Valve validating rejected

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Unfortunately, this ideal valve substitute does not exist, and each of the currently available prosthetic valves has inherent limitations. Caged ball valves, which consist of a silastic ball with a circular sewing ring and a cage formed by 3 metal arches, are no longer implanted.However, several thousands of patients still have caged ball valves, and these patients require follow-up.Moreover, in the mitral position, the surgeon should implant bileaflet valves in the antianatomic position and monoleaflet valves with their larger orifice oriented posteriorly to ensure more physiological flow patterns.PPM occurs when the EOA of a normally functioning prosthesis is too small in relation to the patient’s body size (and therefore cardiac output requirements), resulting in abnormally high postoperative gradients.Once the prosthesis model and size have been selected, it is important to implant the prosthesis using an optimal surgical technique.

The opening angle of the disk relative to valve annulus ranges from 60° to 80°, resulting in 2 distinct orifices of different sizes.Nonetheless, many of the prosthesis-related complications can be prevented or their impact minimized through optimal prosthesis selection in the individual patient and careful medical management and follow-up after implantation.The purpose of this article is to provide an overview of the current state of knowledge and future perspectives with regard to optimal prosthesis selection and clinical management after valve implantation.To this effect, it should be underlined that the hemodynamic performance is not equivalent for all models of prostheses.Indeed, it is generally superior in newer compared with older generations of prostheses, in mechanical compared with stented bioprosthetic valves, shows that, compared with stented bioprostheses, stentless valves provide larger EOAs, reduced transprosthetic gradients, and greater left ventricular (LV) mass regression, but at the expense of prolonged cardiopulmonary bypass time.

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