Department of Cardiac and Thoracic Vascular Surgery, University Hospital of Schleswig Holstein, Lübeck, Germany.
University of Lübeck, Lübeck, Germany.
Interact Cardiovasc Thorac Surg. 2022 Aug 3;35(3). doi: 10.1093/icvts/ivac199.
We investigated the hydrodynamic performance and cusp kinematics of the Ozaki neocuspidized aortic valve in comparison with the native aortic and prosthetic valves in an ex vivo study.
Native aortic valves of swine hearts were replaced by aortic valve substitutes, and their hydrodynamic performance (effective orifice area and mean pressure gradient) was evaluated in a mock circulation under defined conditions. The following aortic valve substitutes were investigated: native aortic valve, Ozaki valve, Perimount Magna Ease, Trifecta and St. Jude Medical Masters. All prosthetic valves had a labelled size of 21 mm.
The Ozaki valve and native aortic valve showed a similar and significantly larger orifice area than all investigated prosthetic valves particularly at high flow rates. There was no significant difference between the Ozaki valve and the native aortic valve. The native aortic valve and Ozaki valve showed a similar increase in orifice area with increasing flow through the valve while prosthetic valves showed a markedly weaker increase. Similarly, the native and Ozaki valve showed a similar increase in mPG with forward flow which was weaker than prosthetic valves. Cusp kinematics were similar between the native and Ozaki valve, whilst prosthetic valves were clearly distinguishable from them.
The Ozaki procedure showed excellent hydrodynamic performance compared to prosthetic valves and showed similar cusp motion characteristics to the native aortic valve. Our results suggest that the Ozaki neocuspidized valve behaves physiologically in many aspects, which may contribute to beneficial clinical outcomes.
我们通过离体研究比较了 Ozaki 去瓣化主动脉瓣与天然主动脉瓣和人工瓣膜的流体力学性能和瓣叶运动学。
用主动脉瓣替代物置换猪心的天然主动脉瓣，并在模拟循环下在规定条件下评估其流体力学性能（有效瓣口面积和平均压力梯度）。研究了以下主动脉瓣替代物：天然主动脉瓣、Ozaki 瓣、Perimount Magna Ease、Trifecta 和 St. Jude Medical Masters。所有人工瓣膜的标记尺寸均为 21mm。
Ozaki 瓣和天然主动脉瓣的瓣口面积明显大于所有研究的人工瓣膜，特别是在高流量时。Ozaki 瓣和天然主动脉瓣之间没有显著差异。天然主动脉瓣和 Ozaki 瓣的瓣口面积随通过瓣口的流量增加而相似增加，而人工瓣膜的增加则明显较弱。同样，天然瓣和 Ozaki 瓣的平均压力梯度随前向血流而增加，这比人工瓣膜弱。天然瓣和 Ozaki 瓣的瓣叶运动学相似，而人工瓣膜则与之明显不同。
与人工瓣膜相比，Ozaki 术式具有出色的流体力学性能，并且与天然主动脉瓣具有相似的瓣叶运动学特征。我们的结果表明，Ozaki 去瓣化瓣膜在许多方面表现出生理性，这可能有助于临床获益。
