The sinus of Valsalva relieves abnormal stress on aortic valve leaflets by facilitating smooth closure Susumu Katayama, BE, Nobuyuki Umetani, BE, Seiryo.

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Presentation transcript:

The sinus of Valsalva relieves abnormal stress on aortic valve leaflets by facilitating smooth closure Susumu Katayama, BE, Nobuyuki Umetani, BE, Seiryo Sugiura, MD, PhD, Toshiaki Hisada, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 136, Issue 6, Pages 1528-1535.e1 (December 2008) DOI: 10.1016/j.jtcvs.2008.05.054 Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Configurations of the model. A, Cylindrical (left) and pseudosinus (right) aortic roots with details of their dimensions. B, Valvular leaflet and fiber orientation (right). C, Simulated aortic pressure was applied to the proximal end of the model aortic root. To the distal end, a 3-element Windkessel model was connected. R1, Characteristic impedance (100 dynes · s · cm−5); R2, peripheral resistance (1600 dynes · s · cm−5); C, capacitance (2.1 × 10−3 L/mm Hg). The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1528-1535.e1DOI: (10.1016/j.jtcvs.2008.05.054) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Motion of the leaflet. A, The distance from the axis of the aorta is shown as a function of time. Solid line, Pseudosinus model; dotted line, cylindrical model. B, Schematic diagram showing the indices characterizing the motion of leaflet. D1, Maximum distance; D2, distance immediately before the rapid closing. RCT, Rapid closing time. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1528-1535.e1DOI: (10.1016/j.jtcvs.2008.05.054) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Comparison of valve functions. A, Slow closing distance (SCD). B, Closing time. C, Rapid valve closing velocity (RVCV). D, Regurgitant fraction. White bar, Cylindrical model; black bar, pseudosinus model. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1528-1535.e1DOI: (10.1016/j.jtcvs.2008.05.054) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Strain and stress in the leaflet. A, Strain (ɛ). B, Stress (σ). Values for membrane (tensile), bending, and total are shown in parallel (‖) and perpendicular (tt) to the fiber direction. White bar, Cylindrical model; black bar, pseudosinus model. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1528-1535.e1DOI: (10.1016/j.jtcvs.2008.05.054) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Stress in the leaflet and deformation. A, Close-up views of the leaflet in the late phase of ejection for pseudosinus (upper panel) and cylindrical (lower panel) models. Stress values shown in color coding indicate the higher stress in the cylindrical model. B, Schematic diagrams showing the direction of stress and induced deformation of the leaflets for pseudosinus (upper panel) and cylindrical (lower panel) models. Movies corresponding to this figure are available online. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1528-1535.e1DOI: (10.1016/j.jtcvs.2008.05.054) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions