Reader response draft 2

According to the webpage "Mechanical Heart Valves", Abbott introduces the Masters HP 15mm Mitral Mechanical Heart Valves, the only mechanical heart valve in the world designed to treat new-borns and babies (Abbott, n.d.-a). The Masters HP 15mm valve is considered the gold standard and the most trusted mechanical heart valve in the world showing little complications in the long run, due to its unique design features with many testimonies (Abbott, n.d.-b), and has already treated over 3 million patients to support its claim (Abbott, n.d.-a). Among its functions, the valve acts as an artificial valve, by replacing damaged valves and then controlling the normal flow of blood into and out of the heart. In terms of features, it has a bileaflet design that opens to an 85-degree during heart contractions, a minimised carbon surface area, a low valve implant height of 2.2mm with an overall height of 8.5mm, a controlled torque rotation mechanism for rotation and intraoperative adjustment (Abbott, n.d.-b), and a diameter measuring at only 15mm, making it the smallest valve in the world (Abbott, n.d.-a). With its minute size and high durability, the Masters HP 15mm is clearly an advancement over the Epic™ Plus Mitral stented tissue valve, being able to target new-borns and infants, thus giving them a new lease of life and with little complications in the long run. One of the advancements is the reduction in its diameter, standing at only 15mm (Abbott, n.d.-b). This minute-sized valve has successfully enabled doctors to treat babies and toddlers with smaller mitral valves, which was not possible before as larger valves are usually not suitable given the smaller size of children’s heart (Abbott, n.d.-b). In contrast, larger valves like the Epic™ Plus Mitral stented tissue valves are usually sized between 25-33mm according to Abbott (Abbott, n.d.-c). The mismatch of the mechanical valve and children’s smaller mitral annular size (Panicker et al., 2021) will increase the risk of operative mortality (Elmahrouk et al., 2021). However, with the minute size of the Masters HP 15mm valve offered by Abbott, the risk of operative mortality is now minimised. Another advancement is the extremely high durability of the valve, which avoids potential calcification, that occurs with the Epic™ Plus Mitral stented tissue valve (Abbott, n.d.-a). The Masters Series valves prove long-term durability based on experiences of more than 3 million successful implants over several decades (Abbott, n.d.-e). Thus, with its high durability, patients do not have to worry about needing to replace their valves again. Furthermore, the valve targets paediatric patients, who often have a longer lifespan due to their age and durability is one of the most important factors to consider for them. Hence, the Masters HP 15mm has a great advantage over tissue valves like the Epic™ Plus Mitral valve that often wear out after 12 to 15 years (Conte, 2017). One problem that the Masters HP 15mm brings is the patients’ ability to tolerate the anticoagulation therapy. After the surgical procedure, anticoagulation therapy is required to prevent the tendency for blood clots to form on the metal surfaces of the valves, which can in turn increase the risk of bleeding (Office of the Commissioner, 2018). As such, patients need to be on consumption of blood thinner medications for life (Conte, 2017), failure to do so, can potentially lead to the death of the patient. However, it is proven that the Masters HP 15mm is able to give paediatric patients a new lease of life, as seen from Sadie Rutenberg’s life story for example. Sadie Rutenberg was the first infant to undergo the implantation of the Masters HP 15mm valve, and is now a healthy 3-year-old girl, leading life just like any other child. (Abbott, n.d.-b) This is a clear indicator of the success of the valve. Also, the low thrombogenicity nature of the valve further reduces the tendency for blood clots to form on its surfaces, hence mitigating the problem of the valve. According to the Abbott Mechanical Heart Valves brochure, Abbott mechanical valves showed lower thromboembolism, thrombosis and bleeding even at a low internationalised normalised ratio range (Abbott, n.d.-f). All in all, the advantages of the mechanical valves outweighs the disadvantages, and showed an advancement over other mechanical valves and tissue valves like the Epic™ Plus Mitral valve. In conclusion, the minute size of the Masters HP 15mm valve, along with its high durability can help save the lives of numerous paediatric patients’ that the Epic™ Plus Mitral stented tissue valve could not achieve. With these significant features and advancements, the Masters HP 15mm valve would be the key to the success of treating paediatric patients with mitral regurgitation, giving them a new lease of life with minimal complications in the long run. References Abbott. (n.d.-a). Mechanical Heart Valves. Retrieved September 13, 2023, from https://www.structuralheart.abbott/int/products/mechanical-heart-valve/regent-valve-masters-series-mechanical-heart-valve#c2068 Media, R. (n.d.). Mechanical heart valves: Regent valve and master series. International Health Care Professionals. https://www.structuralheart.abbott/int/products/mechanical-heart-valve/regent-valve-masters-series-mechanical-heart-valve#c2068 Abbott. (n.d.-b). FDA APPROVES THE WORLD'S SMALLEST MECHANICAL HEART VALVE FOR PEDIATRIC PATIENTS WITH HEART DEFECTS. Retrieved September 13, 2023, from https://abbott.mediaroom.com/2018-03-06-FDA-Approves-the-Worlds-Smallest-Mechanical-Heart-Valve-for-Pediatric-Patients-with-Heart-Defects Abbott. (n.d.-c). Epic™ Plus Mitral and Aortic. Retrieved September 13, 2023, from https://www.cardiovascular.abbott/us/en/hcp/products/structural-heart/surgical-valve-solutions/epic-tissue-valve.html Abbott. (n.d.-d). Epic™ Plus Mitral and Aortic Stented Tissue Valves. Retrieved September 13, 2023, from https://www.structuralheart.abbott/products/mitral-aortic-valve-replacement/epic-tissue-valve#features Abbott. (n.d.-e). Key Mitral MHV selection considerations: durability, size range, hemodynamics, and implantability. Retrieved September 13, 2023, from https://www.structuralheart.abbott/fileadmin/content/clinical-research/clinical-insights/46704_Global_Masters_Clinical_Insights.pdf Abbott. (n.d.-f). Abbott Mechanical Heart Valves. Retrieved September 13, 2023, from https://gamida.co.il/medical/wp-content/uploads/sites/3/2022/01/9-EH-1-12392-01-06-2021_MHV-Brochure.pdf Alberta (2022, September 7). Learning About Life With a Mechanical Heart Valve. https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abk2194 Conte, V. (2017, May 2). Deciding Between a Tissue and a Mechanical Valve. https://ctsurgerypatients.org/deciding-between-a-tissue-and-a-mechanical-valve#:~:text=Age%20is%20one%20of%20the,patient%20survival%20are%20both%20unpredictable Elmahrouk, A. F., Mashali, M. H., Ismail, M., Arafat, A. A., Alamri, R., Baho, H., Shihata, M., & Jamjoom, A. (2021). Mitral valve replacement in infants and younger children. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8316334/ Caldarone, C. A., Raghuveer, G., Hills, C. B., Atkins, D. L., Burns, T. L., Behrendt, D. M., & Moller, J. H. (2001). Long-Term Survival After Mitral Valve Replacement in Children Aged <5 Years. https://www.ahajournals.org/doi/10.1161/circ.104.suppl_1.i-143 Office of the Commissioner. (2018). 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 Panicker, V. T., Sreekantan, R., & Lokanath, N. (2021). Preoperative mitral annulus size – Can we get it right? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8404588/