What question did this study set out to answer?

To compare the fluid-dynamic performance of four widely used pericardial stented bioprostheses surgically implanted into small aortic roots.

November 20, 2014European Journal of Cardio-Thoracic SurgeryOpen Access

Fluid-dynamic results of in vitro comparison of four pericardial bioprostheses implanted in small porcine aortic roots

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Why the study?

Does the type of pericardial bioprosthesis affect fluid-dynamic performance in small porcine aortic roots?

Population

8 porcine aortic roots with a native annulus of 2.1 cm

Comparison

Four pericardial stented bioprostheses implanted… vs Comparison among the four bioprostheses

Design

Preclinical, randomized sequence

Authors

GTGiordano TascaMuscular Dystrophy UK RVRiccardo VismaraFondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico GFGianfranco Beniamino FiorePolitecnico di Milano

Discussion

Member takes

Implication

Should not yet guide prosthesis selection in small roots; leaves open need for clinical outcome validation.

Key Points

To compare the fluid-dynamic performance of four widely used pericardial stented bioprostheses surgically implanted into small aortic roots.
Four pericardial bioprostheses (Magna Ease 21, Trifecta 21, Soprano-Armonia 20, and Mitroflow 23) were implanted in a randomized sequence into eight porcine aortic roots with native 2.1-cm annuli.
Valves were evaluated in an in vitro mock loop at 65 ml stroke volume to measure effective orifice area, mean pressure drop, performance index, valve resistance, and energy loss percentage.
Trifecta bioprostheses demonstrated the largest effective orifice area at 2.3 ± 0.3 cm², compared with 1.77 ± 0.2 cm² for Mitroflow, 1.75 ± 0.2 cm² for Soprano-Armonia, and 1.57 ± 0.2 cm² for Magna Ease (P < 0.001).
Trifecta exhibited the lowest mean pressure gradient (6.1 ± 2 mmHg vs. 9.6 ± 2 for Soprano-Armonia, 10.2 ± 3 for Mitroflow, and 13.2 ± 3 for Magna Ease; P < 0.001) and the lowest energy loss (6.6 ± 1.6% vs. 10.7%–13.5%; P < 0.001).

Structured PICO

Does the type of pericardial bioprosthesis affect fluid-dynamic performance in small porcine aortic roots?

Population

8 porcine aortic roots with a native annulus of 2.1 cm

Intervention

Four pericardial stented bioprostheses (Magna Ease 21, Trifecta 21, Soprano-Armonia 20, Mitroflow 23) implanted in a randomized sequence and tested in a mock loop at 65 ml stroke volume

Comparator

Comparison among the four bioprostheses

Outcome

Hydrodynamic parameters including mean pressure drop, effective orifice area, performance index, valve resistance, and % of energy losssurrogate

In an in vitro porcine aortic root model, bioprostheses with the pericardium outside the stent demonstrated superior fluid-dynamic efficiency compared to other designs.

Cite This Study

Tasca et al. (2014) studied this question.

synapsesocial.com/papers/6a7628409f6847b0a98c5ce1 https://doi.org/10.1093/ejcts/ezu446

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Fluid-dynamic results of in vitro comparison of four pericardial bioprostheses implanted in small porcine aortic roots

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Fluid-dynamic results of in vitro comparison of four pericardial bioprostheses implanted in small porcine aortic roots

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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