In vitro comparison of everting vs. non-everting suture techniques for the implantation of a supra-annular biological heart valve.

Abstract:

Background:The aim of this study was to evaluate the hemodynamic effect of different suturing techniques for aortic valve replacement (AVR) in vitro. Whether or not the applied suturing technique impacts the outflow tract diameter by narrowing the annulus diameter was examined. Methods:The commonly applied non-everting pledget forced suture technique (NE, n=13) was compared with an everting pledget forced suture (ET, n=13) for AVR using the 25 mm St. Jude Trifecta aortic valve. Hemodynamic parameters were obtained in a pulsatile flow simulator. A high speed camera captured the visual aspects of the suturing technique. Results:Despite some kind of left ventricular outflow narrowing due to protruding pledgets using the NE suture technique, mean pressure gradients of both techniques were nearly similar (NE 5.88±2.7 mmHg, ET 5.23±1.31 mmHg, P=0.44). Closing volume (NE 3.16±0.48 mL; ET 3.51±0.68 mL; P=0.14) and the leakage volume (NE: 8.09±2.53 mL; ET: 8.35±3.65 mL; P=0.83) also showed no differences. Conclusions:AVR using either suturing techniques leads to a similar hemodynamic performance in vitro. The impact of the suturing technique may be higher in a smaller annulus. Therefore, further studies using smaller prostheses are necessary.

journal_name

J Thorac Dis

authors

Puluca N,Münsterer A,Prinzing A,Sexton ZA,Lange R,Meyer-Saraei R,Scharfschwerdt M

doi

10.21037/jtd.2020.03.55

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

2443-2449

issue

5

eissn

2072-1439

issn

2077-6624

pii

jtd-12-05-2443

journal_volume

12

pub_type

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