Comparison of the Performance of a Sutureless Bioprosthesis With Two Pericardial Stented Valves on Small Annuli: An In Vitro Study

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• 作者：Giordano Tasca ; MD^a ; ^b ; ^{giordano.tasca67@gmail.com} ; Riccardo Vismara ; PhD^b ; ^c ; Andrea Mangini ; MD^b ; ^c ; ^d ; Claudia Romagnoni ; MD^c ; ^d ; Monica Contino ; MD^c ; ^d ; Alberto Redaelli ; PhD^b ; ^c ; Gianfranco Beniamino Fiore ; PhD^b ; ^c ; Carlo Antona ; MD^c ; ^d
• 刊名：The Annals of Thoracic Surgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：103
• 期：1
• 页码：139-144
• 全文大小：356 K
• 卷排序：103

文摘

Aortic valve replacement has evolved recently with the development of the sutureless bioprosthesis. One such valve is the Perceval bioprosthesis, which is built by mounting leaflets of bovine pericardium to a thin stent; this approach has the potential to provide an excellent fluid dynamic performance. We undertook an in vitro study to compare the hydrodynamic performance of the sutureless bioprosthesis with two standard pericardial stented bioprostheses (Crown and Magna).MethodsTests were conducted using a mock loop, testing on two sizes of the three prostheses. The prosthesis sizes were chosen to house the valves in porcine aortic roots with a native annulus diameter of 19 mm (n = 6) or 21 mm (n = 6). The stroke volume ranged from 25 mL to 105 mL at a simulated heart rate of 70 beats per minute.ResultsMean pressure drop and energy loss rose with increasing stroke volume in all of the valves tested (p < 0.001), with the sutureless valve showing the lowest values for both variables (p < 0.001). Effective orifice area values were stable across the stroke volume intervals and were larger in the sutureless valves (p < 0.001).ConclusionsAll of the valves tested provided good fluid dynamic performances. The sutureless bioprosthesis provided the best performance with the least hindrance to flow behavior. From the hydrodynamic perspective, the sutureless prosthesis may present an advance in the evolution of bioprostheses, ensuring low gradients and potential for low incidence of patient-prosthesis mismatch even in small annuli.