Influence of Transvalvar Pressure Gradient on Hinge Washing in Closed Mechanical Prosthetic Cardiac Valves Under Pulmonary Pressure Conditions: A Comparative In Vitro Study.

Autor:	Pragt H; 1 Center for Congenital Heart Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.; 2 Department of Cardiothoracic Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., van Melle JP; 1 Center for Congenital Heart Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.; 3 Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Mariani MA; 2 Department of Cardiothoracic Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands., Verkerke GJ; 4 Department of Rehabilitation Medicine, University of Groningen, Groningen, University Medical Center Groningen, the Netherlands.; 5 Department of Biomechanical Engineering, University of Twente, Enschede, the Netherlands., Ebels T; 1 Center for Congenital Heart Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.; 2 Department of Cardiothoracic Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.; 6 Department of Cardiothoracic Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.
Jazyk:	angličtina
Zdroj:	World journal for pediatric & congenital heart surgery [World J Pediatr Congenit Heart Surg] 2019 Mar; Vol. 10 (2), pp. 145-150.
DOI:	10.1177/2150135118818760
Abstrakt:	Objective: Hinge washing is a crucial factor in the prevention of mechanical prosthetic valvar thrombosis, especially in the pulmonary valve position. The aim of this laboratory study was to determine the relationship between pressure difference and the amount of hinge washing in the closed position, using the pressures that are normal for the right ventricle and pulmonary artery. Methods: In an in vitro setting, four different bileaflet mechanical valves were tested for hinge washing in closed position. Based on similarity in inner diameter (range: 20.5-21.4 mm), the following valves were tested: Abbott SJM Regent size 23, Cryolife On-X size 23, LivaNova Carbomedics-R size 25, Medtronic Open Pivot (M-OP)-A size 25. Tests were carried out in a range between 3 and 100 mm Hg pressure difference, using water as a test fluid. The amount of leakage per minute through the closed valve was measured. Results: All four valves showed an increase in leakage with increasing transvalvar gradient, and the relationship between pressure and leakage behaves in logarithmic fashion. Leakage under normal pulmonary diastolic pressure conditions (10 mm Hg) was between 23.3% and 29.3% of the leakage under aortic diastolic pressure conditions (80 mm Hg). The Cryolife On-X valve showed the highest closed leakage volume under pulmonary conditions (10 mm Hg) 0.254 ± 0.01 (L/min), where the Medtronic M-OP showed the lowest leakage volume with 0.125 ± 0.014 (mL/min). Conclusion: Hinge washing is related to transvalvar pressure difference in closed position. Valve brands differed significantly from each other in the amount of hinge washing.
Databáze:	MEDLINE
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