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DOI: 10.1055/s-0029-1191448
In-vitro hemodynamics, leaflet function and geometry of a new anatomically shaped aortic root prothesis
Objectives: Valve sparing aortic root replacement procedures are well established, however, the shape of the native root, composed of three straight commissural pillars and bulked sinuses otherwise, is not entirely imitated by available prostheses. Therefore a more physiological designed root prosthesis was developed.
Methods: In an in-vitro model porcine aortic roots were replaced in a valve sparing reimplantation fashion using the new anatomically shaped prosthesis with designed sinuses (n=7). During pulsatile flow, transvalvular hemodynamics, root dimensions and distensibility were measured. Valve motions were recorded using highspeed video and cusp bending deformation was determined.
Results: Transvalvular pressure was 3.8±0.7mmHg, closing volume was 2.8±1.1ml. No leakage of the valves could be observed. Cusp bending deformation index was 0.57±0.1, comparable to other techniques. Dimensional measurements revealed that the predefined shape of the prosthesis was preserved under pressure, whilst overall distensibility was low due to the use of standard polyester fabric for the prosthesis.
Conclusions: Valve sparing root replacement with the new prosthesis showed excellent hemodynamics. The predefined anatomical shape was warranted under pulsatile pressure conditions, however, material inherent low distensibility does not allow for improvements in cusp deformation index.