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The 25 Landmark ‘Milestone’ Papers Published by ASAIO

1955-2003

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Cardiac Valves

1. Hufnagel, C and Villegas A:., "Aortic Valvular Replacement," Trans ASAIO 4:235-239, 1958.

Commentary: The Hufnagel ball valve originated from an idea that was patented in 1858 by John Williams for a bottle stopper. Dr. Charles Hufnagel, professor of surgical research at the Georgetown University Medical Center began experimenting with an aortic valve prosthesis in 1946.The Hufnagel valve was intended to be placed in the descending aorta and not in the subcoronary position. This valve was implanted clinically for the first time in the descending aorta in 1952. Among the first ten patients there were four deaths, but considering that these patients were in the terminal stages of severe aortic incompetence, the results were favorable. Anticoagulants after surgery were not used and it is interesting to note that there were no cases of valve malfunctioning or clotting. Though not very efficient in relieving aortic insufficiency, the Hufnagel ball valve demonstrated, for the very first time, that a prosthetic valve device could be successfully placed in the human circulatory system. The Hufnagel valve ushered half a century of design improvements in mechanical cardiac valves beginning with the ball-and-cage design first commercialized as the Starr-Edwards valve in 1961. – Steven J. Phillips, M.D.

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