Trileaflet Semilunar Valve Reconstruction: Acute Porcine in Vivo Evaluation

Lisa Carlson Hanse; Marcell Juan Tjørnild; Zarmiga Karunanithi; Johannes Høgfeldt Jedrzejczyk; Lejla Islamagič; Nynne Emilie Hummelshøj; Malene Enevoldsen; Germán Lugones; Mette Høj Lauridsen; Vibeke Elisabeth Hjortdal; Ignacio Lugones

doi:10.1177/21501351231166662

Trileaflet Semilunar Valve Reconstruction: Acute Porcine in Vivo Evaluation

Lisa Carlson Hanse, Marcell Juan Tjørnild, Zarmiga Karunanithi, Johannes Høgfeldt Jedrzejczyk, Lejla Islamagič, Nynne Emilie Hummelshøj, Malene Enevoldsen, Germán Lugones, Mette Høj Lauridsen, Vibeke Elisabeth Hjortdal, Ignacio Lugones

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Objective: The surgical treatment of malformed semilunar valves in congenital heart defects is challenging in terms of providing both longevity and the potential to grow with the recipient. We investigated a new surgical technique "Trileaflet Semilunar Valve Reconstruction" in an acute porcine model, a technique with geometrical properties that could remain sufficient and allow for some growth with the child. Methods: An acute 60-kg porcine model was used. With echocardiography, baseline pulmonary valvular geometry and hemodynamics were investigated. On cardiopulmonary bypass, the pulmonary leaflets were explanted, and the Trileaflet Semilunar Valve Reconstruction was performed with customized homograft-treated pericardial neo-leaflets. Off bypass, hemodynamics was reassessed. Results: Twelve animals were investigated. The neo-valves were found sufficient in ten animals and with minimal regurgitation in two animals. The neo-valve had a peak gradient of 3 ± 2 mm Hg with a peak velocity of 0.8 ± 0.2 m/s. The coaptation in the neo-valve had a mean increase of 4 ± 3 mm, P < .001. The neo-valve had a windmill shape in the echocardiographic short-axis view, and the neo-leaflets billowed at the annular plane in the long-axis view. Conclusions: In this acute porcine model, the neo-valve had no clinically significant regurgitation or stenosis. The neo-valve had an increased coaptation, a windmill shape, and leaflets that billowed at the annular plane. These geometric findings may allow for sustained sufficiency as the annular and pulmonary artery dimension increase with the child's growth. Further long-term studies should be performed to evaluate the efficacy and the growth potential.

Original language	English
Journal	World Journal for Pediatric and Congenital Heart Surgery
Volume	14
Issue	4
Pages (from-to)	509-515
Number of pages	7
ISSN	2150-1351
DOIs	https://doi.org/10.1177/21501351231166662
Publication status	Published - Jul 2023

Keywords

cardiovascular surgery
congenital heart disease
echocardiography
experimental surgery
pulmonary valve reconstruction
Heart Valve Prosthesis
Humans
Pulmonary Valve/diagnostic imaging
Heart Defects, Congenital/surgery
Animals
Swine
Heart Valve Prosthesis Implantation/methods
Aortic Valve/surgery

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10.1177/21501351231166662

Cite this

Hanse, L. C., Tjørnild, M. J., Karunanithi, Z., Høgfeldt Jedrzejczyk, J., Islamagič, L., Hummelshøj, N. E., Enevoldsen, M., Lugones, G., Høj Lauridsen, M., Hjortdal, V. E., & Lugones, I. (2023). Trileaflet Semilunar Valve Reconstruction: Acute Porcine in Vivo Evaluation. World Journal for Pediatric and Congenital Heart Surgery, 14(4), 509-515. https://doi.org/10.1177/21501351231166662

