Comparison of hemodynamics and root configurations between remodeling and reimplantation methods for valve-sparing aortic root replacement: a pulsatile flow study

Figures

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  Fig. 1. Preparation of the valves. The remodeling and reimplantation models were prepared using porcine aortic roots. A 24-mm Dacron graft was used in both models. Grafts with sinuses were handcrafted in the reimplantation model. External suture annuloplasty was used as a remodeling technique to reduce the annulus to 22 or 18 mm

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  Fig. 2. Pulsatile flow simulator. a Schematic of the pulsatile flow circuit. b An overall view of the pulsatile flow circuit

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  Fig. 3. Flow and pressure waveforms. a Schematic of pulsatile flow waveforms. Forward flow, regurgitation, and leakage were measured. b Pressure waveform. Diagonal lines represent the pressure gradient between the ventricle and aorta. *T = valve opening time

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  Fig. 4. An analysis of the three-dimensional morphological structure of the valves using micro-CT

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  Fig. 5. The comparison of hemodynamics. (a) Regurgitation flow, (b) leakage flow, (c) backflow, (d) forward flow. *P < 0.05; **P < 0.01

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  Fig. 6. The comparison of pressure gradients during valve opening. (a) Peak pressure gradient, (b) mean pressure gradient. *P < 0.05; **P < 0.01

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  Fig. 7. The comparison of valve-closing times. Valve-closing time was assessed with a high-speed camera. *P < 0.05; **P < 0.01

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  Fig. 8. The comparison of aortic root configurations. The diameters were calculated from the cross-sectional perimeters of three areas. (a) VAJ diameter; (b) sinus of Valsalva diameter; (c) STJ diameter. *P < 0.05; **P < 0.01

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  Fig. 9. Valsalva/VAJ and STJ/VAJ ratio. Each ratio was calculated from the data examined using micro-CT. (a) Valsalva/VAJ ratio; (b) STJ/VAJ ratio. *P < 0.05; **P < 0.01