Document Detail


Turbulence downstream of subcoronary stentless and stented aortic valves.
MedLine Citation:
PMID:  21696741     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Jonas Amstrup Funder; Markus Winther Frost; Per Wierup; Kaj-Erik Klaaborg; Vibeke Hjortdal; Hans Nygaard; J Michael Hasenkam
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-06-21
Journal Detail:
Title:  Journal of biomechanics     Volume:  44     ISSN:  1873-2380     ISO Abbreviation:  J Biomech     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-08-01     Completed Date:  2012-01-23     Revised Date:  2012-10-10    
Medline Journal Info:
Nlm Unique ID:  0157375     Medline TA:  J Biomech     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2273-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Ltd. All rights reserved.
Affiliation:
Department of Cardiothoracic and Vascular Surgery, Institute of Clinical Medicine, Aarhus University Hospital, Skejby, Brendstrupgaards vej, DK-8200 Aarhus N, Denmark. funder@ki.au.dk
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MeSH Terms
Descriptor/Qualifier:
Animals
Aortic Valve / anatomy & histology,  physiology*
Bioprosthesis*
Blood Flow Velocity
Blood Pressure
Cardiopulmonary Bypass
Equipment Design
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation / instrumentation*
Heart Valves
Models, Anatomic
Pressure
Regression Analysis
Stents
Swine
Ultrasonography, Doppler / methods

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


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