The outcome of New Miltonia Mechanical Bileaflet Valve Implantation in Severe Mitral Stenosis: A Case Series of Rheumatic Heart Disease

The most common heart valve affected by rheumatic heart disease (RHD) is the Mitral Valve. The bileaflet mechanical heart valves have demonstrated their superiority over previous designs in surgical management of RHD. It is better in terms of lower transvalvular gradients, a more physiologic flow pattern distribution, and, possibly, a lower thrombogenic potential. In 2018, the new MILTONIA mechanical bileaflet valve manufactured by Meril Life Sciences Pvt. Ltd. was approved for clinical use by the Indian authorities. The main advantage of this model over other leaflet models was the possibility of rotation once implanted, utilizing a new sewing ring design. We have performed mitral valve replacement in three continuous cases of RHD induced severe mitral valve stenosis using the MILTONIA mechanical bileaflet valve. The results of the procedure have been very satisfactory with none of the patients showing any valve-related complications like thrombosis, endocarditis and anticoagulation-related bleeding in a follow up period of 3 years. The authors believe that the use of the Miltonia valve is very safe and effective. A study with a larger patient population and longer follow-up is warranted to assess the device further.