@article{67a1af7d32804d26bc9c430308138163,

title = "Trileaflet Semilunar Valve Reconstruction: Acute Porcine in Vivo Evaluation",

abstract = "Objective: The surgical treatment of malformed semilunar valves in congenital heart defects is challenging in terms of providing both longevity and the potential to grow with the recipient. We investigated a new surgical technique {"}Trileaflet Semilunar Valve Reconstruction{"} in an acute porcine model, a technique with geometrical properties that could remain sufficient and allow for some growth with the child. Methods: An acute 60-kg porcine model was used. With echocardiography, baseline pulmonary valvular geometry and hemodynamics were investigated. On cardiopulmonary bypass, the pulmonary leaflets were explanted, and the Trileaflet Semilunar Valve Reconstruction was performed with customized homograft-treated pericardial neo-leaflets. Off bypass, hemodynamics was reassessed. Results: Twelve animals were investigated. The neo-valves were found sufficient in ten animals and with minimal regurgitation in two animals. The neo-valve had a peak gradient of 3 ± 2 mm Hg with a peak velocity of 0.8 ± 0.2 m/s. The coaptation in the neo-valve had a mean increase of 4 ± 3 mm, P < .001. The neo-valve had a windmill shape in the echocardiographic short-axis view, and the neo-leaflets billowed at the annular plane in the long-axis view. Conclusions: In this acute porcine model, the neo-valve had no clinically significant regurgitation or stenosis. The neo-valve had an increased coaptation, a windmill shape, and leaflets that billowed at the annular plane. These geometric findings may allow for sustained sufficiency as the annular and pulmonary artery dimension increase with the child's growth. Further long-term studies should be performed to evaluate the efficacy and the growth potential.",

keywords = "cardiovascular surgery, congenital heart disease, echocardiography, experimental surgery, pulmonary valve reconstruction, Heart Valve Prosthesis, Humans, Pulmonary Valve/diagnostic imaging, Heart Defects, Congenital/surgery, Animals, Swine, Heart Valve Prosthesis Implantation/methods, Aortic Valve/surgery",

author = "Hanse, {Lisa Carlson} and Tj{\o}rnild, {Marcell Juan} and Zarmiga Karunanithi and {H{\o}gfeldt Jedrzejczyk}, Johannes and Lejla Islamagi{\v c} and Hummelsh{\o}j, {Nynne Emilie} and Malene Enevoldsen and Germ{\'a}n Lugones and {H{\o}j Lauridsen}, Mette and Hjortdal, {Vibeke Elisabeth} and Ignacio Lugones",

year = "2023",

month = jul,

doi = "10.1177/21501351231166662",

language = "English",

volume = "14",

pages = "509--515",

journal = "World Journal for Pediatric and Congenital Heart Surgery",

issn = "2150-1351",

publisher = "Sage Publications, Inc.",

number = "4",

}

Hanse, LC , Tjørnild, MJ , Karunanithi, Z , Høgfeldt Jedrzejczyk, J, Islamagič, L, Hummelshøj, NE, Enevoldsen, M, Lugones, G, Høj Lauridsen, M, Hjortdal, VE & Lugones, I 2023, 'Trileaflet Semilunar Valve Reconstruction: Acute Porcine in Vivo Evaluation', World Journal for Pediatric and Congenital Heart Surgery, vol. 14, no. 4, pp. 509-515. https://doi.org/10.1177/21501351231166662

Trileaflet Semilunar Valve Reconstruction: Acute Porcine in Vivo Evaluation. / Hanse, Lisa Carlson ; Tjørnild, Marcell Juan ; Karunanithi, Zarmiga et al.
In: World Journal for Pediatric and Congenital Heart Surgery, Vol. 14, No. 4, 07.2023, p. 509-515.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Trileaflet Semilunar Valve Reconstruction

