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      A turbulence in-vitro assessment of ON-X and St. Jude Medical prostheses

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      The Journal of Thoracic and Cardiovascular Surgery

      Elsevier BV

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          Abstract

          The objective of this study is to investigate and compare the hemodynamic and turbulence characteristics upon implantation of St. Jude Medical (SJM) and ON-X bileaflet mechanical valves (BMHV). Both valves are considered highly successful BMHVs characterized by good clinical outcomes despite their numerous design differences. While thromboembolism remains the main disadvantage of BMHVs, ON-X has been shown to need less anti-coagulation therapy. Hemodynamic assessment of a 23mm ON-X bileaflet mechanical valve and a 23mm bileaflet St. Jude Mechanical valve (SJM) implanted in an aortic root was performed under pulsatile physiological conditions. Time-resolved and phase-locked Particle-Image-Velocimetry images and high-speed imaging data were acquired. Pressure gradients (PG), effective orifice areas (EOA), dimensionless area index (AI), leaflet position tracking, velocity and Principal Reynolds shear stress (RSS) were calculated. (a) PG across ON-X was 4.15±0.099mmHg versus 4.75±0.048mmHg for SJM(p<0.001). EOA across ON-X was 2.61±0.045cm 2 versus 2.36±0.022cm 2 for SJM(p<0.001); (b) AI was higher with SJM (0.87±0.008) than with ON-X (0.73±0.013)(p<0.001); (c)ON-X showed a fluctuating leaflet behavior during systole while SJM leaflets were stable; (d) at peak systole, the maximal velocity with ON-X was 1.86m/s versus 2.33m/s with SJM; (d) RSS was higher with ON-X compared with SJM at peak systole (95 versus 72Pa); (e) Higher velocity fluctuations was noted with ON-X. This study shows that despite the design differences that characterize ON-X, the hemodynamic and turbulence parameters were not necessarily improved compared with SJM.

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          Author and article information

          Journal
          The Journal of Thoracic and Cardiovascular Surgery
          The Journal of Thoracic and Cardiovascular Surgery
          Elsevier BV
          00225223
          February 2019
          February 2019
          Article
          10.1016/j.jtcvs.2019.02.046
          6703975
          30905419
          © 2019

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