The quest for the perfect prosthetic heart valve.

Thirty years have elapsed since the introduction of the first artifical heart valves. Since that time, many improvements have been made in the design and fabrication of prosthethic valves, but the perfect valve remains elusive. After experience with clinical implantation of more than 5000 artificial valves of all types, we designed a new prosthesis which we believe incorporates the best features of the earlier models and reflects our concepts of the best configuration of an artificial valve. Thus far we have implanted over 2500 Cooley-Cutter valves and the results have been gratifying. The valve has a full-orifice design with the metallic frame milled from a single block of medical-grade titanium, has a pyrolite occluder in a double-cone configuration, and Teflon sewing rings to conform to the aortic and mitral annuli. A major problem with prostheses made from synthetic materials is the need for prolonged anticoagulation. The incidence of thromboembolic complications with this valve has been very low and excellent late results encourage us to use this prosthesis routinely except in unusual circumstances.