In vitro hydrodynamics, cusp-bending deformation, and root distensibility for different types of aortic valve–sparing operations: Remodeling, sinus prosthesis, and reimplantation

Abstract

In vitro the various aortic valve-sparing operations differed characteristically in their ability to spare valve function, none of them completely meeting native valve behavior. The remodeling techniques exhibited valve dynamics closest to those of the native aortic root. The more the aortic valve is fixed with noncompliant prosthetic material, the more the native root dynamics are impaired.

An Expansible Aortic Ring for a Standardized and Physiological Approach of Aortic Valve Repair

“…The valve shows asymmetric motion after reimplantation. The cusp bending deformation index is increased with the reimplantation techniques and sinus prosthesis compared with the control and remodeling groups (Erasmi et al, 2005;Furukawa et al, 1999;Grande-Allen et al, 2000).…”

“…However, in earlier series of the remodeling technique, the reoperation rate was higher after type A aortic dissection and in patients with Marfan syndrome (Lansac et al, 2006;Leyh et al, 2002;Luciani et al, 1999;Yacoub et al, 1998). In the unselected population of the original remodeling series, up to 30 % of patients presented recurrence of AI grade II or III (Erasmi et al, 2005;Furukawa et al, 1999;Lansac et al, 2006;Luciani et al, 1999). The only risk factor for failure was a dilated native aortic annulus (diameter ≥ 25 mm) (Hanke et al, 2009;Lansac et al, 2006;Leyh et al, 2002;Luciani et al, 1999;Yacoub et al, 1998).…”

Video-Based Measuring of Quality Parameters for Tricuspid Xenograft Heart Valve Implants

“…This worst case valve is a hypothetical reference model, whose leaflets are all identical and exhibit a BDI of 0.95. The worst natural valves do not exceed a BDI of 0.8 [7], [20]. In the time domain, each leaflet of the worst case valve flutters at 60 Hz.…”

“…In some special cases-related to medical research rather than medical routine-the fluttering is also analyzed. For this purpose, the bending deformation index (BDI) [7] is again manually computed only for a few images. The BDI is computed as the depth of a leaflet's border divided by its side [see Fig.…”

In Vitro Study of Aortic Valves Treated with Neo-Chordae Grafts: Hydrodynamics and Tensile Force Measurements

“…Further benefits are strictly dependent upon the specifically adopted surgery technique, according to a general rationale stating that, the more the original ARFU structure is preserved, the better the behavior of the repaired structure in terms of structure dynamics and hydrodynamics. 6 In general, the short-term outcomes of reparative surgery (in terms of survival rate, freedom from aortic insufficiency, and percentage of reoperations) are deemed satisfactory, whereas mid-and long-term stabilities are still challenging. 1,5 In this framework, at the Cardiothoracic Surgery Unit of the Sacco Hospital, the neo-chordae (NC) technique is being applied since 2004 in the correction of aortic leaflet prolapse.…”