T2 - Acute Porcine in Vivo Evaluation

AU - Hanse, Lisa Carlson

AU - Tjørnild, Marcell Juan

AU - Karunanithi, Zarmiga

AU - Høgfeldt Jedrzejczyk, Johannes

AU - Islamagič, Lejla

AU - Hummelshøj, Nynne Emilie

AU - Enevoldsen, Malene

AU - Lugones, Germán

AU - Høj Lauridsen, Mette

AU - Hjortdal, Vibeke Elisabeth

AU - Lugones, Ignacio

PY - 2023/7

Y1 - 2023/7

N2 - Objective: The surgical treatment of malformed semilunar valves in congenital heart defects is challenging in terms of providing both longevity and the potential to grow with the recipient. We investigated a new surgical technique "Trileaflet Semilunar Valve Reconstruction" in an acute porcine model, a technique with geometrical properties that could remain sufficient and allow for some growth with the child. Methods: An acute 60-kg porcine model was used. With echocardiography, baseline pulmonary valvular geometry and hemodynamics were investigated. On cardiopulmonary bypass, the pulmonary leaflets were explanted, and the Trileaflet Semilunar Valve Reconstruction was performed with customized homograft-treated pericardial neo-leaflets. Off bypass, hemodynamics was reassessed. Results: Twelve animals were investigated. The neo-valves were found sufficient in ten animals and with minimal regurgitation in two animals. The neo-valve had a peak gradient of 3 ± 2 mm Hg with a peak velocity of 0.8 ± 0.2 m/s. The coaptation in the neo-valve had a mean increase of 4 ± 3 mm, P < .001. The neo-valve had a windmill shape in the echocardiographic short-axis view, and the neo-leaflets billowed at the annular plane in the long-axis view. Conclusions: In this acute porcine model, the neo-valve had no clinically significant regurgitation or stenosis. The neo-valve had an increased coaptation, a windmill shape, and leaflets that billowed at the annular plane. These geometric findings may allow for sustained sufficiency as the annular and pulmonary artery dimension increase with the child's growth. Further long-term studies should be performed to evaluate the efficacy and the growth potential.

AB - Objective: The surgical treatment of malformed semilunar valves in congenital heart defects is challenging in terms of providing both longevity and the potential to grow with the recipient. We investigated a new surgical technique "Trileaflet Semilunar Valve Reconstruction" in an acute porcine model, a technique with geometrical properties that could remain sufficient and allow for some growth with the child. Methods: An acute 60-kg porcine model was used. With echocardiography, baseline pulmonary valvular geometry and hemodynamics were investigated. On cardiopulmonary bypass, the pulmonary leaflets were explanted, and the Trileaflet Semilunar Valve Reconstruction was performed with customized homograft-treated pericardial neo-leaflets. Off bypass, hemodynamics was reassessed. Results: Twelve animals were investigated. The neo-valves were found sufficient in ten animals and with minimal regurgitation in two animals. The neo-valve had a peak gradient of 3 ± 2 mm Hg with a peak velocity of 0.8 ± 0.2 m/s. The coaptation in the neo-valve had a mean increase of 4 ± 3 mm, P < .001. The neo-valve had a windmill shape in the echocardiographic short-axis view, and the neo-leaflets billowed at the annular plane in the long-axis view. Conclusions: In this acute porcine model, the neo-valve had no clinically significant regurgitation or stenosis. The neo-valve had an increased coaptation, a windmill shape, and leaflets that billowed at the annular plane. These geometric findings may allow for sustained sufficiency as the annular and pulmonary artery dimension increase with the child's growth. Further long-term studies should be performed to evaluate the efficacy and the growth potential.

KW - cardiovascular surgery

KW - congenital heart disease

KW - echocardiography

KW - experimental surgery

KW - pulmonary valve reconstruction

KW - Heart Valve Prosthesis

KW - Humans

KW - Pulmonary Valve/diagnostic imaging

KW - Heart Defects, Congenital/surgery

KW - Animals

KW - Swine

KW - Heart Valve Prosthesis Implantation/methods

KW - Aortic Valve/surgery

U2 - 10.1177/21501351231166662

DO - 10.1177/21501351231166662

M3 - Journal article

C2 - 37039366

SN - 2150-1351

VL - 14

SP - 509

EP - 515

JO - World Journal for Pediatric and Congenital Heart Surgery

JF - World Journal for Pediatric and Congenital Heart Surgery

IS - 4

ER -

Trileaflet Semilunar Valve Reconstruction: Acute Porcine in Vivo Evaluation

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Keywords

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