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September 17, 2026JACC AsiaOpen Access

Human Ex Vivo Working-Heart Evaluation of Coronet-Framed Valve-Sparing Aortic Root Replacement

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Population

Ex vivo human heart explanted during orthotopic transplantation (n=1)

Design

Preclinical

Key result

A coronet-framed annular stabilization platform during valve-sparing aortic root reconstruction was technically feasible in an ex vivo human working-heart model, preserving leaflet coaptation.

Authors

JKJoon Bum KimASAmit SharirSEStefan Elde

Discussion

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Overview

Ex vivo feasibility does not support clinical use; leaves open need for in vivo validation before trials.

Key Points

  • To assess the structural feasibility and qualitative functional performance of a novel coronet-framed annular stabilization device for valve-sparing aortic root reconstruction in an ex vivo human working-heart platform.
  • Conducted benchtop valve-sparing aortic root replacement using a coronet-framed device in an explanted human heart obtained during orthotopic transplantation.
  • Mounted the reconstructed heart onto an ex vivo cardiopulmonary bypass-based perfusion circuit transitioning from Langendorff reperfusion to an actively loaded working-heart state.
  • Evaluated dynamic valve competence and leaflet kinematics using saline-filled endoscopic visualization under simulated loading conditions.
  • Benchtop surgical implantation of the coronet frame was technically feasible, yielding a geometrically stable aortic root construct.
  • Reperfusion and defibrillation successfully restored intrinsic ventricular ejection and sustained coronary recirculation under working-heart conditions.
  • Direct endoscopic imaging revealed preserved central leaflet coaptation with no visual evidence of leaflet prolapse or commissural distortion.

Structured PICO

P
Population
One explanted human heart used for ex vivo evaluation of a coronet-framed annular stabilization platform during valve-sparing aortic root reconstruction.
I
Intervention
Bench valve-sparing aortic root reconstruction (VSARR) using a coronet-framed stabilization device
O
Outcome
Structural feasibility and qualitative functional performance (dynamic valve competence, central leaflet coaptation)surrogate

An ex vivo human working-heart model demonstrated the structural feasibility and functional competence of a coronet-framed annular stabilization device for valve-sparing aortic root reconstruction.

Cite This Study

Kim et al. (2026) studied Valve-sparing aortic root reconstruction (n=1). Coronet-framed annular stabilization platform was evaluated on Structural feasibility and qualitative functional performance. A coronet-framed annular stabilization platform during valve-sparing aortic root reconstruction was technically feasible in an ex vivo human working-heart model, preserving leaflet coaptation.

synapsesocial.com/papers/6aaba4611561938ee54ba369https://doi.org/10.1016/j.jacasi.2026.08.007
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Surgical Treatment of Aneurysms of the Ascending Aorta in the Marfan Syndrome1986 · 208 citations
  2. 2Investigating the physiology of normothermic ex vivo heart perfusion in an isolated slaughterhouse porcine model used for device testing and training2019 · 23 citations
  3. 3Dimensions and Geometric Relationships of the Human Aortic Value as a Function of Pressure1974 · 351 citations
  4. 4Aortic Valvular Insufficiency Associated with Cystic Medial Necrosis1967 · 30 citations
  5. 5A technique for complete replacement of the ascending aorta1968 · 1,492 citations