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In vitro evaluation of a new aortic valved conduit |
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| Authors: | Vahid Sadri Immanuel David Madukauwa-David Ajit P Yoganathan |
| Institution: | 1. Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Ga;2. George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Ga;1. Cardiac Surgery Center, Beijing Anzhen Hospital Affiliated with Capital Medical University, Beijing, China;2. Beijing Institute of Heart Lung and Vascular Disease, Beijing Anzhen Hospital Affiliated with Capital Medical University, Beijing, China;1. Division of Cardiothoracic Surgery, Spectrum Health, Grand Rapids, Mich;2. Department of Cardiac Surgery, Medical University of Silesia School of Medicine in Katowice, Katowice, Poland;3. Department of Cardiac, Vascular, and Endovascular Surgery and Transplantology, Medical University of Silesia School of Medicine in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland;4. Department of Aerospace Engineering and Engineering Mechanics and Biomedical Engineering, Institute for Computational Engineering and Science, University of Texas at Austin, Austin, Tex;1. Department of Cardiothoracic Surgery, Stanford University, Stanford, Calif;2. Department of Mechanical Engineering, Stanford University, Stanford, Calif;3. Department of Bioengineering, Stanford University, Stanford, Calif;1. Department of Cardio-Thoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands;2. Cardiac Surgery Service, Quebec Heart and Lung Institute, Quebec City, Quebec, Canada;3. Cardiac and Vascular Surgery Service, University Hospital of Bordeaux, Bordeaux, France;4. Department of Cardiothoracic Surgery, Columbia University Medical Center, New York, NY;5. Department of Cardiothoracic Surgery, ProMedica Toledo Hospital, Toledo, Ohio;6. University Clinic for Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany;7. Department of Biostatistics, Coronary and Structural Heart, Medtronic, Mounds View, Minn;8. Thorax Center, Erasmus University Medical Center, and Office of Medical Affairs, Medtronic, Rotterdam, The Netherlands;9. Department of Surgery, University Hospitals, Case Western Reserve University School of Medicine, Cleveland, Ohio;1. Division of Cardiac Surgery, Department of Surgery, Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine and Northwestern Medicine, Chicago, Ill;2. Division of Biostatistics, Department of Preventive Medicine, Northwestern University, Chicago, Ill |
| Abstract: | BackgroundThis study examined whether the presence of a sinus of Valsalva equivalent in the KONECT RESILIA aortic valved conduit (Edwards Lifesciences, Irvine, Calif) improves valve hemodynamics, kinematics, and performance.MethodsA 28-mm KONECT RESILIA aortic valved conduit was used to create an in vitro flow test model, and the same aortic valved conduit model without a sinus section was used as a control. Particle image velocimetry and hydrodynamic characterization experiments were conducted in the vicinity of the valves in a validated left-heart simulator at 3 cardiac output levels. In addition, leaflet kinematics of the valves were determined through en face high-speed imaging.ResultsThe KONECT RESILIA aortic valved conduit model exhibited lower mean and peak transvalvular pressure gradients than the control model at all 3 cardiac outputs. In addition, its leaflets opened more fully than did those of the valved conduit without the sinuses, yielding greater effective and geometric orifice areas. It was found that the presence of the sinuses not only facilitated the development of larger and more stable vortices at the initial stages of the cardiac cycle but also helped to maintain these vortices during the late stages of the cardiac cycle, leading to smoother valve closure.ConclusionsThe KONECT RESILIA aortic valved conduit reproduces the bulged section of the aortic root corresponding to the sinuses of Valsalva. With this Valsalva-type conduit, larger orifice areas were observed, improving valve hemodynamics that may enhance performance. |
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