Percutaneous heart valves performance

The crucial role of the heart in serving as the pump to maintain a continuous blood supply to all the organs of the body depends on flexible heart valve leaflets that need to cycle back and forth with each beat of the heart. This occurs about 100,000 times each day and places exceptionally high demand on the bending fatigue performance of a prosthetic heart valve material, which should yet be required to last some minimum number of years. The development of a percutaneously delivered textile based heart valve with flexible and fatigue resistant leaflets is described in Chapter 16. This prototype under development shows promise based on the in vitro fatigue work and animal trials aheady conducted. 

The latest major breakthrough pertains to the development of percutaneous bioprosthetic heart valves. The first deployment of a porcine heart valve contained within a stent using a percutaneous approach in an animal heart was achieved by Andersen et al. in 1992 [10]. The first human implant was performed 9 years later by Bonhoeffer et al. [11]. In this procedure, a valve was implanted in the pulmonary position... 

Invasive hemodynamic monitoring usually is performed with a flow-directed pulmonary artery (PA) or Swan-Ganz catheter placed percutaneously through a central vein and advanced through the right side of the heart and into the PA. Inflation of a balloon proximal to the end port allows the catheter to wedge, yielding the PAOP, which estimates the pulmonary venous (left atrial) pressure and, in the absence of intracardiac shunt or mitral valve or pulmonary disease, left ventricular diastolic pressure. Additionally, cardiac output may be measured and systemic vascular resistance (SVR) calculated. Normal values for hemodynamic parameters are listed in Table 14—12. 

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