Abstract
Restoration of physiologic hemodynamics in the ascending aorta following aortic valve Rreplacement: a 4D flow MR study
Highlights
Previous work has illustrated that blood flow patterns following aortic valve and/or aortic root replacement (AVR/ ARR) are dependent on the valve and procedure type
11 patients (9 men, 45 ± 12 years) with aortic valve disease underwent contrast-enhanced 4D flow MR at 1.5T before and after AVR ± ARR with an On-X mechanical valve prosthesis. 11 age/gender-matched controls (9 men, 42 ± 12 years) were analyzed to characterize baseline, physiologic flow patterns. 4D flow MR data were corrected for eddy currents, Maxwell terms, and velocity aliasing in Matlab
Peak transvalvular pressure gradients were computed from peak velocity, using the Simplified Bernoulli equation (ΔP = 4v2), and aortic hemodynamics were visualized with streamlines (Ensight) and graded separately for helicity by two blinded reviewers (1-3; 360°)
Summary
Previous work has illustrated that blood flow patterns following aortic valve and/or aortic root replacement (AVR/ ARR) are dependent on the valve and procedure type. ARR with bioprosthetic and mechanical valves demonstrated increased blood velocities and helicity/vorticity in the ascending aorta, with none restoring physiologic hemodynamics. On-X mechanical valves have unique design features, such as flared inlets and larger length-to-diameter ratios more analogous to the natural left ventricular outflow tract. We sought to examine the impact of this alternative design on ascending aortic hemodynamics
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