Comparison of aortic valve repair techniques with single- and double-ring annuloplasties.

Autor:	Benhassen LL; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark., Hedensted JH; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark., Sharghbin M; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark., Bechsgaard T; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.; Department of Electrical and Computer Engineering, Faculty of Technical Sciences, Aarhus University, Aarhus, Denmark., Nielsen SL; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark., Hasenkam JM; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark., Johansen P; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.; Department of Electrical and Computer Engineering, Faculty of Technical Sciences, Aarhus University, Aarhus, Denmark.
Jazyk:	angličtina
Zdroj:	European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2023 May 02; Vol. 63 (5).
DOI:	10.1093/ejcts/ezad164
Abstrakt:	Objectives: For patients with isolated aortic regurgitation, a double sub- and supravalvular annuloplasty has been shown to reduce recurrent aortic regurgitation after aortic valve repair compared with a single subvalvular annuloplasty. The objective of this study was to compare the geometrical and dynamic properties of single- and double-ring annuloplasties in an in vitro model. Methods: Eighteen aortic roots from 80 kg pigs were randomized into a control, single-ring and double-ring group. Experiments were conducted in a pulsatile in vitro model. Hydrodynamics, radial force measurements at annular and sinotubular level and 2D echographic imaging were obtained. Results: Both the single- and double-ring annuloplasties downsized the aortic annulus and sinotubular junction (STJ) significantly and increased the coaptation height. The double-ring annuloplasty showed an additional significant increase in coaptation height compared with the single ring [8.5 (0.9)-9.8 (0.8) mm, P < 0.01]. The single-ring annuloplasty reduced radial forces at both levels, whereas the double-ring annuloplasty showed the greatest force reduction of the STJ. Conclusions: By treating the whole functional aortic annulus, encompassing both the aortic annulus and the STJ, a greater force reduction is observed. A subvalvular annuloplasty alone is efficient in reducing aortic annulus diameter and increasing coaptation height, however, by treating the STJ as well, an additional effect is observed on coaptation height, creating a more efficient stabilization. Reduction of annular force-distensibility ratio with the double-ring annuloplasty compared with the native controls indicates a sustained stabilizing effect. (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
Databáze:	MEDLINE
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