Opening and closing characteristics of the aortic valve after different types of valve-preserving surgery
The surgical approach to aortic root aneurysm and/or dissection remains controversial. The use of valve-sparing operations, which are thought to have many advantages, is increasing. We hypothesized that the particular technique and type of surgery could influence valve motion characteristics and fun...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 1999-11, Vol.100 (21), p.2153-2160 |
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| creator | LEYH, R. G SCHMIDTKE, C SIEVERS, H.-H YACOUB, M. H |
| description | The surgical approach to aortic root aneurysm and/or dissection remains controversial. The use of valve-sparing operations, which are thought to have many advantages, is increasing. We hypothesized that the particular technique and type of surgery could influence valve motion characteristics and function. Therefore, we studied the instantaneous opening and closing characteristics of the aortic valve after the main 2 types of valve-sparing surgery.
In 20 patients (10 with tube replacement of the aortic root, group A; and 10 with separate replacement of the sinuses of Valsalva, group B) and 10 controls (group C), transthoracic and transesophageal studies on aortic valve dynamics were performed. Three distinct phases of aortic valve motion were identified. They were as follows: (1) a rapid opening, with a velocity of 20.9+/-4.2 cm/s in group C, 27.1+/-10.9 cm/s in group B (P=NS), and 58.3+/-18.4 cm/s in group A (group A versus group C, P |
| doi_str_mv | 10.1161/01.cir.100.21.2153 |
| format | Article |
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In 20 patients (10 with tube replacement of the aortic root, group A; and 10 with separate replacement of the sinuses of Valsalva, group B) and 10 controls (group C), transthoracic and transesophageal studies on aortic valve dynamics were performed. Three distinct phases of aortic valve motion were identified. They were as follows: (1) a rapid opening, with a velocity of 20.9+/-4.2 cm/s in group C, 27.1+/-10.9 cm/s in group B (P=NS), and 58.3+/-18.4 cm/s in group A (group A versus group C, P<0. 001; group A versus group B, P=0.001); (2) a slow systolic closure, with 12.5+/-6.6% and 10.8+/-2.2% of maximal opening in groups C and B, respectively (P=NS), and 3.8+/-1.6% in group A (group A versus group C, P=0.001; group A versus group B, P<0.001); and (3) a rapid closing movement, with a velocity of 26.3+/-5.6 cm/s in group C, 32. 4+/-11.4 cm/s in group B (P=NS), and 21.8+/-3.5 cm/s in group A (group A versus group C, P=NS; group A versus group B, P=0.008). The pressure strain of the elastic modulus was different in groups C and B only at the commissures (682+/-145 g/cm(2) versus 1896+/-726 g/cm(2), respectively; P<0.001). At all root levels, the distensibility was reduced in group A (P<0.001). Systolic contact of aortic cusps and wall occurred only in group A.
Near-normal opening and closing characteristics can be achieved by a technique that preserves the shape and independent mobility of the sinuses of Valsalva.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.cir.100.21.2153</identifier><identifier>PMID: 10571974</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Aged ; Aortic Valve - physiology ; Aortic Valve - surgery ; Biological and medical sciences ; Blood Flow Velocity ; Coronary Circulation ; Echocardiography ; Female ; Humans ; Male ; Medical sciences ; Middle Aged ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart</subject><ispartof>Circulation (New York, N.Y.), 1999-11, Vol.100 (21), p.2153-2160</ispartof><rights>2000 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. Nov 23, 1999</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c508t-60e9e54895c0d568d097f58147b32a5aeb6f782e6117122d4ca62516a555a61e3</citedby><cites>FETCH-LOGICAL-c508t-60e9e54895c0d568d097f58147b32a5aeb6f782e6117122d4ca62516a555a61e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,3691,27933,27934</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1195387$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10571974$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LEYH, R. G</creatorcontrib><creatorcontrib>SCHMIDTKE, C</creatorcontrib><creatorcontrib>SIEVERS, H.-H</creatorcontrib><creatorcontrib>YACOUB, M. H</creatorcontrib><title>Opening and closing characteristics of the aortic valve after different types of valve-preserving surgery</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>The surgical approach to aortic root aneurysm and/or dissection remains controversial. The use of valve-sparing operations, which are thought to have many advantages, is increasing. We hypothesized that the particular technique and type of surgery could influence valve motion characteristics and function. Therefore, we studied the instantaneous opening and closing characteristics of the aortic valve after the main 2 types of valve-sparing surgery.
In 20 patients (10 with tube replacement of the aortic root, group A; and 10 with separate replacement of the sinuses of Valsalva, group B) and 10 controls (group C), transthoracic and transesophageal studies on aortic valve dynamics were performed. Three distinct phases of aortic valve motion were identified. They were as follows: (1) a rapid opening, with a velocity of 20.9+/-4.2 cm/s in group C, 27.1+/-10.9 cm/s in group B (P=NS), and 58.3+/-18.4 cm/s in group A (group A versus group C, P<0. 001; group A versus group B, P=0.001); (2) a slow systolic closure, with 12.5+/-6.6% and 10.8+/-2.2% of maximal opening in groups C and B, respectively (P=NS), and 3.8+/-1.6% in group A (group A versus group C, P=0.001; group A versus group B, P<0.001); and (3) a rapid closing movement, with a velocity of 26.3+/-5.6 cm/s in group C, 32. 4+/-11.4 cm/s in group B (P=NS), and 21.8+/-3.5 cm/s in group A (group A versus group C, P=NS; group A versus group B, P=0.008). The pressure strain of the elastic modulus was different in groups C and B only at the commissures (682+/-145 g/cm(2) versus 1896+/-726 g/cm(2), respectively; P<0.001). At all root levels, the distensibility was reduced in group A (P<0.001). Systolic contact of aortic cusps and wall occurred only in group A.
