Key result
The Ozaki neocuspidized aortic valve demonstrated a significantly larger effective orifice area and weaker increase in mean pressure gradient compared to prosthetic valves, behaving similarly to the native aortic valve.
Why the study?
The hydrodynamic performance and cusp kinematics of the Ozaki neocuspidized aortic valve compared with the native aortic valve and prosthetic valves remained to be investigated ex vivo.
Does the Ozaki neocuspidized aortic valve improve hydrodynamic performance compared to prosthetic valves in an ex vivo swine heart model?
Does the Ozaki neocuspidized aortic valve improve hydrodynamic performance compared to prosthetic valves in an ex vivo swine heart model?
The Ozaki procedure provides excellent hydrodynamic performance and physiological cusp kinematics comparable to the native aortic valve, outperforming standard 21 mm prosthetic valves in an ex vivo model.
Should not change aortic valve practice; leaves open whether ex vivo hydrodynamic gains translate to clinical outcomes.
OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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Saisho et al. (2022) studied Aortic valve substitutes (ex vivo evaluation). Ozaki neocuspidized aortic valve vs. Native aortic valve and prosthetic valves (Perimount Magna Ease, Trifecta, St. Jude Medical Masters) was evaluated on Hydrodynamic performance (effective orifice area and mean pressure gradient) and cusp kinematics. The Ozaki neocuspidized aortic valve demonstrated a significantly larger effective orifice area and weaker increase in mean pressure gradient compared to prosthetic valves, behaving similarly to the native aortic valve.
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