Update of the European standards for inactive surgical implants in the area of heart valve prostheses.

OBJECTIVE The approval of a heart valve for the European market takes place in accordance with European and international standards. A new version of the EN Standards was published in June 2006, which responded to different technical innovations in the area of heart valve technology. This work outlines the differences between the new EN ISO 5840 (2005) and the old EN 12006-1 (1999). METHODS We compared the 'new' EN ISO 5840 (2005) and the 'old' EN 12006-1 (1999). RESULTS The following aspects have been updated in the new EN ISO 5840: Size designation of biological and mechanical heart valve prostheses in accordance with the patient annulus. Differentiation of the annular implantation position (intra-annular, intra-supra-annular, supra-annular). Table for the description of the components of a heart valve prosthesis. Use of compliance chambers for the hydrodynamic testing of prostheses without scaffold. Determination of the minimum requirement for heart valve prostheses in hydrodynamic tests and specification of reference values with regard to prosthesis-related complications in clinical studies. Definition of the requirements for clinical long-term studies (patient number, length). Introduction of an obligatory post-observation timeframe of 5 years for mechanical heart valves and of 10 years for biological heart valves. CONCLUSIONS The update in the new EN ISO 5840 gives consideration to the technologic evolution of heart valve development. Several changes in the new standard will improve safety for the patient and ensure high quality in the field of heart valve technology.