peculiar features such as larger dimensions of the aortic valve components, higher calcium burden, presence of a heavily calcified raphe, and associated aortopathy represent some pitfalls when treating BAV patients with TAVI. (frontiersin.org)

Mechanical valves come in three main types - caged ball, tilting-disc and bileaflet - with various modifications on these designs. (wikipedia.org)

Opening angles on CT differ according to the type of valve dysfunction and a decreased opening angle may suggest an elevated PG. (elsevierpure.com)

The tests can include those to assess the physical, chemical, biological, and mechanical properties of heart valve substitutes and of their materials and components. (iso.org)

We compared the safety and efficacy of endobronchial-valve therapy in patients with heterogeneous emphysema versus standard medical care. (nih.gov)
Repairing versus replacing the aortic valve is determined by a number of factors, such as the anatomy of the valve and the degree of its disease. (hoag.org)

There's also color flow coming in through the mitral prosthesis into the left ventricle. (medscape.com)

Long-Term Durability of Transcatheter Aortic Valve Prostheses. (ox.ac.uk)
BACKGROUND: Very little is known about long-term valve durability after transcatheter aortic valve replacement (TAVR). (ox.ac.uk)
Not only does it feature genuine design and material science innovations around in-vitro noise reduction, blood flow resistance reduction, and durability, but the valve also uses the highest quality materials and manufacturing for the frame, occluder, and sewing ring components. (globalhealth.care)
citation needed] The major advantage of mechanical valves over bioprosthetic valves is their greater durability. (wikipedia.org)
Objective: Improved durability of bioprostheses has led some surgeons to recommend biologic rather than mechanical prostheses for patients younger than 65 years. (elsevierpure.com)
Pressure fixation of valves can compromise the function and durability of the bioprosthesis. (medtronic.com)

Results of valve replacement with Omniscience prostheses. (lvhn.org)
Surgical replacement of the mechanical pulmonic valve as well as reconstruction of the main pulmonary arteries was performed, with resolution of symptoms. (massgeneral.org)
Facing such disruption from an indigenous entrant, the MNCs all lowered their prices for replacement valves to parity with Chitra's as a way to stay in the market. (globalhealth.care)
This targets a substantial portion of the market for valve replacement as mitral valve regurgitation is the most common form of heart valve disease in the U.S., suggesting that there are even more Mitral Valve Replacement surgeries per year than the 20,000 or so Aortic Valve Replacement surgeries per year. (globalhealth.care)
In this case, valve replacement may be performed. (hoag.org)
The good news is Hoag was the first center in Orange County to offer a ground-breaking minimally-invasive procedure for individuals who need aortic valve replacement called Transcatheter Aortic Valve Replacement (TAVR) . (hoag.org)
However, when a valve is not projected to last that long, a replacement approach will be used. (hoag.org)
Can it be avoided for patients needing heart valve replacement surgery? (heart-valve-surgery.com)
She had no risk factors for coronary artery disease in her medical history but it was learned that she had undergone a mitral valve replacement 2 years before because of rheumatic mitral stenosis and that no international normalized ratio (INR) analysis had been done in the last 6 months. (who.int)

Only serious cardiovascular surgery centers perform heart valve replacements, and these will likely opt for products that exhibit even marginal medical benefit over others, at least to protect themselves from unnecessary legal liabilities. (globalhealth.care)

citation needed] Companies that manufacture heart valves include Edwards Lifesciences, Medtronic, Abbott (St. Jude Medical), CryoLife, and LifeNet Health. (wikipedia.org)
Special focus is paid to the interaction of such helical flow with different designs of mechanical prosthetic heart valves, comparing a classical bileaflet mechanical heart valve, the St. Jude Medical Regent valve (SJM Regent BMHV), with the Triflo trileaflet mechanical heart valve T2B version (Triflo TMHV). (city.ac.uk)

ISO 5840-1 defines operational conditions for heart valve substitutes. (iso.org)
There is debate about the differential effects of valve substitutes. (uea.ac.uk)
An obvious step in the development of heart valve substitutes was the use of naturally occurring heart valves. (writework.com)

Mechanical valve throm- bosis is a serious complication [2-4]. (who.int)
Signs and symptoms of prosthetic heart valve malfunction depend on the type of valve, its location, and the nature of the complication. (medscape.com)
Clinical cases: five observations of patients presenting with a complication of mechanical valve prostheses collected in the cardiology department of the Libreville University Hospital Center during the period from January 2017 to December 2021, were reported. (bvsalud.org)

We analyzed clinical, transthoracic and transesophageal echocardiography (TEE) data in 23 patients presenting with 24 obstructed prosthetic valves and compared the findings to pathology at surgery. (nih.gov)

