Braunwald-Cutter Heart Valve

Description:

This open-caged ball valve has silastic or silicone rubber poppets. This was the first time a valve had cloth-covered struts. The reasoning behind this design was that Dr. Nina Starr Braunwald, one of its creators, believed it would reduce clot formation because tissue infiltrated the fabric. However, fabric covered metal actually increased thrombogenicity, and clots soon covered by endothelial cells yielded a non-thrombogenic surface. According to the donor Manny Villafana, the Braunwald-Cutter Valve is an example of good engineering that failed.

In 1967, Braunwald began work in conjunction with Cutter Laboratories to develop this cloth covered caged ball valve, using Dacron fabric and polypropylene mesh. It had good hemodynamics and was made of polypropylene over titanium, a silastic poppet, and polypropylene mesh. This in one of two Braunwald-Cutter valves (see 2015.0031.36.02 for the second valve) which were previously implanted in people and then explanted. The large valve (shown here) shows wear/variance on the poppet as well as a large crack. The mesh on the struts has worn down or completely come off. The small valve (2015.0031.36.02) also shows wear of the cloth from the struts. Clinical use of the valve began in 1968 and lasted until 1979, when there were a significant number of cases of fabric wear, poppet abrasion, and poppet escape.

Dr. Nina Starr Braunwald (1928-1992) led the surgical team that was the first to implant a prosthetic heart valve which she designed (1960). She received her MD from New York University School of Medicine and was one of the first women to train as a general surgeon at New York's Bellevue Hospital, from 1952 to 1955. She completed her training in general surgery and her residency at Georgetown University Medical Center, with a postdoctoral fellowship in Dr. Charles Hufnagel's surgical laboratory.

From 1958 to 1968 Dr. Braunwald practiced at the National Heart Institute (now the National Heart, Lung and Blood Institute) of the National Institutes of Health (NIH) in Bethesda, Maryland. From 1958 to 1965 she served as the chief of surgery. While at the NIH she developed her caged ball artificial heart valve, the Braunwald-Cutter valve, which was implanted in patients during the late 1960s and early 1970s. In 1972, Dr. Braunwald joined the faculty at Harvard Medical School. She was the first woman to be elected to the American Association for Thoracic Surgery.