Mechanisms of aortic valve incompetence: finite element modeling of aortic root dilatation K.Jane Grande, PhD, Richard P Cochran, MD, Per G Reinhall,

Slides:

Advertisements

Similar presentations

Functional Collagen Fiber Architecture of the Pulmonary Heart Valve Cusp Erinn M. Joyce, BS, Jun Liao, PhD, Frederick J. Schoen, MD, PhD, John E. Mayer,

Advertisements

Aortic Valve Replacement With Patch Enlargement of the Aortic Annulus

Aortic Root Biomechanics After Sleeve and David Sparing Techniques: A Finite Element Analysis Giordano Tasca, MD, Matteo Selmi, MS, Emiliano Votta, PhD,

Modeling leaflet correction techniques in aortic valve repair: A finite element study Michel R. Labrosse, Munir Boodhwani, Benjamin Sohmer, Carsten J.

Impact of aortic annular geometry on aortic valve insufficiency: Insights from a preclinical, ex vivo, porcine model Talal Al-Atassi, MD, MPH, Hadi Daood.

Biomechanical implications of the congenital bicuspid aortic valve: A finite element study of aortic root function from in vivo data Carlo A. Conti,

Survival Benefit of Aortic Valve Replacement in Patients With Severe Aortic Stenosis With Low Ejection Fraction And Low Gradient With Normal Ejection.

Ali N. Azadani, PhD, Sam Chitsaz, MD, Peter B

Aortic Root Biomechanics After Sleeve and David Sparing Techniques: A Finite Element Analysis Giordano Tasca, MD, Matteo Selmi, MS, Emiliano Votta, PhD,

Bicuspid aortic valves undergo excessive strain during opening: A simulation study Susumu Katayama, MSc, Nobuyuki Umetani, MEnv, Toshiaki Hisada, PhD,

Andras C. Kollar, MD, PhD, Scott D. Lick, MD, Vincent R. Conti, MD

Preoperative Three-Dimensional Valve Analysis Predicts Recurrent Ischemic Mitral Regurgitation After Mitral Annuloplasty Wobbe Bouma, MD, Eric K. Lai,

Unidirectional Monovalve Homologous Aortic Patch for Repair of Ventricular Septal Defect With Pulmonary Hypertension Bo Zhang, MD, Shuming Wu, MD, Jiali.

Orientation of tilting disc and bileaflet aortic valve substitutes for optimal hemodynamics Joachim Laas, MD, Peter Kleine, MD, Michael J Hasenkam, MD,

Functional Collagen Fiber Architecture of the Pulmonary Heart Valve Cusp Erinn M. Joyce, BS, Jun Liao, PhD, Frederick J. Schoen, MD, PhD, John E. Mayer,

Andrew K. Knutsen, PhD, Ningning Ma, BS, Ajay K. Taggar, MD, Beckah D

Basal cusp enlargement for repair of aortic valve insufficiency

Stent and Leaflet Stresses in 29-mm Second-Generation Balloon-Expandable Transcatheter Aortic Valve Yue Xuan, PhD, Kapil Krishnan, PhD, Jian Ye, MD,

CTSNet: a unique educational vehicle

Myosplint decreases wall stress without depressing function in the failing heart: a finite element model study Julius M Guccione, PhD, Ali Salahieh,

Heart Booster: a pericardial support device

Cause of degenerative disease of the trileaflet aortic valve: review of subject and presentation of a new theory Francis Robicsek, MD, PhD, Mano J Thubrikar,

Alison M. Pouch, PhD, Benjamin M

The congenitally bicuspid aortic valve: how does it function

Doreen Richardt, MD, Bence Bucsky, MD, Efstratios I

Reply The Annals of Thoracic Surgery

Impact of aortic annular geometry on aortic valve insufficiency: Insights from a preclinical, ex vivo, porcine model Talal Al-Atassi, MD, MPH, Hadi Daood.

An intraoperative test device for aortic valve repair

Congenital Absence of a Single Pulmonary Valve Cusp

Regional Annular Geometry in Patients With Mitral Regurgitation: Implications for Annuloplasty Ring Selection Arminder S. Jassar, MBBS, Mathieu Vergnat,

Aortic Valve Annuloplasty: New Single Suture Technique

Asymmetric Mechanical Properties of Porcine Aortic Sinuses

Measurement of Mitral Leaflet and Annular Geometry and Stress After Repair of Posterior Leaflet Prolapse: Virtual Repair Using a Patient-Specific Finite.

