The first valve replacements that led to long term survivors were mechanical cage ball valves used by the Harken in the aortic position and Starr in the mitral position both in 1960. 1 The first biological valves used successfully were transplants from human cadavers, called homograft or allograft pioneered by Ross and Barratt-Boyes in 1962. 1 Successful use of autologous grafts began with the pulmonary autograft in 1967 1 . Mechanical valves are the most durable replacement alternative,

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... d to last a lifetime, for patients of all ages. A study by Lund et al. of 694 aortic valve implants documented 100% freedom from mechanical failures at 18 years 2 . A study by Remadi et al. of 440 mitral valve implants documented 100% freedom from structural dysfunction at 19 years 3 . The mechanical valve designs that have prevailed until today are the ball and cage valve, tilting disc valve, and the bileaflet valve. The use of pyrolitic carbon has reduced but could not completely remove the unavoidable