Comparison of Dacron ring and suture annuloplasty for aortic valve repair-a porcine study

Leila Louise Benhassen; Diana Mathilde Ropcke; Mona Sharghbin; Troels Lading; Jens Kæstel Skov; Marcell Juan Tjørnild; Karen Bagger Poulsen; Tommy Bechsgaard; Søren Nielsen Skov; Sten Lyager Nielsen; John Michael Hasenkam

doi:10.21037/acs.2019.04.02

Comparison of Dacron ring and suture annuloplasty for aortic valve repair-a porcine study

Leila Louise Benhassen, Diana Mathilde Ropcke, Mona Sharghbin, Troels Lading, Jens Kæstel Skov, Marcell Juan Tjørnild, Karen Bagger Poulsen, Tommy Bechsgaard, Søren Nielsen Skov, 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

14 Citationer (Scopus)

Abstract

Background: A subvalvular annuloplasty is often used for aortic valve repair in patients with isolated aortic regurgitation with aortic annulus dilatation. Our aim was to characterize and compare annulus geometry and dynamics of the Dacron ring and suture annuloplasty and compare it with the native aortic annulus under standardized conditions.

Methods: We randomized 29 pigs of 80 kg into a Dacron ring group, a suture annuloplasty group and a native control group. The assessment was performed using sonomicrometry crystals for evaluation of dynamic geometry, and pressure measurements and echocardiography to evaluate valve performance.

Results: Aortic annulus area (AAA) was significantly reduced in the Dacron and Suture group compared with the Native group. Expansibility was similar and within normal physiologic limits in all three groups (Native: 12%±7%; Dacron: 11%±3%; Suture: 10%±4%). The largest segmental expansion was observed at the right coronary sinus (RC) in the Native and Dacron group but in the Suture group there was no significant difference between segments. The aortic annulus was primarily oval in systole and became more circular in diastole in the Native and Dacron group, however, in the Suture group, the sphericity remained relatively unchanged throughout the cardiac cycle.

Conclusions: This study is the first to describe and compare detailed segmental geometry of the Dacron ring and suture annuloplasty in a standardized porcine model. The two annuloplasties effectively downsized the aortic annulus, while expansibility was maintained. Each annuloplasty had its own geometrical characteristics, but the Dacron ring was more similar to the native aortic annulus than the suture annuloplasty. This study suggests that the Dacron ring offers a more physiological and standardized support by mimicking the geometry and dynamics of the native aortic annulus and thus is a preferable choice over the suture annuloplasty for valve-sparing aortic root procedures.

Originalsprog	Engelsk
Tidsskrift	Annals of Cardiothoracic Surgery
Vol/bind	8
Nummer	3
Sider (fra-til)	342-350
Antal sider	9
ISSN	2225-319X
DOI	https://doi.org/10.21037/acs.2019.04.02
Status	Udgivet - maj 2019

Adgang til dokumentet

10.21037/acs.2019.04.02

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6562077/pdf/acs-08-03-342.pdf

Andre filer og links

Link to publication in Scopus

Citationsformater

@article{623b6a28171c4bd6a45e0de17b84f171,

title = "Comparison of Dacron ring and suture annuloplasty for aortic valve repair-a porcine study",

abstract = "Background: A subvalvular annuloplasty is often used for aortic valve repair in patients with isolated aortic regurgitation with aortic annulus dilatation. Our aim was to characterize and compare annulus geometry and dynamics of the Dacron ring and suture annuloplasty and compare it with the native aortic annulus under standardized conditions.Methods: We randomized 29 pigs of 80 kg into a Dacron ring group, a suture annuloplasty group and a native control group. The assessment was performed using sonomicrometry crystals for evaluation of dynamic geometry, and pressure measurements and echocardiography to evaluate valve performance.Results: Aortic annulus area (AAA) was significantly reduced in the Dacron and Suture group compared with the Native group. Expansibility was similar and within normal physiologic limits in all three groups (Native: 12%±7%; Dacron: 11%±3%; Suture: 10%±4%). The largest segmental expansion was observed at the right coronary sinus (RC) in the Native and Dacron group but in the Suture group there was no significant difference between segments. The aortic annulus was primarily oval in systole and became more circular in diastole in the Native and Dacron group, however, in the Suture group, the sphericity remained relatively unchanged throughout the cardiac cycle.Conclusions: This study is the first to describe and compare detailed segmental geometry of the Dacron ring and suture annuloplasty in a standardized porcine model. The two annuloplasties effectively downsized the aortic annulus, while expansibility was maintained. Each annuloplasty had its own geometrical characteristics, but the Dacron ring was more similar to the native aortic annulus than the suture annuloplasty. This study suggests that the Dacron ring offers a more physiological and standardized support by mimicking the geometry and dynamics of the native aortic annulus and thus is a preferable choice over the suture annuloplasty for valve-sparing aortic root procedures.",

keywords = "Aortic annulus, Aortic regurgitation, Dacron ring annuloplasty, Dynamic characterization, Suture annuloplasty, Valve-sparing procedures",

author = "Benhassen, {Leila Louise} and Ropcke, {Diana Mathilde} and Mona Sharghbin and Troels Lading and Skov, {Jens K{\ae}stel} and Tj{\o}rnild, {Marcell Juan} and Poulsen, {Karen Bagger} and Tommy Bechsgaard and Skov, {S{\o}ren Nielsen} and Nielsen, {Sten Lyager} and Hasenkam, {John Michael}",

year = "2019",

month = may,

doi = "10.21037/acs.2019.04.02",

language = "English",

volume = "8",

pages = "342--350",

journal = "Annals of Cardiothoracic Surgery",

issn = "2225-319X",

publisher = "AME Publishing Company",

number = "3",

}

Comparison of Dacron ring and suture annuloplasty for aortic valve repair-a porcine study. / Benhassen, Leila Louise; Ropcke, Diana Mathilde; Sharghbin, Mona et al.
I: Annals of Cardiothoracic Surgery, Bind 8, Nr. 3, 05.2019, s. 342-350.

