Bottio Tomaso, Tarzia Vincenzo, Rizzoli Giulio, Gerosa Gino
Cardiovascular Institute, University of Padova, Via Giustiniani 2, 36100 Padova, Italy.
Interact Cardiovasc Thorac Surg. 2008 Oct;7(5):750-4. doi: 10.1510/icvts.2008.182469. Epub 2008 Jul 15.
The aims of the present study were to compare hydrodynamics of three pericardial and two porcine valves while performing at different stroke volume (SV) and increasing pulse rate (PR). Carpentier-Edwards Magna-21 (CEM), Sorin Soprano-20 (SS), Mitroflow-23 (MF), SJM-Biocor-Epic-Supra-21 (SJME), and Medtronic Mosaic Ultra-23 (MMU) were tested in the aortic chamber (23-mm in diameter) of the Sheffield-Pulse-Duplicator. The tests were carried out at increasing pulse-rate and at each pulse-rate the valve was tested at different SV. CEM and MF showed significantly lower gradients than porcine valves and SS. Transvalvular gradients were unrelated to PR showing a constant value with increasing PR. While SJME valve showed the lowest regurgitant volume, on the contrary CEM showed the highest. At increasing SV, effective-orifice-area (EOA) observed with CEM was significantly larger than with the other tested valves, even though at SV 60 ml MF was comparable and at SV 65 ml significantly better. SS, SJME and MMU showed comparable EOAs with bigger area at increasing PR. The latter relation was reversed for CEM and MF. Our results show that CEM and MF have shown significantly better in-vitro hydrodynamics in comparison with their porcine counterpart and SS. Nevertheless, at increasing pulse rate, porcine tissue valves and SS may guarantee higher EOA values.
本研究的目的是比较三种心包瓣膜和两种猪瓣膜在不同 stroke volume（SV，每搏输出量）和递增脉率（PR）情况下的流体动力学性能。在谢菲尔德脉冲复制器的主动脉腔（直径 23 毫米）中对 Carpentier-Edwards Magna-21（CEM）、Sorin Soprano-20（SS）、Mitroflow-23（MF）、SJM-Biocor-Epic-Supra-21（SJME）和 Medtronic Mosaic Ultra-23（MMU）进行测试。测试在递增脉率下进行，并且在每个脉率下，瓣膜在不同的 SV 下进行测试。CEM 和 MF 显示出比猪瓣膜和 SS 显著更低的梯度。跨瓣梯度与 PR 无关，随着 PR 的增加呈现恒定值。虽然 SJME 瓣膜显示出最低的反流容积，相反 CEM 显示出最高的反流容积。随着 SV 的增加，CEM 观察到的有效开口面积（EOA）比其他测试瓣膜显著更大，尽管在 SV 为 60 毫升时 MF 与之相当，在 SV 为 65 毫升时显著更好。SS、SJME 和 MMU 在 PR 增加时显示出具有更大面积的可比 EOA。CEM 和 MF 的后一种关系则相反。我们的结果表明，与它们的猪瓣膜对应物和 SS 相比，CEM 和 MF 在体外流体动力学方面表现出显著更好的性能。然而，在脉率增加时，猪组织瓣膜和 SS 可能保证更高的 EOA 值。
