Novel Expansible Aortic Annuloplasty Ring Exhibits Similar Characteristics as the Dacron Ring—an In Vitro Evaluation

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Abstract

An increasing body of research indicates that annular stability plays a key role for a successful aortic valve repair. The aim of this study was to evaluate and compare a novel open aortic annuloplasty ring (the A-ring) with the Dacron ring. Both rings were compared with native aortic roots in vitro. Eighteen aortic roots were included in the study and randomized into three groups: the native, Dacron, and A-ring group. The roots were evaluated in an in vitro physiologic pulsatile model simulating the left side of the heart. Aortic annulus diameters were significantly reduced both in the Dacron ring group ( p = 0.003) and the A-ring group ( p = 0.020) when compared with the native group. Both the Dacron ring and A-ring effectively downsized the aortic annulus diameter. The A-ring also displayed an ability to maintain aortic root distensibility during the cardiac cycle equally to the Dacron ring.

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Supplementary Information

The online version contains supplementary material available at 10.1007/s12265-023-10393-7.

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Most cited references 24

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Recommendations on the Echocardiographic Assessment of Aortic Valve Stenosis: A Focused Update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography.

Helmut Baumgartner, Judy Hung, Javier Bermejo … (2017)

Echocardiography is the key tool for the diagnosis and evaluation of aortic stenosis. Because clinical decision-making is based on the echocardiographic assessment of its severity, it is essential that standards are adopted to maintain accuracy and consistency across echocardiographic laboratories. Detailed recommendations for the echocardiographic assessment of valve stenosis were published by the European Association of Echocardiography and the American Society of Echocardiography in 2009. In the meantime, numerous new studies on aortic stenosis have been published with particular new insights into the difficult subgroup of low gradient aortic stenosis making an update of recommendations necessary. The document focuses in particular on the optimization of left ventricular outflow tract assessment, low flow, low gradient aortic stenosis with preserved ejection fraction, a new classification of aortic stenosis by gradient, flow and ejection fraction, and a grading algorithm for an integrated and stepwise approach of aortic stenosis assessment in clinical practice.

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2017 ESC/EACTS Guidelines for the Management of Valvular Heart Disease

Helmut Baumgartner, Volkmar Falk, Jeroen J. Bax … (2018)

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Late results of a valve-preserving operation in patients with aneurysms of the ascending aorta and root.

E Birks, Matthew Child, V. Chandrasekaran … (1998)

There is still no agreement about the best method of dealing with malfunction of the aortic valve caused by aneurysm or dissection of the aortic root. The experience, rationale, and development of a valve-preserving technique introduced and used since 1979 is described. During this period 158 patients (78% of all patients undergoing resection of aneurysm of the ascending aorta) were operated on using this technique. Their ages ranged from 2 to 72 years (mean 46.6 years). Of the patients 107 were male and 51 were female. A total of 68 patients had skeletal manifestations of Marfan's syndrome. The original disease was chronic aneurysm of the ascending aorta or root in 92 (58.2%), chronic dissection in 17 (10.8%), and acute dissection in 49 (31%) patients. One hundred eleven additional procedures were performed in 84 patients. In all there were five early deaths (4.6% +/- 2%) in the 109 patients with chronic aneurysm and one death in the 103 patients operated on electively (0.97% +/- 0.9%). Actuarial survival for patients operated on for chronic aneurysm was 93.3%, 88.0%, 79.0%, and 57.9% at 1, 5, 10, and 15 years and 96.8%, 91.2%, 82.0%, and 60.0% for those operated on electively. Actuarial survival for patients operated on for acute dissection was 72.8%, 63.4%, and 53.3% at 1, 5, and 10 years. The probability of needing reoperation was 3.0% +/- 2%, 11% +/- 0.5%, and 11% +/- 0.5% at 1, 5, and 10 years. There were no instances of infective endocarditis or thromboembolic complications except in two patients operated on early in the series who had cusp extension. No anticoagulants were used. Echocardiography showed reduction in left ventricular end-systolic and end-diastolic dimensions, which was maintained. At the end of follow-up trivial or no aortic regurgitation was demonstrated in 63.6%, mild to moderate in 33.3%, and severe in 3%. Valve-sparing operations are possible in a large proportion of patients with aneurysms of the ascending aorta and the medium and long-term results are encouraging.

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Author and article information

Contributors

Mariam Abdi Noor:

ORCID: http://orcid.org/0000-0002-9206-5893

noor@clin.au.dk

Journal

Journal ID (nlm-ta): J Cardiovasc Transl Res

Journal ID (iso-abbrev): J Cardiovasc Transl Res

Title: Journal of Cardiovascular Translational Research

Publisher: Springer US (New York )

ISSN (Print): 1937-5387

ISSN (Electronic): 1937-5395

Publication date (Electronic): 1 June 2023

Publication date PMC-release: 1 June 2023

Publication date (Print): 2023

Volume: 16

Issue: 5

Pages: 1144-1152

Affiliations

[1 ]Department of Clinical Medicine, Aarhus University, ( https://ror.org/01aj84f44) Aarhus, Denmark

[2 ]Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, ( https://ror.org/040r8fr65) Aarhus, Denmark

[3 ]Department of Electrical and Computer Engineering, Aarhus University, ( https://ror.org/01aj84f44) Aarhus, Denmark

[4 ]Department of Surgery, University of the Witwatersrand, ( https://ror.org/03rp50x72) Johannesburg, South Africa

Author notes

Associate Editor Craig M. Stolen oversaw the review of this article.

Author information

Mariam Abdi Noor http://orcid.org/0000-0002-9206-5893

Article

Publisher ID: 10393

DOI: 10.1007/s12265-023-10393-7

PMC ID: 10615915

PubMed ID: 37261643

SO-VID: d56a3da3-0d2b-4ba2-8b62-9f261a43071e

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Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 29 September 2022

Date accepted : 24 April 2023

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100009708, Novo Nordisk Fonden;

Award ID: NNF17OC0029864

Award Recipient : John Michael Hasenkam

Funded by: Aarhus University Hospital

Open Access :

Open access funding provided by Royal Danish Library

Custom metadata

ScienceOpen disciplines: Cardiovascular Medicine

Keywords: aortic valve repair,annuloplasty,hemodynamics,cardiovascular interventions

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ScienceOpen disciplines: Cardiovascular Medicine

Keywords: aortic valve repair, annuloplasty, hemodynamics, cardiovascular interventions

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Novel Expansible Aortic Annuloplasty Ring Exhibits Similar Characteristics as the Dacron Ring—an In Vitro Evaluation

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Abstract

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Supplementary Information

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Karger: Cardiovascular System

Most cited references 24

Recommendations on the Echocardiographic Assessment of Aortic Valve Stenosis: A Focused Update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography.

2017 ESC/EACTS Guidelines for the Management of Valvular Heart Disease

Late results of a valve-preserving operation in patients with aneurysms of the ascending aorta and root.

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