Draft #4

 As introduced by Abbott (n.d.-a) in "Surgical heart valves”, the "Masters HP 15 mm Mitral Mechanical Heart Valves" is a mechanical heart valve suitable for treating newborns and babies. Abbott's mechanical valve is considered the gold standard and the world's most trusted mechanical heart valve (Abbott, n.d.-b), producing the world’s smallest 15 mm paediatric mechanical valve that is approved by the U.S. Food and Drug Administration [FDA] (US Food and Drugs Administration, 2018). Its function includes a rotatable bi-leaflet valve designed for secure implantation in the mitral position (Abbott, n.d.-a) for patients with a diseased, damaged, or malfunctioning mitral heart valve. It has unique specifications and design features such as a tissue annulus diameter of only 15 mm (Abbott, n.d.-a). Furthermore, it has a unique design feature, which uses the "Pivot Guard Design,'' which has low thrombogenicity at the forefront of the valve. With several enhanced features like the “Pivot Guard Design” and being the smallest mechanical valve with a “rotatable bi-leaflet valves” function, the Masters HP 15 mm Mitral Mechanical Heart Valve from Abbot is a revolutionary technology that can save newborns and babies with mitral valve problems. 

One important function of Abbott’s artificial heart valve is the rotatable bi-leaflet valve, which has proven low thrombogenicity and excellent patient outcomes through clinical trials (Abbott, n.d.-b). The valve leaflets open up to an 85-degree angle in systole (Abbott, n.d.-b): a process of contraction and ejection of the ventricular on both the left and right heart. The Systole stage of the cardiac cycle “begins when the mitral valve (tricuspid) closes, and concludes with the closure of the aortic valve (pulmonic)”, representing ventricular contraction,  forcing blood into the arteries (Pollock & Makaryus, 2020). The leaflets allow strong, uniform velocities of blood to flow within the hinge recess area, aiding in the washout of blood and preventing blood clots (Abbott, n.d.-b). As compared to caged ball or tilting-disc valves, bi-leaflet carry a lower risk of blood clots (Artificial Heart Valve, 2023). Therefore, the role of the bi-leaflet valves is crucially important for the patients to ensure that blood flows smoothly in the arteries. This will potentially reduce the risk of blood clots, a common complication with currently existing prosthetic valves (Fliesler, 2020).

 

Features-wise, the 15 mm mitral valve uses the rotatable bi-leaflet function, one of the three types of mechanical heart valves: caged ball, tilting-disc and bi-leaflet valves (Artificial Heart Valve, 2023). According to Artificial Heart Valve (2023), a bi-leaflet has a larger opening as compared to a caged ball or tilting-disc valve, which lowers the risk of blood clotting. Despite being the smallest 15mm mitral valve, blood is able to flow through the valve with the help of low thrombogenicity material of the leaflets, lowering the tendency of a material to generate blood clotting, when in contact with blood. This reduces the tendency of blood clotting, which endangers mitral valve patients. Furthermore, the “Pivot Guard Design” helps to shield the pivot mechanism from pannus ingrowth (Abbott, n.d.-b), a growth of abnormal tissue around a prosthetic heart valve, causing the heart valve to be dysfunctional (Ha et al., 2018). This design ensures a consistent 85-degree opening angle of the bi-leaflet valve, promoting minimised leaflet flutter and more laminar flow through the orifice (Abbott, n.d.-b) which helps reduce energy loss in blood flow. It minimises viscous interactions between the adjacent layers of blood and the wall of the arteries (Klabunde, 2022). The two features, improves the flow of blood through the mechanical heart valve, lowering the chance of blood clotting with the selection of bi-leaflet valve with the “Pivot Guard Design”.

 

Being the smallest mechanical valve, the main drawback of Masters HP 15 mm mitral mechanical heart valve is the side effects of lifetime consumption of blood thinner. According to Marcin (2022), long-term consumption of blood thinner has the risk of bleeding, bleeding significantly from small cuts, skin rashes and hair loss. Aside from bleeding-related issues, consumption over a period of time might cause nausea and low blood count, causing fatigue, weakness, dizziness and shortness of breath (Klabunde, 2022), all of which might possibly affect patients’ daily lives.

 

In conclusion,  the Masters HP 15 mm Mitral Mechanical Heart Valve from Abbott targets newborns and babies due to the increase in the number of children left untreated or delayed treatment, resulting in more loss of lives. Its unique features make surgery possible for newborns and babies with mitral valve problems a possible option that can be considered to reduce the number of deaths in newborns and babies due to mitral valve problems.

 

 

References

Abbott. (n.d.-a). Masters Mitral and Aortic Mechanical Valves. Abbott Cardiovascular. https://www.cardiovascular.abbott/us/en/hcp/products/structural-heart/surgical-valve-solutions/masters-mechanical-valves.html

Abbott. (n.d.-b). Mechanical Heart Valves. Structural Heart. https://www.structuralheart.abbott/products/mechanical-heart-valve/regent-valve-masters-series-mechanical-heart-valve

Artificial heart valve. (2023, September 10). In Wikipedia. https://en.wikipedia.org/wiki/Artificial_heart_valve

Fliesler, N. (2020, February 20). Breakthrough bileaflet heart valve could be the only one a child needs - Boston Children's Answers. Boston Children's Answers. https://answers.childrenshospital.org/bileaflet-heart-valve/

Ha, H., Koo, H. J., Huh, H. K., Kim, G. B., Kweon, J., Kim, N., Kim, Y.-H., Kang, J.-W., Lim, T. H., Song, j. K., Lee, S. J., & Yang, D. H. (2018). Effect of pannus formation on the prosthetic heart valve: In vitro demonstration using particle image velocimetry. PLOS. https://doi.org/10.1371/journal.pone.0199792

Klabunde, R. E. (n.d.). Laminar Flow. Cardiovascular Physiology Concepts. https://cvphysiology.com/hemodynamics/h006

Klabunde, R. E. (2022, December 15). 7 Things to Know About Taking Blood Thinners Safely. Mercy. https://www.mercy.net/service/atrial-fibrillation/taking-blood-thinners-safely/

Marcin, A. (2022, December 2). What to Know About Long-Term Blood Thinner Use. Healthline. https://www.healthline.com/health/living-with-atrial-fibrillation/advancements/long-term-blood-thinner-use

US Food and Drug Administration. (2018, March 6). FDA expands approval of replacement heart valve, smallest mechanical valve size approved in the world. https://www.fda.gov/news-events/press-announcements/fda-expands-approval-replacement-heart-valve-smallest-mechanical-valve-size-approved-world 

Pollock, J. D., & Makaryus, A. N. (2020). Physiology, Cardiac Cycle. PubMed; StatPearls Publishing. 

https://www.ncbi.nlm.nih.gov/books/NBK459327/#:~:text=Cardiac%20cycle%20events%20can%20be