Key result
Apico-aortic valved conduit implantation significantly reduced the left ventricular-aortic pressure gradient compared to control dogs (18.67 vs 70 mmHg, P<0.01) at 6 months postoperatively.
Why the study?
Does apico-aortic valved conduit (AAVC) implantation improve hemodynamics and relieve left ventricular pressure overload in a canine model of aortic stenosis?
Does apico-aortic valved conduit (AAVC) implantation improve hemodynamics and relieve left ventricular pressure overload in a canine model of aortic stenosis?
In a canine model of aortic stenosis, an apico-aortic valved conduit successfully relieved left ventricular pressure overload and prevented concentric myocardial hypertrophy.
A new valved conduit was developed using a canine aortic valve. The bioprosthetic valve was fixed with glutaraldehyde and epoxy compound (Denacol-EX313/810). A vascular graft composed of ultra-fine polyester fiber (10 mm in diameter, 200 mm in length) was used. Four dogs underwent apico-aortic valved conduit (AAVC) implantation and aortic banding (bypass group, BG), while another 4 dogs underwent aortic banding without AAVC implantation (control group, CG). Cardiac catheterization and angiocardiography were performed for assessment of hemodynamics 2 weeks and 6 months after surgery. Left ventricular systolic pressure, left ventricular end-diastolic pressure and the left ventricular-aortic pressure gradient differed significantly (P<0.01) between the BG and CG dogs. Left ventricular angiocardiography showed patency of the valved conduit in all the BG dogs. Echocardiography was performed before and 2, 4 and 6 months after surgery, and showed that while pressure overload caused concentric myocardial hypertrophy in the CG dogs, the left ventricle dilated eccentrically in the BG dogs. Furthermore, relief of left ventricular pressure overload by AAVC was maintained.
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Hirao et al. (2005) studied Aortic stenosis (experimental model) (n=8). Apico-aortic valved conduit (AAVC) implantation vs. Aortic banding without AAVC implantation was evaluated on Left ventricular-aortic pressure gradient (LV-AoPG) at 6 months (p=<0.01). Apico-aortic valved conduit implantation significantly reduced the left ventricular-aortic pressure gradient compared to control dogs (18.67 vs 70 mmHg, P<0.01) at 6 months postoperatively.
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