Document Detail


The aortic valve blood supply.
MedLine Citation:
PMID:  10678369     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIM OF THE STUDY: Normal valves are known to be metabolically active, yet the route of oxygen delivery is unclear. Although diffusion from the valve surface is the presumed source, the presence, distribution and importance of the aortic valve's vascular bed is unclear. METHODS: Seventeen porcine hearts (51 cusps) were obtained at slaughter. The coronary circulation was pressure-rinsed with a heparin solution and filled with an Aquablack solution at physiological pressure. The cusps were subsequently dissected and fixed for viewing with an inverted microscope. The anterior leaflet of the mitral valve was evaluated as a control for the vessel filling protocol. Using Adobe Photoshop and captured images, whole cusps were reconstructed, a grid was overlaid and vascular distribution evaluated. RESULTS: Of the 15 porcine aortic valves that filled, 32/45 (71%) of the cusps contained vessels. Nine valves had vasculature in all three cusps and two valves were completely avascular. Vessels were found predominantly in the basal third of the cusps and extended in from the commissures almost to the level of the free edge. There was a statistically significant difference (p<0.001) between the appearance of vessels in the basal region and in the mid and free edge regions of the valve. No difference in vascularization pattern was noted between the left, right or non-coronary cusps. CONCLUSIONS: The presence of a vasculature suggests that the metabolic activity of the cusp is greater than can be supported by diffusion from the cusp surface alone. The absence of functioning vessels might explain the failure associated with cryopreserved implants and may play a role in the durability problems faced by bioprosthetic valves. It will also be important to consider the role of this intrinsic circulation with the advent of tissue-engineered valves.
Authors:
K L Weind; C G Ellis; D R Boughner
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of heart valve disease     Volume:  9     ISSN:  0966-8519     ISO Abbreviation:  J. Heart Valve Dis.     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-03-01     Completed Date:  2000-03-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9312096     Medline TA:  J Heart Valve Dis     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1-7; discussion 7-8     Citation Subset:  IM    
Affiliation:
The Heart Valve Laboratory, Robarts Research Institute, London, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Animals
Aortic Valve / anatomy & histology*
Coronary Circulation*
Microcirculation
Swine
Comments/Corrections
Comment In:
J Heart Valve Dis. 2000 Sep;9(5):736-8   [PMID:  11041193 ]

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


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