Early experience with the Jyros bileaflet valve. Is leaflet rotation clinically important?

The design of the Jyros bileaflet prosthesis provides for a continuous, circumferential rotation of the hinge. Previous in vitro testing has confirmed the uninterrupted gyration of the leaflets, which reduces the risk of stasis within the hinge area, and as a consequence, possibly reduces the risk of thromboembolism. Twenty Jyros bileaflet valves were implanted in 19 patients between July 1991 and September 1992. There was one hospital death not related to the prosthesis. One valve had to be removed from the mitral position immediately after implantation because preservation of the posterior mitral leaflet led to malfunction of the prosthesis. Clinical and radiological follow up demonstrated that all surviving patients were clinically well, but nine of the remaining 18 valves (50%) showed no rotation of the leaflets.