The human heart contains four valves: tricuspid valve, pulmonary valve, mitral valve and aortic valve. (wikipedia.org)
A heart contains four valves (tricuspid, pulmonary, mitral and aortic valves) which open and close as blood passes through the heart. (wikipedia.org)
From there, blood is pumped through the pulmonary valve to enter the lungs. (wikipedia.org)
Endobronchial valves that allow air to escape from a pulmonary lobe but not enter it can induce a reduction in lobar volume that may thereby improve lung function and exercise tolerance in patients with pulmonary hyperinflation related to advanced emphysema. (nih.gov)
And the continuous-wave Doppler through the pulmonic valve and pulmonary artery as well. (medscape.com)
We've seen that, and the manifestations of that would be high velocities to the pulmonic valve and pulmonary artery. (medscape.com)

Although coronary embolism was performed because her chest pain tral prosthetic valve. (who.int)
We did not perform acute coronary syndrome, coronary elevation myocardial infarction, whereas angioplasty because the obstruction embolism should be kept in mind in the rest present with non-ST elevation was in the distal portion of the vessel those with prosthetic valves even in the myocardial infarction [8]. (who.int)

In contrast, the two parallel leaflets for the bileaflet valve impose a flow straightener effect, annihilating the angular momentum, which has a negative impact on kinetic energy of the flow. (city.ac.uk)
Medtronic Open Pivot™ mechanical heart valves bring something fundamentally different to bileaflet valve design. (medtronic.com)

This was mostly due to extension of thrombi into the left atrium in prosthetic mitral valves. (nih.gov)

Using the modified Bernoulli equation, a maximum instantaneous and mean aortic valve gradient can be derived from the continuous-wave Doppler velocity across the aortic valve. (medscape.com)

The following warning will also be added to the Edwards SAPIEN 3 Ultra Transcatheter Heart Valve System IFU: " Failure to use slow, controlled inflation and prescribed nominal inflation volumes may result in balloon rupture, difficulty retrieving the delivery system, and may require subsequent conversion to surgical intervention. (fda.gov)
Specifies an approach for verifying/validating the design and manufacture of a transcatheter heart valve substitute through risk management. (saiglobal.com)
For these peculiarities and the higher rates of paravalvular leak (PVL), new permanent pacemaker (PPM), need for a second transcatheter heart valve (THV), risk of annulus rupture or aortic dissection, and brain injury ( 13 - 15 ) BAV patients have been initially excluded from the randomized trials. (frontiersin.org)

We sought to determine the clinical and echocardiographic parameters that differentiate thrombus from pannus formation as the etiology of obstructed mechanical prosthetic valves. (nih.gov)

Outside echocardiography (oblique parasternal view) of the pulmonic valve prosthesis was limited by significant shadowing artifact from the prosthetic valve leaflets. (massgeneral.org)
ECG-gated CTA multiphase thick MPR and volume rendered (upper right) reformats illustrates normal opening of the leaflets of a well-seated mechanical aortic valve. (massgeneral.org)
citation needed] Introduced in 1979, bileaflet valves are made of two semicircular leaflets that revolve around struts attached to the valve housing. (wikipedia.org)

OBJECTIVES: This study sought to evaluate the incidence of structural valve degeneration (SVD) 5 to 10 years post-procedure. (ox.ac.uk)

Fourteen valves had thrombus and 10 had pannus formation. (nih.gov)
Abnormal prosthetic valve motion was detected by TEE in all cases with thrombus formation but in 60% with pannus (p=0.0198). (nih.gov)

Prosthetic heart valve, which includes transcatheter-implanted prostheses and homografts. (dentalcare.com)

Caged ball valves are no longer implanted. (wikipedia.org)

Anatomy9

Diseases19

Chemicals and Drugs9

Analytical, Diagnostic and Therapeutic Techniques and Equipment53

Phenomena and Processes3

Technology, Industry, Agriculture6

Named Groups1

Health Care3

Implantation12

Cardiac16

Thrombosis7

Mismatch6

Complications5

Artificial15

Endocarditis4

Underwent6

Reoperation4

Stentless4

Valvular1

Tissue9

Aorta2

Anticoagulation4

Pumped through the mitral valve1

TAVI2

Tilting-disc and bileaflet1

Dysfunction1

Biological1

Versus2

Left ventricle1

Durability6

Replacement9

Cardiovascular1

Jude Medical2

Substitutes3

Complication3

Pathology1

Pulmonary6

Embolism2

Bileaflet valve2

Prosthetic mitral1

Aortic valve gradient1

Transcatheter heart valve3

Mechanical prosthetic1

Leaflets3

Structural valve1

Pannus2

Homografts1

Ball valves1