St. Jude Medical Valve (SJM) :  This is a low profile bi-leaflet valve, which was introduced in 1977. The leaflets and the housing are made of pyrolitic carbon. The currently available models are rotatable after valve is sutured and fixed. This helps to achieve unobstructed opening and closing of the leaflets in aortic and mitral positions. Two relatively high velocity regurgitation jets (seen in echocardiography) allow 10 per cent regurgitation, preventing blood stasis and thrombosis at the pivots. Anti coagulation and prophylaxis against prosthetic endocarditis are Mechanical failure is uncommon.