Role of the sinuses of Valsalva on the opening of the aortic valve

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Presentation transcript:

Role of the sinuses of Valsalva on the opening of the aortic valve Giuseppe Pisani, MS, Raffaele Scaffa, MD, Ornella Ieropoli, PhD, Edoardo M. Dell’Amico, MS, Daniele Maselli, MD, Umberto Morbiducci, PhD, Ruggero De Paulis, MD The Journal of Thoracic and Cardiovascular Surgery Volume 145, Issue 4, Pages 999-1003 (April 2013) DOI: 10.1016/j.jtcvs.2012.03.060 Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 The 2 root configurations with (left) and without (right) sinuses created out of silicon with the same compliance. The conduit diameter was 25 mm and the stentless valve size was 25 mm in both cases. The maximum diameter at the sinuses was 35 mm. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 999-1003DOI: (10.1016/j.jtcvs.2012.03.060) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 The 2 root hybrid configurations with (left) and without (right) sinuses created out of silicon in which the upper part was cut out following the valve contours and substituted with a straight graft or a Valsalva Dacron graft. Both conduit diameters were 26 mm. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 999-1003DOI: (10.1016/j.jtcvs.2012.03.060) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Diagram of pressure decrease across the valve in the Valsalva silicon and straight silicon configurations (left) and in the Valsalva-hybrid and straight-hybrid configurations (right). When the cardiac output (CO) increased from 5 L/min to 7 L/min, an increase in the pressure decrease only occurred in the roots without sinuses. Note that no marked difference was present within each group with the same root configuration. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 999-1003DOI: (10.1016/j.jtcvs.2012.03.060) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Diagram of effective orifice area (EOA) in the Valsalva-silicon and straight-silicon configurations (left) and in the Valsalva-hybrid and straight-hybrid configurations (right). When the cardiac output (CO) increased from 5 to 7 L/min, an increase in the EOA was only present in the roots with sinuses. Note that no marked difference was present within each group with the same root configuration. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 999-1003DOI: (10.1016/j.jtcvs.2012.03.060) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Direct visualization of valve operating condition inside a root with and without sinuses (hybrid configurations) at a cardiac output of 7 L/min. A larger opening area was evident in the valve inserted in a root with sinuses. The Journal of Thoracic and Cardiovascular Surgery 2013 145, 999-1003DOI: (10.1016/j.jtcvs.2012.03.060) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions