Altered stresses and dynamics after single and double annuloplasty ring for aortic valve repair

Leila Louise Benhassen; Jacob Hesselby Hedensted; Mona Sharghbin; Søren Nielsen Skov; Lisa Carlson Hanse; Marcell Juan Tjørnild; Tommy Bechsgaard; Diana Mathilde Ropcke; Sten Lyager Nielsen; John Michael Hasenkam

doi:10.1093/ejcts/ezaa001

Altered stresses and dynamics after single and double annuloplasty ring for aortic valve repair

Leila Louise Benhassen, Jacob Hesselby Hedensted, Mona Sharghbin, Søren Nielsen Skov, Lisa Carlson Hanse, Marcell Juan Tjørnild, Tommy Bechsgaard, Diana Mathilde Ropcke, Sten Lyager Nielsen, John Michael Hasenkam

Institut for Klinisk Medicin - Hjerte-, Lunge- og Karkirurgi

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

4 Citationer (Scopus)

122 Downloads (Pure)

Abstract

OBJECTIVES: Aortic valve repair procedures for the treatment of isolated aortic valve insufficiency may be improved by stabilizing the functional aortic annulus using a double annuloplasty ring at the aortic annulus and sinotubular junction (STJ). The objective of this study was to compare the geometrical changes and aortic root stress distribution when using a single subvalvular ring and a double sub- and supravalvular ring in vivo.

METHODS: Both the single- and double-ring procedures were performed successively in nine 80-kg pigs. Measurements were performed intraoperatively using sonomicrometry crystals in the aortic root to evaluate geometrical changes and annular and STJ force transducers measuring the segmental radial stress distribution.

RESULTS: The total force in the STJ was significantly reduced after the double-ring procedure from 1.7 ± 0.6 to 0.04 ± 1.1 N (P = 0.001). The double-ring procedure significantly reduced the STJ area from 234.8 ± 37.6 to 147.5 ± 31.8 mm2 (P = 0.001) and expansibility from 17 ± 6% to 8 ± 3% (P = 0.001). With the single-ring procedure, the STJ shape was circular but became more oval with the double-ring procedure. The double-ring procedure did not affect stress distribution or geometry in the aortic annulus.

CONCLUSIONS: The double-ring procedure stabilized the whole aortic root by reducing radial stress distribution in the STJ more efficiently than the single-ring procedure. Both area and expansibility were reduced with the double-ring procedure. These results confirm the importance of addressing the entire functional aortic annulus for optimal aortic valve repair procedures.

Originalsprog	Engelsk
Tidsskrift	European Journal of Cardio-Thoracic Surgery
Vol/bind	57
Nummer	6
Sider (fra-til)	1210-1217
Antal sider	8
ISSN	1010-7940
DOI	https://doi.org/10.1093/ejcts/ezaa001
Status	Udgivet - 2020

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10.1093/ejcts/ezaa001Licens: CC BY-NC

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Benhassen, L. L., Hedensted, J. H., Sharghbin, M., Skov, S. N., Carlson Hanse, L., Tjørnild, M. J., Bechsgaard, T., Ropcke, D. M., Nielsen, S. L., & Hasenkam, J. M. (2020). Altered stresses and dynamics after single and double annuloplasty ring for aortic valve repair. European Journal of Cardio-Thoracic Surgery, 57(6), 1210-1217. https://doi.org/10.1093/ejcts/ezaa001

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title = "Altered stresses and dynamics after single and double annuloplasty ring for aortic valve repair",

abstract = "OBJECTIVES: Aortic valve repair procedures for the treatment of isolated aortic valve insufficiency may be improved by stabilizing the functional aortic annulus using a double annuloplasty ring at the aortic annulus and sinotubular junction (STJ). The objective of this study was to compare the geometrical changes and aortic root stress distribution when using a single subvalvular ring and a double sub- and supravalvular ring in vivo.METHODS: Both the single- and double-ring procedures were performed successively in nine 80-kg pigs. Measurements were performed intraoperatively using sonomicrometry crystals in the aortic root to evaluate geometrical changes and annular and STJ force transducers measuring the segmental radial stress distribution.RESULTS: The total force in the STJ was significantly reduced after the double-ring procedure from 1.7 ± 0.6 to 0.04 ± 1.1 N (P = 0.001). The double-ring procedure significantly reduced the STJ area from 234.8 ± 37.6 to 147.5 ± 31.8 mm2 (P = 0.001) and expansibility from 17 ± 6% to 8 ± 3% (P = 0.001). With the single-ring procedure, the STJ shape was circular but became more oval with the double-ring procedure. The double-ring procedure did not affect stress distribution or geometry in the aortic annulus.CONCLUSIONS: The double-ring procedure stabilized the whole aortic root by reducing radial stress distribution in the STJ more efficiently than the single-ring procedure. Both area and expansibility were reduced with the double-ring procedure. These results confirm the importance of addressing the entire functional aortic annulus for optimal aortic valve repair procedures.",

keywords = "Aortic annulus, Aortic insufficiency, Aortic valve repair, Dacron ring annuloplasty, Double-ring annuloplasty, Dynamic characterization",

