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Morphometrical and biomechanical analyses of a stentless bioprosthetic valve: an implication to avoid potential primary tissue failure

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Abstract

Objectives

Stentless bioprosthetic valves provide hemodynamic advantages over stented valves as well as excellent durability. However, some primary tissue failures in bioprostheses have been reported. This study was conducted to evaluate the morphometrical and biomechanical properties of the stentless Medtronic Freestyle™ aortic root bioprosthesis, to identify any arising problem areas, and to speculate on a potential solution.

Methods

The three-dimensional heterogeneity of the stentless bioprosthesis wall was investigated using computed tomography. The ascending aorta and the right, left, and non-coronary sinuses of Valsalva were resected and examined by an indentation test to evaluate their biomechanical properties.

Results

The non-coronary sinus of Valsalva was significantly thinner than the right sinus of Valsalva (p < 0.01). Young’s modulus, calculated as an indicator of elasticity, was significantly greater at the non-coronary sinus of Valsalva (430.7 ± 374.2 kPa) than at either the left (190.6 ± 70.6 kPa, p < 0.01) or right sinuses of Valsalva (240.0 ± 56.5 kPa, p < 0.05).

Conclusions

Based on the morphometrical and biomechanical analyses of the stentless bioprosthesis, we demonstrated that there are differences in wall thickness and elasticity between each sinus of Valsalva. These differences suggest that the non-coronary sinus of Valsalva is the most vulnerable and at greater risk of tissue failure. The exclusion of the non-coronary sinus of Valsalva may be beneficial to mitigate the long-term risks of tissue failure in the stentless bioprosthesis.

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Author notes

  1. H. Takaya and S. Masuda contributed to this manuscript equally.

Authors and Affiliations

  1. Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryocho, Aoba-ku, Sendai, Miyagi, 980-8575, Japan

    Hiroki Takaya, Shinya Masuda, Masaaki Naganuma, Ichiro Yoshioka, Goro Takahashi, Masatoshi Akiyama, Osamu Adachi & Yoshikatsu Saiki

  2. Research Division of Sciences for Aortic Disease, Tohoku University Graduate School of Medicine, Sendai, Japan

    Kiichiro Kumagai

  3. Biomechanics Laboratory, Department of Mechanical Engineering, Graduate School of Engineering, Nagoya Institute of Technology, Nagoya, Japan

    Shukei Sugita

Authors
  1. Hiroki Takaya
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  2. Shinya Masuda
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  3. Masaaki Naganuma
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  4. Ichiro Yoshioka
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Correspondence to Hiroki Takaya.

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Takaya, H., Masuda, S., Naganuma, M. et al. Morphometrical and biomechanical analyses of a stentless bioprosthetic valve: an implication to avoid potential primary tissue failure. Gen Thorac Cardiovasc Surg 66, 523–528 (2018). https://doi.org/10.1007/s11748-018-0959-1

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  • DOI: https://doi.org/10.1007/s11748-018-0959-1

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