Effects of Aneurysm on the Mechanical Properties and Histologic Structure of Aortic Sinuses Eleftherios P. Kritharis, PhD, Dimitrios C. Iliopoulos, MD,

Robotic Resection of an Aortic Valve Papillary Fibroelastoma

Walter B. Eichinger, MD, PhD, Ina M

Patient-Specific Finite Element–Based Analysis of Ventricular Myofiber Stress After Coapsys: Importance of Residual Stress Richard Carrick, BS, Liang.

Maria Kalliopi Konstantinidou, MD, PhD, Neil Moat, MD, PhD

K. Jane Grande-Allen, PhD, Richard P. Cochran, MD, Per G

Ebstein’s Anomaly Assessed by Real-Time 3-D Echocardiography

Anatomic correction of the syndrome of prolapsing right coronary aortic cusp, dilatation of the sinus of valsalva, and ventricular septal defect Magdi.

Dynamic analysis of the aortic valve using a finite element model

Reversed “C” ministernotomy for aortic valve replacement

Biomechanical implications of the congenital bicuspid aortic valve: A finite element study of aortic root function from in vivo data Carlo A. Conti,

Sinus of valsalva aneurysm or fistula: management and outcome

Redo Aortic Valve Replacement in Children

Matthew C. Henn, MD, Christopher P

Wall Stress and Geometry of the Thoracic Aorta in Patients With Aortic Valve Disease Barry J. Doyle, PhD, Paul E. Norman, DS, Peter R. Hoskins, DSc, David.

Stent and leaflet stresses in a 26-mm first-generation balloon-expandable transcatheter aortic valve Yue Xuan, PhD, Kapil Krishnan, PhD, Jian Ye, MD,

Andrew Gogbashian, MD, Ravi K

Aortic root and valve relationships: Impact on surgical repair

Aortic root numeric model: Annulus diameter prediction of effective height and coaptation in post–aortic valve repair Gil Marom, MSc, Rami Haj-Ali, PhD,

Tricuspid Valve Repair: How I Teach It

Are mechanical valves with enhanced inner diameter advantageous in the small sized aortic annulus? Johannes M Albes, MD, Martin Hartrumpf, MD, Volker.

Paul Urbanski, MD, PhD The Annals of Thoracic Surgery

Transient dysfunction of the freestyle stentless xenograft

Effect of Adjustable Passive Constraint on the Failing Left Ventricle: A Finite-Element Model Study Choon-Sik Jhun, PhD, Jonathan F. Wenk, PhD, Zhihong.

Mathieu Vergnat, MD, Arminder S. Jassar, MBBS, Benjamin M

Henry F Tripp, MD, Robert M Stiegel, MD, Joseph P Coyle, MD

Left Ventricular Pacing Through the Anterior Interventricular Vein in a Patient With Mechanical Tricuspid, Aortic and Mitral Valves Masataka Yoda, MD,

Comparing Aortic Root Replacements: Porcine Bioroots Versus Pericardial Versus Mechanical Composite Roots: Hemodynamic and Ventricular Remodeling at Greater.

Remodeling of the aortic root and reconstruction of the bicuspid aortic valve Hans-Joachim Schäfers, MD, PhD, Frank Langer, MD, Diana Aicher, MD, Thomas.

Influence of Prosthesis–Patient Mismatch on Diastolic Heart Failure After Aortic Valve Replacement Shahab Nozohoor, MD, Johan Nilsson, MD, PhD, Carsten.

Clemens Aigner, MD, Ernst Wolner, MD, Werner Mohl, MD, PhD

Bicuspid Aortic Valves and Dilatation of the Ascending Aorta: Reply

Designing valves: An art or science?

