Key result
The CarboMedics valve showed larger regurgitant volumes but higher stroke volumes and cardiac outputs at higher heart rates than the Monostrut valve in an in vitro pediatric VAD model.
Why the study?
Does a bileaflet valve (CPHV) improve hydrodynamic performance compared to a monoleaflet valve (Björk-Shiley Monostrut) in a pulsatile pediatric ventricular assist device?
Does a bileaflet valve (CPHV) improve hydrodynamic performance compared to a monoleaflet valve (Björk-Shiley Monostrut) in a pulsatile pediatric ventricular assist device?
In an in vitro pediatric VAD model, a bileaflet valve demonstrated higher cardiac output at higher heart rates but greater regurgitant volume compared to a monoleaflet valve.
Bileaflet valves may enhance output at high rates in pediatric VADs despite more regurgitation; leaves open optimal valve choice pending in vivo data.
A pulsatile pediatric ventricular assist device with a dynamic stroke volume of 12 ml is currently under development at the Pennsylvania State University. A monoleaflet valve (Björk-Shiley Monostrut) and a bileaflet valve (CPHV, CarboMedics Prosthetic Heart Valve) were examined in this study. A high-speed video and data acquisition system was used to simultaneously record video images, pressure waveforms, and flow waveforms for an array of in vitro test conditions that varied heart rate and systolic duration. The CPHV in both the horizontal and vertical orientations have larger regurgitant volumes than the Monostrut valves at all operating conditions in both the inlet and outlet positions. However, the CPHV has higher stroke volumes and cardiac outputs than the Monostrut valve at higher heart rates and longer systolic durations. In addition, the hydrodynamic performance of the Monostrut valve is more sensitive to changes in operating conditions for the pulsatile pediatric ventricular assist device than the CPHV in both orientations. Additional testing is under way to identify the optimal operating conditions for each type of valve.
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Zapanta et al. (2007) studied Pediatric ventricular assist device development. CarboMedics Prosthetic Heart Valve (CPHV) vs. Björk-Shiley Monostrut valve was evaluated on Hydrodynamic performance (regurgitant volumes, stroke volumes, cardiac outputs). The CarboMedics valve showed larger regurgitant volumes but higher stroke volumes and cardiac outputs at higher heart rates than the Monostrut valve in an in vitro pediatric VAD model.
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