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• W1966557628 abstract "A trileaflet mechanical heart valve (TTV, Triflo Inc., Costa Mesa, CA.) is undergoing development. Preliminary in vitro studies with the TTV suggest that the design successfully combines the durability of a mechanical heart valve (MHV) with the centra flow characteristics, sensitivity to pressure variations (i.e., initiation of closure prior to deceleration of blood flow), and higher cavitation threshold of a bioprosthesis. We are conducting site-specific evaluation of TTV in the aortic position in a recently develope calf model to compare its in vivo performance to that of the St. Jude Medical valv (SJM). We present here the preliminary results from the first four animals in thi comparative preclinical series. Methods: The calves were placed on CPB usin HeartPort® access. The native aortic valve was replaced via left thoracotomy with either a 21-mm SJM (n=2) or a 21-mm TTV (n=2). No anticoagulation therapy wa administered after post-operative day 7. Cardiac output (CO) and mean and pea transvalvular pressure gradients (ΔP) were measured with echocardiography at implan and catheterization at explant. Necropsy, gross pathology and light microscopy wer performed in the routine fashion. Results: The calves tolerated the procedure well an continued to gain weight throughout the study. Both SJM animals were electivel sacrificed when they began to exhibit clinical symptoms of aortic stenosis while TT animals remained symptom-free throughout the study. At necropsy both valves in either group were free of thrombi, pannus, occlusive tissue, or mechanical impairment of leaflet motion. However, in both SJM animals there was significant concentric left ventricula hypertrophy consistent with aortic stenosis. In addition, there were patchy areas of transmural infarct in the basal septal and anteroseptal myocardium in the second SJ animal. The myocardial thickness and histology were unremarkable in both TTV animals Discussion: This is the first report of a 21 mm aortic mechanical heart valve implantatio in the bovine model. The significantly higher gradient and LV hypertrophy in the SJ animals were probably secondary to the relatively smaller effective orifice area mode which precluded adaptation to increasing transvalvular volumes in the growing animal This problem was not observed with the TTV. Further findings in this experimental series should clarify whether these preliminary trends accurately reflect significan differences in the hemodynamic characteristics between the peripheral flow bileaflet and the central flow trileaflet valve designs and predict their clinical performance.Table" @default.
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• W1966557628 date "2001-03-01" @default.
• W1966557628 modified "2023-10-18" @default.
• W1966557628 title "COMPARISON OF A MECHANICAL TRILEAFLET VALVE TO THE BILEAFLET STANDARD" @default.
• W1966557628 doi "https://doi.org/10.1097/00002480-200103000-00146" @default.
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