Pulmonary versus aortic pressure behavior of a bovine pericardial valve.

Autor:	Pragt H; Center for Congenital Heart Disease, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., van Melle JP; Center for Congenital Heart Disease, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Verkerke GJ; Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands., Mariani MA; Department of Thoracic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands., Ebels T; Center for Congenital Heart Disease, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Thoracic Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Cardiothoracic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. Electronic address: T.Ebels@umcg.nl.
Jazyk:	angličtina
Zdroj:	The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2020 Mar; Vol. 159 (3), pp. 1051-1059.e1. Date of Electronic Publication: 2019 Jul 05.
DOI:	10.1016/j.jtcvs.2019.05.084
Abstrakt:	Background: The Carpentier Edwards Perimount Magna Ease aortic valvular prosthesis (Edwards Lifesciences, Irvine, Calif) has been among the most frequently and successfully used tissue prosthetic cardiac valves. Furthermore, this prosthesis has been used off-label in the pulmonary position. Until now, there has been a paucity of data regarding the functioning of tissue prosthetic valves under pulmonary conditions. Methods: Using a pulse duplicator, hydrodynamic characteristics of a 21-mm and 25-mm Magna Ease valve were evaluated. Among parameters evaluated were leakage orifice area, closing time (ie, time required to close), and leakage duration. This procedure was performed under different pulmonic pressure conditions (15/5 mm Hg, 28/11 mm Hg, 73/32 mm Hg) and normal aortic pressure (120/80 mm Hg) as a reference. Moving images were obtained using a Phantom MIRO M320S high-speed camera (Vision Research Inc, Wayne, NJ) at 600 frames per second and used to analyze valve area in closed position. Results: Under normal pulmonic conditions (28/11 mm Hg) the leakage orifice area was 0.020 ± 0.012 mm 2 for the 21-mm valve and 0.054 ± 0.041 mm 2 for the 25-mm valve (P = .03). Hydrodynamic characteristics of the valves differed between pulmonary and aortic testing condition. Valve closing volumes were significantly lower under pulmonary hypotension and normal pulmonary conditions than under normal aortic conditions (P < .05). Conclusions: Under normal pulmonary pressure conditions, the hydrodynamic characteristics of Magna Ease valves are significantly different compared with aortic conditions. Further research is needed to determine whether these results are associated with prosthetic valve failure. (Copyright © 2019 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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