author = "Benhassen, {Leila Louise} and Hedensted, {Jacob Hesselby} and Mona Sharghbin and Skov, {S{\o}ren Nielsen} and {Carlson Hanse}, Lisa and Tj{\o}rnild, {Marcell Juan} and Tommy Bechsgaard and Ropcke, {Diana Mathilde} and Nielsen, {Sten Lyager} and Hasenkam, {John Michael}",

note = "{\textcopyright} The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.",

year = "2020",

doi = "10.1093/ejcts/ezaa001",

language = "English",

volume = "57",

pages = "1210--1217",

journal = "European Journal of Cardio-Thoracic Surgery",

issn = "1010-7940",

publisher = "European Association for Cardio-Thoracic Surgery",

number = "6",

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Altered stresses and dynamics after single and double annuloplasty ring for aortic valve repair. / Benhassen, Leila Louise; Hedensted, Jacob Hesselby; Sharghbin, Mona et al.
I: European Journal of Cardio-Thoracic Surgery, Bind 57, Nr. 6, 2020, s. 1210-1217.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - Altered stresses and dynamics after single and double annuloplasty ring for aortic valve repair

AU - Benhassen, Leila Louise

AU - Hedensted, Jacob Hesselby

AU - Sharghbin, Mona

AU - Skov, Søren Nielsen

AU - Carlson Hanse, Lisa

AU - Tjørnild, Marcell Juan

AU - Bechsgaard, Tommy

AU - Ropcke, Diana Mathilde

AU - Nielsen, Sten Lyager

AU - Hasenkam, John Michael

N1 - © The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.

PY - 2020

Y1 - 2020

N2 - OBJECTIVES: Aortic valve repair procedures for the treatment of isolated aortic valve insufficiency may be improved by stabilizing the functional aortic annulus using a double annuloplasty ring at the aortic annulus and sinotubular junction (STJ). The objective of this study was to compare the geometrical changes and aortic root stress distribution when using a single subvalvular ring and a double sub- and supravalvular ring in vivo.METHODS: Both the single- and double-ring procedures were performed successively in nine 80-kg pigs. Measurements were performed intraoperatively using sonomicrometry crystals in the aortic root to evaluate geometrical changes and annular and STJ force transducers measuring the segmental radial stress distribution.RESULTS: The total force in the STJ was significantly reduced after the double-ring procedure from 1.7 ± 0.6 to 0.04 ± 1.1 N (P = 0.001). The double-ring procedure significantly reduced the STJ area from 234.8 ± 37.6 to 147.5 ± 31.8 mm2 (P = 0.001) and expansibility from 17 ± 6% to 8 ± 3% (P = 0.001). With the single-ring procedure, the STJ shape was circular but became more oval with the double-ring procedure. The double-ring procedure did not affect stress distribution or geometry in the aortic annulus.CONCLUSIONS: The double-ring procedure stabilized the whole aortic root by reducing radial stress distribution in the STJ more efficiently than the single-ring procedure. Both area and expansibility were reduced with the double-ring procedure. These results confirm the importance of addressing the entire functional aortic annulus for optimal aortic valve repair procedures.

AB - OBJECTIVES: Aortic valve repair procedures for the treatment of isolated aortic valve insufficiency may be improved by stabilizing the functional aortic annulus using a double annuloplasty ring at the aortic annulus and sinotubular junction (STJ). The objective of this study was to compare the geometrical changes and aortic root stress distribution when using a single subvalvular ring and a double sub- and supravalvular ring in vivo.METHODS: Both the single- and double-ring procedures were performed successively in nine 80-kg pigs. Measurements were performed intraoperatively using sonomicrometry crystals in the aortic root to evaluate geometrical changes and annular and STJ force transducers measuring the segmental radial stress distribution.RESULTS: The total force in the STJ was significantly reduced after the double-ring procedure from 1.7 ± 0.6 to 0.04 ± 1.1 N (P = 0.001). The double-ring procedure significantly reduced the STJ area from 234.8 ± 37.6 to 147.5 ± 31.8 mm2 (P = 0.001) and expansibility from 17 ± 6% to 8 ± 3% (P = 0.001). With the single-ring procedure, the STJ shape was circular but became more oval with the double-ring procedure. The double-ring procedure did not affect stress distribution or geometry in the aortic annulus.CONCLUSIONS: The double-ring procedure stabilized the whole aortic root by reducing radial stress distribution in the STJ more efficiently than the single-ring procedure. Both area and expansibility were reduced with the double-ring procedure. These results confirm the importance of addressing the entire functional aortic annulus for optimal aortic valve repair procedures.

KW - Aortic annulus

KW - Aortic insufficiency

KW - Aortic valve repair

KW - Dacron ring annuloplasty

KW - Double-ring annuloplasty

KW - Dynamic characterization

UR - http://www.scopus.com/inward/record.url?scp=85085231089&partnerID=8YFLogxK

U2 - 10.1093/ejcts/ezaa001

DO - 10.1093/ejcts/ezaa001

M3 - Journal article

C2 - 32031602

SN - 1010-7940

VL - 57

SP - 1210

EP - 1217

JO - European Journal of Cardio-Thoracic Surgery

JF - European Journal of Cardio-Thoracic Surgery

IS - 6

ER -

Altered stresses and dynamics after single and double annuloplasty ring for aortic valve repair

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