TY - JOUR

T1 - Turbulence downstream of subcoronary stentless and stented aortic valves

AU - Funder, Jonas Amstrup

AU - Frost, Markus Winther

AU - Wierup, Per

AU - Klaaborg, Kaj-Erik

AU - Hjortdal, Vibeke

AU - Nygaard, Hans

AU - Hasenkam, J Michael

N1 - Copyright © 2011 Elsevier Ltd. All rights reserved.

PY - 2011/8/11

Y1 - 2011/8/11

N2 - Regions of turbulence downstream of bioprosthetic heart valves may cause damage to blood components, vessel wall as well as to aortic valve leaflets. Stentless aortic heart valves are known to posses several hemodynamic benefits such as larger effective orifice areas, lower aortic transvalvular pressure difference and faster left ventricular mass regression compared with their stented counterpart. Whether this is reflected by diminished turbulence formation, remains to be shown. We implanted either stented pericardial valve prostheses (Mitroflow), stentless valve prostheses (Solo or Toronto SPV) in pigs or they preserved their native valves. Following surgery, blood velocity was measured in the cross sectional area downstream of the valves using 10MHz ultrasonic probes connected to a dedicated pulsed Doppler equipment. As a measure of turbulence, Reynolds normal stress (RNS) was calculated at two different blood pressures (baseline and 50% increase). We found no difference in maximum RNS measurements between any of the investigated valve groups. The native valve had significantly lower mean RNS values than the Mitroflow (p=0.004), Toronto SPV (p=0.008) and Solo valve (p=0.02). There were no statistically significant differences between the artificial valve groups (p=0.3). The mean RNS was significantly larger when increasing blood pressure (p=0.0006). We, thus, found no advantages for the stentless aortic valves compared with stented prosthesis in terms of lower maximum or mean RNS values. Native valves have a significantly lower mean RNS value than all investigated bioprostheses.

AB - Regions of turbulence downstream of bioprosthetic heart valves may cause damage to blood components, vessel wall as well as to aortic valve leaflets. Stentless aortic heart valves are known to posses several hemodynamic benefits such as larger effective orifice areas, lower aortic transvalvular pressure difference and faster left ventricular mass regression compared with their stented counterpart. Whether this is reflected by diminished turbulence formation, remains to be shown. We implanted either stented pericardial valve prostheses (Mitroflow), stentless valve prostheses (Solo or Toronto SPV) in pigs or they preserved their native valves. Following surgery, blood velocity was measured in the cross sectional area downstream of the valves using 10MHz ultrasonic probes connected to a dedicated pulsed Doppler equipment. As a measure of turbulence, Reynolds normal stress (RNS) was calculated at two different blood pressures (baseline and 50% increase). We found no difference in maximum RNS measurements between any of the investigated valve groups. The native valve had significantly lower mean RNS values than the Mitroflow (p=0.004), Toronto SPV (p=0.008) and Solo valve (p=0.02). There were no statistically significant differences between the artificial valve groups (p=0.3). The mean RNS was significantly larger when increasing blood pressure (p=0.0006). We, thus, found no advantages for the stentless aortic valves compared with stented prosthesis in terms of lower maximum or mean RNS values. Native valves have a significantly lower mean RNS value than all investigated bioprostheses.

KW - Animals

KW - Aortic Valve/anatomy & histology

KW - Bioprosthesis

KW - Blood Flow Velocity

KW - Blood Pressure

KW - Cardiopulmonary Bypass

KW - Equipment Design

KW - Heart Valve Prosthesis

KW - Heart Valve Prosthesis Implantation/instrumentation

KW - Heart Valves

KW - Models, Anatomic

KW - Pressure

KW - Regression Analysis

KW - Stents

KW - Swine

KW - Ultrasonography, Doppler/methods

U2 - 10.1016/j.jbiomech.2011.05.035

DO - 10.1016/j.jbiomech.2011.05.035

M3 - Journal article

C2 - 21696741

VL - 44

SP - 2273

EP - 2278

JO - Journal of Biomechanics

JF - Journal of Biomechanics

SN - 0021-9290

IS - 12

ER -