A small (~6.5cm tall), clear plastic artifact, open at opposite ends, contains a nylon ball covered in silicone. The clear plastic housing (cage) has three lobes around its central circumference.
At one end of the cage is a translucent white plastic ring (fixation ring) with inward facing teeth. The ring has a small gap that permits it to be stretched around the aorta.
A rectangular white label adheres to the outside surface of the artifact.
Accession Number: 2020.med.3
Alternative Name: Mechanical Heart Valve (MHV)
Methyl Methacrylate (Plexiglas), Nylon, Silicone.
The white label reads as follows: “MED 223 980.16.23”
Dimensions (cm): Height = 6.5, Max diameter = 4.
The Hufnagel caged ball heart valve was the first prosthetic heart valve to see clinical use. It was designed to be surgically attached to the descending thoracic aorta in order to prevent valvular regurgitation. The cage consists of a highly polished Plexiglas housing that contains a ball (also called an occluder). During systole, the pressure of the blood pushes the ball away from the proximal orifice of the cage , opening the valve. During diastole, the valve was closed.
Two toothed fixation rings at either end of the cage were used to secure the valve to the aorta. (One is present in this example.) These were held in place with a metal tie, forming a clamps that captured the raised rims of the cage.
Detail of a medical illustration depicting the installation of a Hufnagel Valve on the descending thoracic aorta (Hufnagel and Roberts 1975, 7). Medical illustration is by Marsha Jessup.
This artifact appears to be intact and in good condition. Its surface is slightly dirty. The paper label is peeling away. One of the fixation rings is missing.
Associated Instruments:
Brunswick Manufacturing Company. Quincy, Massachusetts.
Date of Manufacture: c. 1950s
This artifact belongs to a small collection of items related to cardiac surgery that was collected by Dr. Wilfred Gordon “Bill” Bigelow (1913 – 2005). After his death, the collection was donated to the Cardiovascular Sciences Collaborative Program of the University of Toronto, where it is currently on display.
Note that the National Museum of American History has a collection of early Hufnagel valves, one of which may be viewed in this catalogue entry. (accessed March 23, 2023)
Jagdish Butany, Manmeet S Ahluwalia, Cristina Fayet, Craig Munroe, Patrick Blit, and Christina Ahn (2002) “Hufnagel Valve: The First Prosthetic Mechanical Valve.” Cardiovascular Pathology 11, 6: 351–53.
Michael C. Fishbein and William C Roberts (1975) “Late Postoperative Anatomic Observations after Insertion of Hufnagel Caged-Ball Prostheses in Descending Thoracic Aorta.” Chest 68, 1: 6–11.
Charles A. Hufnagel, W. Proctor Harvey, Pierre J. Rabil, Thomas F. McDermott. (1989 reprint, original article 1954) “In the beginning: Surgical correction of aortic insufficiency.“ Annals of Thoracic Surgery 47(3):475-6.
Charles Hufnagel (1916-1989) implanted the first aortic heart valve in 1952. The valve supplemented the faulty aortic heart valve of a patient by preventing blood from flowing backward into the heart (valvular regurgitation). It did not replace the original valve.
The plastic fixation ring was developed in response to an early problem in which a simple compression band could cause necrosis leading to rupture of the aortic wall. The teeth of the fixation ring operated on a principle called “multiple-point fixation” that prevented tissue necrosis. (See Fishbein and Roberts 1975, 7.)
The first version of this valve used a hollow acrylic ball and was very noisy. This was replaced by a nylon ball with a silicone covering that reduced the noise (Hufnagel et al. 1954/ 1989, 476).
Approximately 4,000 such valves were manufactured and distributed. They were used into the early 1960s when they were replaced by new forms of prosthetic valves. Newer valves, installed in the natural valve’s anatomical position, were made possible by the introduction of cardiopulmonary bypass; The Hufnagel valve was installed by cross-clamping the aorta. Valves of this kind were associated with several complications. (See Butany et al 2002).