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

TY - JOUR

T1 - Comparison of Dacron ring and suture annuloplasty for aortic valve repair-a porcine study

AU - Benhassen, Leila Louise

AU - Ropcke, Diana Mathilde

AU - Sharghbin, Mona

AU - Lading, Troels

AU - Skov, Jens Kæstel

AU - Tjørnild, Marcell Juan

AU - Poulsen, Karen Bagger

AU - Bechsgaard, Tommy

AU - Skov, Søren Nielsen

AU - Nielsen, Sten Lyager

AU - Hasenkam, John Michael

PY - 2019/5

Y1 - 2019/5

N2 - Background: A subvalvular annuloplasty is often used for aortic valve repair in patients with isolated aortic regurgitation with aortic annulus dilatation. Our aim was to characterize and compare annulus geometry and dynamics of the Dacron ring and suture annuloplasty and compare it with the native aortic annulus under standardized conditions.Methods: We randomized 29 pigs of 80 kg into a Dacron ring group, a suture annuloplasty group and a native control group. The assessment was performed using sonomicrometry crystals for evaluation of dynamic geometry, and pressure measurements and echocardiography to evaluate valve performance.Results: Aortic annulus area (AAA) was significantly reduced in the Dacron and Suture group compared with the Native group. Expansibility was similar and within normal physiologic limits in all three groups (Native: 12%±7%; Dacron: 11%±3%; Suture: 10%±4%). The largest segmental expansion was observed at the right coronary sinus (RC) in the Native and Dacron group but in the Suture group there was no significant difference between segments. The aortic annulus was primarily oval in systole and became more circular in diastole in the Native and Dacron group, however, in the Suture group, the sphericity remained relatively unchanged throughout the cardiac cycle.Conclusions: This study is the first to describe and compare detailed segmental geometry of the Dacron ring and suture annuloplasty in a standardized porcine model. The two annuloplasties effectively downsized the aortic annulus, while expansibility was maintained. Each annuloplasty had its own geometrical characteristics, but the Dacron ring was more similar to the native aortic annulus than the suture annuloplasty. This study suggests that the Dacron ring offers a more physiological and standardized support by mimicking the geometry and dynamics of the native aortic annulus and thus is a preferable choice over the suture annuloplasty for valve-sparing aortic root procedures.

AB - Background: A subvalvular annuloplasty is often used for aortic valve repair in patients with isolated aortic regurgitation with aortic annulus dilatation. Our aim was to characterize and compare annulus geometry and dynamics of the Dacron ring and suture annuloplasty and compare it with the native aortic annulus under standardized conditions.Methods: We randomized 29 pigs of 80 kg into a Dacron ring group, a suture annuloplasty group and a native control group. The assessment was performed using sonomicrometry crystals for evaluation of dynamic geometry, and pressure measurements and echocardiography to evaluate valve performance.Results: Aortic annulus area (AAA) was significantly reduced in the Dacron and Suture group compared with the Native group. Expansibility was similar and within normal physiologic limits in all three groups (Native: 12%±7%; Dacron: 11%±3%; Suture: 10%±4%). The largest segmental expansion was observed at the right coronary sinus (RC) in the Native and Dacron group but in the Suture group there was no significant difference between segments. The aortic annulus was primarily oval in systole and became more circular in diastole in the Native and Dacron group, however, in the Suture group, the sphericity remained relatively unchanged throughout the cardiac cycle.Conclusions: This study is the first to describe and compare detailed segmental geometry of the Dacron ring and suture annuloplasty in a standardized porcine model. The two annuloplasties effectively downsized the aortic annulus, while expansibility was maintained. Each annuloplasty had its own geometrical characteristics, but the Dacron ring was more similar to the native aortic annulus than the suture annuloplasty. This study suggests that the Dacron ring offers a more physiological and standardized support by mimicking the geometry and dynamics of the native aortic annulus and thus is a preferable choice over the suture annuloplasty for valve-sparing aortic root procedures.

KW - Aortic annulus

KW - Aortic regurgitation

KW - Dacron ring annuloplasty

KW - Dynamic characterization

KW - Suture annuloplasty

KW - Valve-sparing procedures

UR - http://www.scopus.com/inward/record.url?scp=85067345032&partnerID=8YFLogxK

U2 - 10.21037/acs.2019.04.02

DO - 10.21037/acs.2019.04.02

M3 - Journal article

C2 - 31240178

SN - 2225-319X

VL - 8

SP - 342

EP - 350

JO - Annals of Cardiothoracic Surgery

JF - Annals of Cardiothoracic Surgery

IS - 3

ER -

Comparison of Dacron ring and suture annuloplasty for aortic valve repair-a porcine study

Abstract

Adgang til dokumentet

Andre filer og links

Fingeraftryk

Citationsformater