Document Detail

Hemodynamic performance of fresh and calcified aortic valve prostheses in critical low stroke volume.
MedLine Citation:
PMID:  18592929     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIM OF THE STUDY: Heart failure is common following aortic valve replacement, and optimal prosthesis function is crucial in this critical clinical setting. The study aim was to investigate the hemodynamic performance and leaflet kinematics of fresh and calcified biological aortic valves in a simulated low stroke volume situation. METHODS: Edwards Perimount Magna (PM) and Medtronic Mosaic Ultra (MU) valves were investigated in an artificial circulation system (130 beats/min, stroke volume 19 ml), and the results compared to normal output (70 beats/min, stroke volume 70 ml). Leaflet kinematics were visualized using a high-speed camera. All valves were exposed to a calcifying solution for six weeks. RESULTS: In the low- and normal-output situation, the PM valve initially demonstrated lower pressure gradients compared to the MU valve (low output 2.4 +/- 0.16 versus 3.4 +/- 0.19 mmHg), but showed a significantly higher closing volume (up to 19% of stroke volume) leading to an increased total energy loss. Regurgitation for the PM valve was explained by progressively longer opening and closing times. The PM valve calcified faster and more severely, leading to increasing gradients and closure volume. CONCLUSION: In the low stroke volume situation pericardial valves demonstrated superior systolic performance, but inferior diastolic performance, leading to a higher total energy loss compared to porcine valves. This finding may have clinical relevance in heart-failure patients.
Omer Dzemali; Farhad Bakhtiary; Ulrich Steinseiffer; Christof Schmitz; Brigit Glasmacher; Anton Moritz; Peter Kleine
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Publication Detail:
Type:  Comparative Study; In Vitro; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  17     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-07-02     Completed Date:  2008-10-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  317-24     Citation Subset:  IM    
Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University Hospital, Frankfurt/Main, Germany.
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MeSH Terms
Aortic Valve / physiology*
Calcinosis / physiopathology*
Cardiomyopathies / physiopathology*
Heart Valve Prosthesis*
Models, Animal
Models, Cardiovascular
Stroke Volume / physiology*

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