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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Aortic root distensibility after subcoronary stentless valve implantation
Jonas A Funder1, Markus W Frost, Kaj-Erik Klaaborg
1Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Skejby, Aarhus, Denmark. funder@ki.au.dk
The Journal of Heart Valve Disease
|June 1, 2012
Summary
Stentless Solo valves better maintained aortic root annular distensibility than stented Mitroflow valves. However, Solo valves showed less longitudinal distensibility, though they offered a more physiologic aortic root expansion pattern.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Biomechanical Analysis
Background:
- Preserving aortic root dynamics is crucial for the long-term durability of bioprosthetic aortic valves.
- Stentless heart valves are hypothesized to better support physiological biomechanics compared to stented valves.
- Previous dynamic analyses were limited to radial direction and full root prostheses.
Purpose of the Study:
- To compare the radial and longitudinal aortic root distensibilities of stentless (Solo, Toronto SPV) and stented (Mitroflow) bioprosthetic valves against native pig valves.
- To investigate the dynamic behavior of subcoronary valve prostheses in the aortic root.
Main Methods:
- Sonomicrometry crystals were implanted on the aortic root of 32 pigs to measure radial and longitudinal distensibility.
- Investigated native porcine valves, stented pericardial (Mitroflow), and stentless (Solo, Toronto SPV) valve prostheses.
Main Results:
- Native and Solo valves demonstrated significantly greater radial distensibility at the annular level compared to Mitroflow valves.
- Native valves were significantly more distensible at the sinotubular junction (STJ), commissures, and aorta than all artificial valves.
- Solo valves had reduced longitudinal distensibility compared to Toronto SPV and Mitroflow valves.
- Toronto SPV showed delayed radial expansion at the STJ, while Solo valves initiated longitudinal expansion earlier.
Conclusions:
- The Solo valve maintained superior annular distensibility post-implantation compared to the Mitroflow valve.
- The Solo valve did not preserve longitudinal distensibility as effectively as other tested valves.
- The Solo valve demonstrated a more physiologic aortic root expansion pattern than its prosthetic counterparts.
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