Effects of Annular Size, Transmitral Pressure, and Mitral Flow Rate on the Edge-To- Edge Repair: An In Vitro Study Jorge H. Jimenez, MS, Joseph Forbess,

Further Anatomical Insights Regarding the Ross Procedure

Transaortic approach for the Alfieri stitch

Aortoscopy: a less invasive intraoperative method to assess the aortic valve Eduardo A Tovar, MD, Jon R Sherman, MD, David M Weinberg, MD, Yonghun C Suh,

Presentation transcript:

Mechanisms of aortic valve incompetence: finite element modeling of aortic root dilatation K.Jane Grande, PhD, Richard P Cochran, MD, Per G Reinhall, PhD, Karyn S Kunzelman, PhD The Annals of Thoracic Surgery Volume 69, Issue 6, Pages 1851-1857 (June 2000) DOI: 10.1016/S0003-4975(00)01307-2

Fig 1 Application of forces to the root nodes (left) creates aortic root dilatation and results in a central opening in the aortic valve (right). The Annals of Thoracic Surgery 2000 69, 1851-1857DOI: (10.1016/S0003-4975(00)01307-2)

Fig 2 Pressure loading curves for the aortic root, aortic valve, and the region of the root underneath the valve (the ventricular-aortic septum). Loading was initiated with root ramp pressure and followed by the addition of valve pressure. Although the curves illustrate the entire course of diastolic pressure, the model loading finished at the end of isovolumic relaxation (the maximum transvalvular pressure). The Annals of Thoracic Surgery 2000 69, 1851-1857DOI: (10.1016/S0003-4975(00)01307-2)

Fig 3 The emergence of an enlarging central deficiency is visible in an overview of models showing stress contours of the aortic root and valve at varying percentages of root dilatation: (A) normal (undilated) model top view; (B) normal side view; (C) 5% dilatation model top view; (D) 5% side view, (E) 15% top view, (F) 15% side view, (G) 30% top view, (H) 30% side view, (I) 50% top view, (J) 50% side view. All model results are shown in the same size scale. Note: the finite element software could not display thickness of valve and root elements in these contour plots. By measuring the distance between the Noduli of Aranti in the three leaflets of the different models, we determined that even though a slight central opening is visible in the 5% and 15% dilatation models, these valves were actually closed. In contrast, in the 30% and 50% dilatation models, these distances were larger than the regional leaflet thicknesses, and therefore the valve was not completely closed (kPa = kilopascal). The Annals of Thoracic Surgery 2000 69, 1851-1857DOI: (10.1016/S0003-4975(00)01307-2)

Fig 4 Aortic valve regional stress in normal (undilated) and dilated models (∗ = significant difference compared with normal model; att = attachment; coapt = coaptation). The Annals of Thoracic Surgery 2000 69, 1851-1857DOI: (10.1016/S0003-4975(00)01307-2)

Fig 5 Schematic illustration of altered leaflet stress patterns in the dilatation models compared with the stress pattern in the normal (undilated) root model (∗ = significant difference compared with normal undilated mode; σ = stress; dil = dilatation). The Annals of Thoracic Surgery 2000 69, 1851-1857DOI: (10.1016/S0003-4975(00)01307-2)

Fig 6 Aortic valve regional strain in normal (undilated) and dilated models (∗ = significant difference compared with normal model; att = attachment; coapt = coaptation). The Annals of Thoracic Surgery 2000 69, 1851-1857DOI: (10.1016/S0003-4975(00)01307-2)

Fig 7 Schematic illustrations of altered leaflet strain patterns in dilatation models compared with strain pattern in normal (undilated) root model (∗ = significant difference compared with normal model; ε = strain; dil = dilatation). The Annals of Thoracic Surgery 2000 69, 1851-1857DOI: (10.1016/S0003-4975(00)01307-2)

Fig 8 Aortic root stress (A) and strain (B) in normal (undilated) and dilated models (∗ = significant difference compared with the normal model; kPa = kilopascal). The Annals of Thoracic Surgery 2000 69, 1851-1857DOI: (10.1016/S0003-4975(00)01307-2)

Fig 9 Cross-sections of the noncoronary sinus wall–valve leaflet functional unit in idiopathic dilatation models. These cross-sections illustrate increasing root diameter and progressive flattening of the closed valve leaflet. The Annals of Thoracic Surgery 2000 69, 1851-1857DOI: (10.1016/S0003-4975(00)01307-2)