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Keywords = valvular asymmetry

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12 pages, 1727 KB  
Article
Bicuspid Morphology and Rapid Deployment Valve Replacement: Is This Still a Contraindication?
by Julia von der Linden, Florian Herrmann, Sergey Belyaev, Gerd Juchem, Sven Peterss, Christian Hagl and Alexey Dashkevich
J. Clin. Med. 2023, 12(23), 7390; https://doi.org/10.3390/jcm12237390 - 29 Nov 2023
Cited by 1 | Viewed by 1270
Abstract
When using rapid deployment surgical aortic valve replacement (RD SAVR) in treating bicuspid aortic valve morphology (BAV), several challenges are faced due to annular asymmetry. The Sievers classification has been traditionally used for the description of BAV morphology. In this study, we aimed [...] Read more.
When using rapid deployment surgical aortic valve replacement (RD SAVR) in treating bicuspid aortic valve morphology (BAV), several challenges are faced due to annular asymmetry. The Sievers classification has been traditionally used for the description of BAV morphology. In this study, we aimed to conduct a retrospective feasibility analysis of RD SAVR in relation to the Sievers classification. From January 2014 to March 2022, 31 patients with BAV morphology (15 patients with Sievers type 0 BAV and 16 with Sievers type 1 BAV) underwent RD SAVR. Specific surgical techniques were applied depending on the BAV morphology. Comparable clinical outcomes were observed. No paravalvular leaks and no valvular re-interventions occurred in either group. CPB and cross-clamping times, as well as the prosthesis sizes used, were also not significantly different. Postoperative mean gradients were comparable in both groups. No significant distinction was found between the groups in terms of postoperative pacemaker indication, postoperative stroke, or death. Annular symmetry can be adequately restored through precise prosthesis sizing and placement according to an individual’s valve morphology regardless of the Sievers classification of BAV by choosing a different landmark for the initial suture. RD SAVR seems to be a safe approach for any bicuspid morphology, with good hemodynamic results and time-saving potential in experienced hands. Full article
(This article belongs to the Special Issue Heart Valve Disease: Recent Advances in Therapeutic Approaches)
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12 pages, 1816 KB  
Article
The Influence of Mitral Valve Asymmetry for an Improved Choice of Valve Repair or Replacement
by Dario Collia and Gianni Pedrizzetti
Fluids 2022, 7(9), 293; https://doi.org/10.3390/fluids7090293 - 5 Sep 2022
Cited by 4 | Viewed by 2240
Abstract
The study of valve asymmetry represents an important avenue for modern cardiac surgery. The correct choice of leaflet reconstruction may indicate a new path in the quality and long-term survival of patients. A systematic investigation was performed with a total of 25 numerical [...] Read more.
The study of valve asymmetry represents an important avenue for modern cardiac surgery. The correct choice of leaflet reconstruction may indicate a new path in the quality and long-term survival of patients. A systematic investigation was performed with a total of 25 numerical simulations using a healthy ventricle and an ideal valve with varying degrees of valve asymmetry. An overall assessment is made in terms of vorticity, kinetic energy, dissipated energy, and hemodynamic forces. The results indicate that the optimal asymmetry to consider for a valve repair or prosthetic design is between 0.2 and 0.4 with an optimal point of about 0.3. Out of this range, the heart is subjected to an excessive workload, which can only worsen the patient’s state of health. Full article
(This article belongs to the Special Issue Recent Advances in Fluid Mechanics: Feature Papers, 2022)
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