Key result
In an in vitro flow loop circuit, the Trifecta 21 bioprosthesis demonstrated higher pressure recovery (54%) compared to Magna 21 (39%) and Crown 23 (41%) valves.
Why the study?
Bioprostheses yield complex fluid dynamics, and it was hypothesized that structural characteristics affect the vena contracta position and downstream pressure recovery.
Does the design of pericardial aortic bioprostheses affect pressure drop, pressure recovery, and vena contracta position in an in vitro steady flow loop circuit?
Does the design of pericardial aortic bioprostheses affect pressure drop, pressure recovery, and vena contracta position in an in vitro steady flow loop circuit?
The structural design of aortic bioprostheses significantly influences fluid dynamics, including pressure recovery and vena contracta position, which may impact clinical hemodynamic assessment.
BACKGROUND: Bioprostheses are complex structures and yield a very complex fluid dynamics. Hence, it can be hypothesized that prosthesis structural characteristics affect the position of the vena contracta and, consequently, influences the pattern and the extent of pressure recovery downstream from the vena contracta. MATERIALS AND METHODS: The study was performed on pericardial aortic prostheses, specifically Crown 21 and 23 (LivaNova PLC, UK), Trifecta 19 and 21 (Edwards Lifescience, USA), and Magna 19 and 21(Abbott, USA), tested in an "ad hoc" devised steady flow loop circuit at four flow rates (10, 15, 20, and 25 L/min). Fluid dynamic quantities were obtained by direct pressure measurement and Doppler interrogation. RESULTS: Pressure drop at 25 L/min flow rate was 26.5 ± 0.3 mm Hg and 14.9 ± 0.1 mm Hg for the Trifecta 19 and 21, 37.1 ± 1.0 mm Hg and 27.3 ± 0.4 mm Hg for the Magna 19 and 21, and 36.6 ± 1.0 mm Hg and 22.7 ± 0.1 mm Hg for Crown 21 and 23, respectively. The vena contracta was shorter for Trifecta compared with the Magna and the Crown in which it developed further downstream and as far as 1 cm from the valve leaflets fringes. The pressure recovery was 54% ± 1% for Trifecta 21, 39% ± 1% for Magna 21, and 41% ± 2% for Crown 23 with different patterns. CONCLUSION: The design of bioprosthesis affects pressure recovery and the position of the vena contracta. The different patterns of pressure recovery might have clinical impact.
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Tasca et al. (2020) studied this question. Trifecta bioprosthesis vs. Magna and Crown bioprostheses was evaluated on Pressure drop, pressure recovery, and spatial positioning of vena contracta. In an in vitro flow loop circuit, the Trifecta 21 bioprosthesis demonstrated higher pressure recovery (54%) compared to Magna 21 (39%) and Crown 23 (41%) valves.
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