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Journal of Artificial Organs
Published in: Journal of Artificial Organs 4/2016

01-12-2016 | Original Article

Opening–closing pattern of four pericardial prostheses: results from an in vitro study of leaflet kinematics

Authors: Giordano Tasca, Gianfranco Beniamino Fiore, Andrea Mangini, Claudia Romagnoni, Amando Gamba, Alberto Redaelli, Carlo Antona, Riccardo Vismara

Published in: Journal of Artificial Organs | Issue 4/2016

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Abstract

Pericardial and porcine stented aortic valves have different leaflet kinematics. To study the biomechanics of a prosthesis thoroughly, the in vitro setting is the most appropriate. The aim of our study was to find out whether the prosthesis design in which the pericardial sheet is outside the stent post might influence the opening and closing patterns of the leaflets. Four pericardial prostheses (Magna Ease [MG] 21, Trifecta [TRI] 21, Soprano-Armonia [SA] 20 and Mitroflow [MF] 23) that fitted aortic roots with a native annulus diameter of 2.1 cm were implanted and their leaflet kinematics was studied by a high-speed digital camera. In the opening phase, MG showed the shortest RVOT and the highest RVOVI, with values of 12 ± 2 and 209 ± 17 ms, respectively. The RVOT of MG was significantly shorter than that of MF (p < 0.01), but not than that of TRI (p = 0.286). Both TRI and SA showed similar opening patterns (TRI: RVOT of 15 ± 3 ms and RVOVI of 132 ± 25 ms; SA: 17 ± 2 ms and 126 ± 19 ms), without statistically significant difference. Conversely, MF showed the slowest profile, with an RVOT of 23 ± 3 ms and an RVOVI of 94 ± 8 ms (Table 1; Fig. 3). The opening/closing profile is not influenced by the position of the pericardial leaflets, but depends on other intrinsic structural characteristics related to the material used for the stent and leaflets. Moreover, the kinematics does not affect the valve performance.
Table 1
Kinematics and hydrodynamic results, reported as means and standard deviations, evaluated over the tested heart samples
 
TRI
SA
MG
MF
ANOVA
TRI versus SA
TRI versus MG
TRI versus MF
SA versus MG
SA versus MF
MG versus MF
p Value
p Value
p Value
p Value
p Value
p Value
p Value
ET (ms)
     
1.0
1.0
1.0
1.0
  
RVOT (ms)
15 ± 3
17 ± 2
12 ± 2
23 ± 3
<0.01
1.0
0.286
<0.01
0.03
<0.01
<0.01
SVCT (ms)
247 ± 14
231 ± 15
256 ± 26
241 ± 11
0.170
0.463
0.853
0.931
0.213
1.0
1.0
RVCT (ms)
35 ± 19
52 ± 13
32 ± 17
52 ± 4
0.07
0.474
1.0
0.494
0.236
1.0
0.247
TVCT (ms)
283 ± 10
283 ± 19
289 ± 10
293 ± 11
0.584
1.00
1.0
1.0
1.0
1.0
1.0
RVOVI (ms−1)
132 ± 25
126 ± 19
209 ± 17
94 ± 8
<0.01
0.959
<0.01
0.02
<0.01
0.07
<0.01
SVCVI (ms−1)
−0.9 ± 0.3
−1.1 ± 0.4
−0.57 ± 0.1
−0.55 ± 0.1
<0.01
1.0
0.353
0.292
0.045
0.04
1.0
RVCVI (ms−1)
−16 ± 4
−10 ± 2
−18 ± 6
−10 ± 1
<0.01
0.396
1.0
0.513
0.025
1.0
0.03
Δp (mmHg)
6.7 ± 3.6
10.6 ± 5.5
15.2 ± 7.9
10.7 ± 6.1
<0.01
0.01
<0.01
0.01
0.04
1.0
<0.01
EOA (cm2)
2.2 ± 1.2
1.7 ± 0.9
1.5 ± 0.8
1.7 ± 0.9
<0.01
0.03
<0.01
0.01
0.261
0.617
0.11
El  %
7.3 ± 1
11.9 ± 1
15.4 ± 2
11.8 ± 3
<0.01
<0.01
<0.01
<0.01
0.04
1.00
0.03
CO (L/min)
3.1 ± 0.4
2.8 ± 0.5
3.1 ± 0.3
3.0 ± 0.5
0.534
0.282
0.792
0.702
0.106
0.552
0.559
ET ejection time, RVOT rapid valve-opening time, SVCT slow valve-closing time, RVCT rapid valve-closing time, TVCT total valve-closing time, RVOVI rapid valve-opening velocity index, SVCVI slow valve-closing velocity index, RVCVI rapid valve-closing velocity index, Δp mean pressure drop, EOA effective orifice area, El % energy loss, CO cardiac output
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Metadata
Title
Opening–closing pattern of four pericardial prostheses: results from an in vitro study of leaflet kinematics
Authors
Giordano Tasca
Gianfranco Beniamino Fiore
Andrea Mangini
Claudia Romagnoni
Amando Gamba
Alberto Redaelli
Carlo Antona
Riccardo Vismara
Publication date
01-12-2016
Publisher
Springer Japan
Published in
Journal of Artificial Organs / Issue 4/2016
Print ISSN: 1434-7229
Electronic ISSN: 1619-0904
DOI
https://doi.org/10.1007/s10047-016-0910-0

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