Research Pathway (Philbert & Zhou Min)

 Zhou Min and I decided to work on biomedical engineering systems as we both had similar interests and studied similar modules when we were in polytechnic previously. We want to work on medical devices focusing on circulatory systems, especially heart valves. As we know, cardiovascular diseases are the leading cause of death not only among the elderly but also among the younger generation of patients suffering from cardiovascular issues. Among all cardiovascular diseases, mitral stenosis is a relatively common disorder that can be associated with high morbidity and mortality if left untreated. The most common treatment for heart valve disease is surgical replacement. However, due to the lack of heart donors, artificial valves are then produced.

We first read news articles on existing heart valves available in the current market and companies developing the valves using Google and Google Scholar.

There are three different types of mitral valves, which include mechanical, bioprosthetic and tissue valves. All these devices have significant limitations, with risks of further morbidity and mortality. We then proceeded with further research and summarised the pros and cons in the table below.

Types of aortic valves	Pros	Cons
1. Mechanical Aortic valves	>More durable, have a longer life span of 20 to 30 years >No contraindication to anticoagulation with Vitamin K antagonist >Lower risk of subsequent valve replacement or repair	>Consumption of blood thinner for life >Not suitable for women of childbearing age >Not suitable for patients prone to fall
2. Bioprosthetic Aortic Valves	>More suitable for older patients	>Shorter life span of 10 to 15 years >Higher risk of subsequent valve replacement or repair >Not very suitable for patients of younger age
3. Tissue Aortic Valves	>No lifelong warfarin therapy to prevent the development of blood clots	>Shorter life span of 10 to 20 years >Poor durability due to the valves being designed with animal/human tissues

Figure 1

Image of a mechanical aortic valve

Minimally Invasive and Bloodless Heart Surgery Center. (2018, November 6). All About Mechanical

Heart Valves | Heart Surgery Information. Heart Surgery Information.

https://heartsurgeryinfo.com/mechanical-heart-valves/

Figure 2

Placement of a bioprosthetic mitral heart valve in a human body

Transcatheter Bioprosthetic Mitral Heart Valve | AMI: 2017 Annual Conference. (n.d.). https://meetingarchive.ami.org/2017/project/1117-2-16-6-2-14-2-2-2-2-2-2-2-2-2-2-2-2-2-2-2-2/

Figure 3

An example of a tissue valve

Ahmed, Dr. M. (2017, September 10). Heart valve surgery - mechanical vs. Bioprosthetic – which is better? • Myheart. MyHeart.

https://myheart.net/articles/heart-valve-surgery-mechanical-vs-bioprosthetic-which-is-better/

In conclusion, all three different types of mitral valves have their pros and cons. Other than the different types of valves, the brand of the valves as well as the skills of the surgeons also play an important role in a patient's surgery and post-surgery. We then compare different companies and different types of mitral heart valves, as well as the pros and cons of each individual valve we come across. We use the information given from the official websites of the company to know more in detail about the specification of the valves, cross-referencing with supporting websites or news that is related to the progression or problems faced when using that particular aortic valve. We then narrow down our leads and decide which valve will be more suitable for our project, as all valves have their strengths and weaknesses. It really depends on who our target audience or patients are and what types of risks each individual patient might encounter.

 After further understanding, we decided to focus on mechanical heart valves, specifically Abbott’s Masters HP 15 mm Mitral Mechanical Heart Valves, as we aim to target younger patients who require artificial aortic valves as our priority. The reason for picking the younger generation, which includes newborns and babies, is due to research that stated statistics and numbers of younger patients in Singapore and globally not being able to receive proper treatment due to their age and body size.

Reference:

1)https://heartsurgeryinfo.com/mechanical-heart-valves/

2)https://meetingarchive.ami.org/2017/project/1117-2-16-6-2-14-2-2-2-2-2-2-2-2-2-2-2-2-2-2-2-2/

3)https://www.ncbi.nlm.nih.gov/books/NBK564339/#:~:text=The%20mechanical%20aortic%20valve%20has,done%20at%20a%20younger%20age.

4)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4526499/#:~:text=Mechanical%20heart%20valves%20are%20made,place%20of%20the%20original%20valve.

5)https://www.heart-valve-surgery.com/learning/biological-replacement-durability-epic-plus/#:~:text=Tissue%20valves%20or%20bioprosthetic%20valves%20generally%20can%20last%20anywhere%20from,they%20are%20likely%20to%20last.

6)https://www.health.harvard.edu/heart-health/valve-replacement-mechanical-or-tissue#:~:text=Tissue%20valves%2C%20which%20are%20made,to%20outlive%20their%20new%20valves.

7)https://heartsurgeryinfo.com/mechanical-heart-valves/

8)https://meetingarchive.ami.org/2017/project/1117-2-16-6-2-14-2-2-2-2-2-2-2-2-2-2-2-2-2-2-2-2/

9)https://myheart.net/articles/heart-valve-surgery-mechanical-vs-bioprosthetic-which-is-better/

10)https://www.singhealth.com.sg/patient-care/conditions-treatments/adult-congenital-heart-disease-achd

11)https://www.marchofdimes.org/find-support/topics/planning-baby/congenital-heart-defects-and-critical-chds