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Abstract：
UNASSIGNED: In this study we aimed to understand the role of interaction of the Medtronic Evolut R transcatheter aortic valve with the ascending aorta (AA) by evaluating the performance of the valve and the pressure recovery in different AA diameters with the same aortic annulus size.
UNASSIGNED: A 26-mm Medtronic Evolut R valve was tested using a left heart simulator in aortic root models of different AA diameter (D): small (D = 23 mm), medium (D = 28 mm), and large (D = 34 mm) under physiological conditions. Measurements of pressure from upstream to downstream of the valve were performed using a catheter at small intervals to comprehensively assess pressure gradient and pressure recovery.
UNASSIGNED: In the small AA, the measured peak and mean pressure gradient at vena contracta were 11.5 ± 0.5 mm Hg and 7.8 ± 0.4 mm Hg, respectively, which was higher (P < .01) compared with the medium (8.1 ± 0.4 mm Hg and 5.2 ± 0.4 mm Hg) and large AAs (7.4 ± 1.0 mm Hg and 5.4 ± 0.6 mm Hg). The net pressure gradient was lower for the case with the medium AA (4.1 ± 1.2 mm Hg) compared with the small AA (4.7 ± 0.8 mm Hg) and large AA (6.1 ± 1.4 mm Hg; P < .01).
UNASSIGNED: We have shown that small and large AAs can increase net pressure gradient, because of the direct interaction of the Medtronic Evolut R stent with the AA (in small AA) and introducing higher level of turbulence (in large AA). AA size might need to be considered in the selection of an appropriate device for transcatheter aortic valve replacement.
UNASSIGNED: A 26-mm Medtronic Evolut R valve was tested using a left heart simulator in aortic root models of different AA diameter (D): small (D = 23 mm), medium (D = 28 mm), and large (D = 34 mm) under physiological conditions. Measurements of pressure from upstream to downstream of the valve were performed using a catheter at small intervals to comprehensively assess pressure gradient and pressure recovery.
UNASSIGNED: In the small AA, the measured peak and mean pressure gradient at vena contracta were 11.5 ± 0.5 mm Hg and 7.8 ± 0.4 mm Hg, respectively, which was higher (P < .01) compared with the medium (8.1 ± 0.4 mm Hg and 5.2 ± 0.4 mm Hg) and large AAs (7.4 ± 1.0 mm Hg and 5.4 ± 0.6 mm Hg). The net pressure gradient was lower for the case with the medium AA (4.1 ± 1.2 mm Hg) compared with the small AA (4.7 ± 0.8 mm Hg) and large AA (6.1 ± 1.4 mm Hg; P < .01).
UNASSIGNED: We have shown that small and large AAs can increase net pressure gradient, because of the direct interaction of the Medtronic Evolut R stent with the AA (in small AA) and introducing higher level of turbulence (in large AA). AA size might need to be considered in the selection of an appropriate device for transcatheter aortic valve replacement.
摘要：
UNASSIGNED：本研究旨在了解MedtronicEvolutR经导管主动脉瓣膜与升主动脉（AA）相互作用的作用，方法是评估不同AA直径下相同主动脉瓣环大小的瓣膜性能和压力恢复情况。
UNASSIGNED：在不同AA直径（D）：小（D=23mm）的主动脉根模型中使用左心模拟器测试了26-mmMedtronicEvolutR瓣膜，中等（D=28毫米），和大（D=34毫米）在生理条件下。使用导管以小间隔进行从瓣膜上游到下游的压力测量,以全面评估压力梯度和压力恢复。
未经评估：在小型AA中，在静脉收缩处测得的峰值和平均压力梯度为11.5±0.5mmHg和7.8±0.4mmHg，分别,与中等（8.1±0.4mmHg和5.2±0.4mmHg）和大AA（7.4±1.0mmHg和5.4±0.6mmHg）相比，更高（P<.01）。与小AA（4.7±0.8mmHg）和大AA（6.1±1.4mmHg；P<0.01）相比，中等AA（4.1±1.2mmHg）的情况下的净压力梯度较低。
UNASSIGNED：我们已经证明，小的和大的AA可以增加净压力梯度，由于MedtronicEvolutR支架与AA（在小AA中）直接相互作用并引入更高水平的湍流（在大AA中）。在选择合适的经导管主动脉瓣置换术装置时，可能需要考虑AA尺寸。
UNASSIGNED：在不同AA直径（D）：小（D=23mm）的主动脉根模型中使用左心模拟器测试了26-mmMedtronicEvolutR瓣膜，中等（D=28毫米），和大（D=34毫米）在生理条件下。使用导管以小间隔进行从瓣膜上游到下游的压力测量,以全面评估压力梯度和压力恢复。
未经评估：在小型AA中，在静脉收缩处测得的峰值和平均压力梯度为11.5±0.5mmHg和7.8±0.4mmHg，分别,与中等（8.1±0.4mmHg和5.2±0.4mmHg）和大AA（7.4±1.0mmHg和5.4±0.6mmHg）相比，更高（P<.01）。与小AA（4.7±0.8mmHg）和大AA（6.1±1.4mmHg；P<0.01）相比，中等AA（4.1±1.2mmHg）的情况下的净压力梯度较低。
UNASSIGNED：我们已经证明，小的和大的AA可以增加净压力梯度，由于MedtronicEvolutR支架与AA（在小AA中）直接相互作用并引入更高水平的湍流（在大AA中）。在选择合适的经导管主动脉瓣置换术装置时，可能需要考虑AA尺寸。
