Document Detail


Influence of orientation of bi-leaflet valve prostheses on coronary perfusion pressure in humans.
MedLine Citation:
PMID:  17670729     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Orientation of a bi-leaflet prosthesis (BLP) might influence coronary perfusion. The aim of this study was to investigate the influence of the orientation on coronary perfusion pressure during hyperemia and adrenergic stimulation. During hyperemia perfusion pressure determines coronary blood flow. Fourteen patients with normal coronary angiogram underwent aortic valve replacement (AVR) by a BLP, and seven received a bio-prosthesis. Patients receiving a BLP were randomized to either orientation A (hinge mechanism perpendicular to a line drawn between the coronary ostia) or B (hinge mechanism parallel to the line between the ostia). Six months after surgery all patients underwent cardiac catheterization. Pressures were measured during resting conditions, during maximum hyperemia, and during maximum adrenergic stimulation with a guiding catheter in the aortic arch (P(ao)), simultaneously with a sensor tipped guide wire in the coronary artery (P(cor)) and in the aortic root (P(root)). P(ao)-P(root) described a flow-induced pressure drop in the aortic root (Venturi effect) and the gradient P(root)-P(cor) described coronary ostium abnormalities. Only small non-significant differences in myocardial perfusion pressure were found between different orientations of a bi-leaflet prosthesis or between bi-leaflet prostheses and bio-prostheses in P(ao)-P(root) and P(root)-P(cor).
Authors:
Marcel van't Veer; Bart van Straten; Frans vande Vosse; Nico Pijls
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2007-07-02
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  6     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-21     Completed Date:  2007-10-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  588-92     Citation Subset:  IM    
Affiliation:
Department of Biomedical Engineering, Cardiovascular Biomechanics, University of Technology Eindhoven, Michelangelolaan 2, P.O.Box 1350, 5602 ZA Eindhoven, The Netherlands. m.v.veer@tue.nl
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MeSH Terms
Descriptor/Qualifier:
Adenosine
Aged
Aortic Valve / surgery*
Bioprosthesis*
Blood Pressure* / drug effects
Cardiotonic Agents / administration & dosage
Coronary Circulation* / drug effects
Dobutamine / administration & dosage
Female
Heart Catheterization
Heart Rate
Heart Valve Diseases / physiopathology,  surgery*
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation / instrumentation*,  methods
Humans
Hyperemia / chemically induced,  physiopathology
Injections, Intravenous
Male
Middle Aged
Pilot Projects
Prosthesis Design
Research Design
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 34368-04-2/Dobutamine; 58-61-7/Adenosine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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