Abstract：
OBJECTIVE: Selection of a surgical aortic valve (SAV) bioprosthesis model for the treatment of aortic valve disease remains controversial. The aim of this study was to characterize the functional performance of 8 SAV models in a standardized in vitro setting.
METHODS: The hydrodynamic performance of 8 SAVs with labelled size 21 mm (Avalus™, Hancock® II, Mosaic® Ultra™, Perimount®, Perimount® Magna Ease, Epic™ Supra, Trifecta™ GT; Freestyle®), was investigated in a pulse duplicator. Transvalvular pressure gradients and effective orifice area (EOA) were recorded. The geometrical orifice area and physical dimensions of the valves were determined, and new functional dimensions were introduced.
RESULTS: Mean pressure gradient (MPG) and EOA differed significantly between the analysed SAVs. The Epic presented with the lowest EOA and highest MPG, while the Trifecta showed the highest EOA and the lowest MPG. We introduce a useful way to determine the minimal internal diameter and a new measure termed \'relative orifice area\' to characterize a valve\'s performance.
CONCLUSIONS: SAVs showed significant differences in their hydrodynamic performance despite the same label size. This finding was related to the construction of the valves. We introduce a new measure that characterizes the functional performance of a valve model and size for the treatment of an aortic annulus of a specific size. Our data emphasize that SAV selection should carefully be done using an individual patient approach and that future research is necessary to improve the current generation of SAVs.
METHODS: The hydrodynamic performance of 8 SAVs with labelled size 21 mm (Avalus™, Hancock® II, Mosaic® Ultra™, Perimount®, Perimount® Magna Ease, Epic™ Supra, Trifecta™ GT; Freestyle®), was investigated in a pulse duplicator. Transvalvular pressure gradients and effective orifice area (EOA) were recorded. The geometrical orifice area and physical dimensions of the valves were determined, and new functional dimensions were introduced.
RESULTS: Mean pressure gradient (MPG) and EOA differed significantly between the analysed SAVs. The Epic presented with the lowest EOA and highest MPG, while the Trifecta showed the highest EOA and the lowest MPG. We introduce a useful way to determine the minimal internal diameter and a new measure termed \'relative orifice area\' to characterize a valve\'s performance.
CONCLUSIONS: SAVs showed significant differences in their hydrodynamic performance despite the same label size. This finding was related to the construction of the valves. We introduce a new measure that characterizes the functional performance of a valve model and size for the treatment of an aortic annulus of a specific size. Our data emphasize that SAV selection should carefully be done using an individual patient approach and that future research is necessary to improve the current generation of SAVs.
摘要：
目的：选择用于治疗主动脉瓣疾病的外科主动脉瓣（SAV）生物假体模型仍存在争议。这项研究的目的是在标准化的体外环境中表征8种SAV模型的功能性能。
方法：标记尺寸为21mm（Avalus™，Hancock®II,Mosaic®Ultra™,Perimount®,Perimount®MagnaEase,Epic™Supra,Trifecta™GT；Freestyle®)，在脉冲复制器中进行了研究。记录跨瓣压力梯度和有效孔口面积(EOA)。确定了阀门的几何孔口面积和物理尺寸，并引入了新的功能维度。
结果:所分析的SAV之间的平均压力梯度(MPG)和EOA显著不同。史诗呈现最低的EOA和最高的MPG，而Trifecta显示最高的EOA和最低的MPG。我们介绍了一种确定最小内径的有用方法和一种称为“相对孔口面积”的新措施，以表征阀门的性能。
结论：尽管标签大小相同，但SAV的流体动力学性能仍存在显着差异。这一发现与阀门的结构有关。我们引入了一种新的措施，该措施表征了瓣膜模型和尺寸的功能性能，以治疗特定尺寸的主动脉瓣环。我们的数据强调，SAV选择应使用个体患者方法仔细进行，并且未来的研究对于改善当前一代的SAV是必要的。
方法：标记尺寸为21mm（Avalus™，Hancock®II,Mosaic®Ultra™,Perimount®,Perimount®MagnaEase,Epic™Supra,Trifecta™GT；Freestyle®)，在脉冲复制器中进行了研究。记录跨瓣压力梯度和有效孔口面积(EOA)。确定了阀门的几何孔口面积和物理尺寸，并引入了新的功能维度。
结果:所分析的SAV之间的平均压力梯度(MPG)和EOA显著不同。史诗呈现最低的EOA和最高的MPG，而Trifecta显示最高的EOA和最低的MPG。我们介绍了一种确定最小内径的有用方法和一种称为“相对孔口面积”的新措施，以表征阀门的性能。
结论：尽管标签大小相同，但SAV的流体动力学性能仍存在显着差异。这一发现与阀门的结构有关。我们引入了一种新的措施，该措施表征了瓣膜模型和尺寸的功能性能，以治疗特定尺寸的主动脉瓣环。我们的数据强调，SAV选择应使用个体患者方法仔细进行，并且未来的研究对于改善当前一代的SAV是必要的。
