Medtronic Hall™ Mechanical Heart Valve

Suture Techniques

A variety of suture techniques have been used successfully by cardiac surgeons. While any suture technique may be used to implant this valve, certain techniques have different advantages and/or disadvantages.

Interrupted Everting Mattress

This is probably the most common technique used to implant mechanical heart valves — with or without pledgets. This technique provides a safe and quick implant. However, the everting of the annulus results in a smaller orifice in which to implant the valve. In the mitral position especially, it has been suggested that multiple suture tails may serve as a nidus for thrombus formation.

Non-Everting Mattress

The non-everting mattress technique is becoming increasingly popular as a quick alternative method which does not draw in the annulus like the everting style. Care must be taken to avoid annular tissue encroachment of the valve inflow rim, reducing the size of the orifice and potentially causing leaflet malfunction.

Simple Suture

Use of simple sutures is an excellent suturing technique, enabling maximal valve size within the annulus and allowing placement of the knots far away from the valve mechanism. This is the preferred Medtronic Hall suture technique of Dr. Manuel Antunes (Coimbra, Portugal) and of Dr. Tirone David (Toronto, Canada).

Figure-of-Eight

The figure-of-eight technique is another suitable technique maintaining excellent annular dimensions (like simple sutures) with the added benefit of reducing the number of sutures to tie.

Continuous, Running

This is the preferred technique by surgeons who want to reduce the quantity of foreign material exposed to blood. Running sutures eliminates the many suture tails common to the above mentioned techniques. This technique is preferred by Dr. Eric Butchart, FRCS, for his mitral valve replacements because it holds the valve high in the annulus and minimizes suture tails, while "wrapping" the annulus within the sewing ring flange.