Abstract:

BACKGROUND: The preservation of subvalvular apparatus can cause an obstruction to the blood flow in downstream. At present, there are few quantitative studies on the obstruction to the blood flow in downstream of different kinds of prosthetic valves with preservation of subvalvular apparatus.
OBJECTIVE: To the compare the advantages and disadvantages of hemodynamic properties in downstream of different kinds of prosthetic valves with preservation of the same subvalvular apparatus.
METHODS: According to the common mitral valve replacement, a standard porcine mitral valve replacement model was established under general anesthesia involving cardiopulmonary bypass. The porcine mitral valve and its subvalvular apparatus were performed three kinds of surgeries: without preservation of the subvalvular apparatus, preservation of the posterior subvalvular apparatus and preservation of the entire subvalvular apparatus. And the implanted valves included monoleaflet mechanical valve, bileaflet mechanical valve and bioprosthetic valve. Turbulent shear stress in downstream of different kinds of prosthetic valves with procine preservation of the same subvalvular apparatus was performed in vivo quantitative experiment by color Doppler echocardiography combined with computerized image analysis.
RESULTS AND CONCLUSION: Hemodynamic performances in downstream of monoleaflet mechanical and bileaflet mechanical valves without preservation of the subvalvular apparatus were the same, which were worse than that of bioprosthetic valve. Of the three kinds of prosthetic valves, the hemodynamic performance in downstream of the bioprosthetic valve with preservation of the same subvalvular apparatus was the best, the bileaflet mechanical valve was worse, while the monoleaflet mechanical valve was the worst.