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SHR Neuro Cancer Cardio Lipid Metab Microb
Mächler, H; Reiter, G; Perthel, M; Reiter, U; Bergmann, P; Zink, M; Rienmüller, R; Laas, J.
Influence of a tilting prosthetic mitral valve orientation on the left ventricular flow - an experimental in vivo magnetic resonance imaging study.
Eur J Cardiothorac Surg. 2007; 32(1):102-7
Doi: 10.1016/j.ejcts.2007.02.038
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- Leading authors Med Uni Graz
- Mächler Heinrich
- Co-authors Med Uni Graz
- Reiter Gert
- Reiter Ursula
- Rienmüller Rainer
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- Abstract:
- OBJECTIVE: Orientation-related monoleaflet mechanical valve flow and velocity studies in the downstream are limited in mitral valve replacement studies. METHODS: In five sheep, ventricular blood flow was visualized prior to the implantation of a Medtronic Hall tilting valve model. In six sheep, the implant orientation was either anatomical (disc aligned with the anterior leaflet) or anti-anatomical. The mitral subvalvular apparatus was preserved. Sheep were positioned within an 1.5 T field strength MR scanner (Magnetom Sonata; Siemens) to assess time-dependent three dimensional blood flow. RESULTS: The preoperative ventricular velocity profiles presented negligible individual variances. Streamlines passed homogeneously without any spatial differences in flow velocities into the left ventricle. Starting from the anatomical position, blood entered mainly through the major orifice of the mechanical valve. The single artificial leaflet mimicked the rudder effect of the natural anterior mitral leaflet, preventing blood streaming directly towards the septum. The area with inhomogeneous blood velocities in the ventricle increased but not significantly from the preoperative status. The non-axial inflow not directed directly to the apex converted to a similar helix as observed in the preoperative cases. Anti-anatomical orientation of the prosthesis caused a significant increase in turbulence immediately after passing the mitral prosthesis. The main stream was changed so significantly that the blood flow shifted towards the septum and caused higher velocities of the stream profiles and turbulence apically. CONCLUSIONS: To achieve optimal hemodynamics, orientation of the mitral tilting valve has to be considered carefully, as has been long known from aortic valve replacement studies.
- Find related publications in this database (using NLM MeSH Indexing)
- Animals - administration & dosage
- Blood Flow Velocity - administration & dosage
- Heart Valve Prosthesis - administration & dosage
- Heart Valve Prosthesis Implantation - methods
- Hemorheology - administration & dosage
- Magnetic Resonance Imaging - methods
- Mitral Valve - anatomy & histology, physiology, surgery
- Sheep - administration & dosage
- Ventricular Function, Left - administration & dosage
- Find related publications in this database (Keywords)
- mitral valve prosthesis
- orientation
- intra-ventricutar flow
- magnetic resonance imaging