Near-normal opening and closing characteristics can be achieved by a technique that preserves the shape and independent mobility of the sinuses of Valsalva.</description><subject>Adult</subject><subject>Aged</subject><subject>Aortic Valve - physiology</subject><subject>Aortic Valve - surgery</subject><subject>Biological and medical sciences</subject><subject>Blood Flow Velocity</subject><subject>Coronary Circulation</subject><subject>Echocardiography</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkdFr2zAQxkXpWLNu_0Afhillb07vJEuyH0fo1kChMLpnocinVsWxPckO5L-f0gRWBge6j_t9H4eOsSuEJaLCW8ClC3GJAEuOuaQ4YwuUvCorKZpztgCAptSC8wv2KaXXLJXQ8iO7QJAaG10tWHgcqQ_9c2H7tnDdkA69e7HRuoliSFNwqRh8Mb1QYYeYZbGz3S4Ln-dFG7ynSP1UTPuR3si3cTlGShR3h7Q0x2eK-8_sg7ddoi-n95L9_nH3tLovHx5_rlffH0onoZ5KBdSQrOpGOmilqltotJc1VnojuJWWNsrrmpNC1Mh5WzmruERlpZRWIYlL9u2YO8bhz0xpMtuQHHWd7WmYk1GNAKgqnsHr_8DXYY593s1w5FrUHDBD_Ai5OKQUyZsxhq2Ne4NgDlcwgGa1_pUlZJs5XCGbvp6S582W2neW47dn4OYE2ORs56PtXUj_OGykqLX4Cz6Fj7Y</recordid><startdate>19991123</startdate><enddate>19991123</enddate><creator>LEYH, R. G</creator><creator>SCHMIDTKE, C</creator><creator>SIEVERS, H.-H</creator><creator>YACOUB, M. H</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>19991123</creationdate><title>Opening and closing characteristics of the aortic valve after different types of valve-preserving surgery</title><author>LEYH, R. G ; SCHMIDTKE, C ; SIEVERS, H.-H ; YACOUB, M. H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c508t-60e9e54895c0d568d097f58147b32a5aeb6f782e6117122d4ca62516a555a61e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aortic Valve - physiology</topic><topic>Aortic Valve - surgery</topic><topic>Biological and medical sciences</topic><topic>Blood Flow Velocity</topic><topic>Coronary Circulation</topic><topic>Echocardiography</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>LEYH, R. G</creatorcontrib><creatorcontrib>SCHMIDTKE, C</creatorcontrib><creatorcontrib>SIEVERS, H.-H</creatorcontrib><creatorcontrib>YACOUB, M. H</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>LEYH, R. G</au><au>SCHMIDTKE, C</au><au>SIEVERS, H.-H</au><au>YACOUB, M. H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Opening and closing characteristics of the aortic valve after different types of valve-preserving surgery</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>1999-11-23</date><risdate>1999</risdate><volume>100</volume><issue>21</issue><spage>2153</spage><epage>2160</epage><pages>2153-2160</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>The surgical approach to aortic root aneurysm and/or dissection remains controversial. The use of valve-sparing operations, which are thought to have many advantages, is increasing. We hypothesized that the particular technique and type of surgery could influence valve motion characteristics and function. Therefore, we studied the instantaneous opening and closing characteristics of the aortic valve after the main 2 types of valve-sparing surgery.
In 20 patients (10 with tube replacement of the aortic root, group A; and 10 with separate replacement of the sinuses of Valsalva, group B) and 10 controls (group C), transthoracic and transesophageal studies on aortic valve dynamics were performed. Three distinct phases of aortic valve motion were identified. They were as follows: (1) a rapid opening, with a velocity of 20.9+/-4.2 cm/s in group C, 27.1+/-10.9 cm/s in group B (P=NS), and 58.3+/-18.4 cm/s in group A (group A versus group C, P<0. 001; group A versus group B, P=0.001); (2) a slow systolic closure, with 12.5+/-6.6% and 10.8+/-2.2% of maximal opening in groups C and B, respectively (P=NS), and 3.8+/-1.6% in group A (group A versus group C, P=0.001; group A versus group B, P<0.001); and (3) a rapid closing movement, with a velocity of 26.3+/-5.6 cm/s in group C, 32. 4+/-11.4 cm/s in group B (P=NS), and 21.8+/-3.5 cm/s in group A (group A versus group C, P=NS; group A versus group B, P=0.008). The pressure strain of the elastic modulus was different in groups C and B only at the commissures (682+/-145 g/cm(2) versus 1896+/-726 g/cm(2), respectively; P<0.001). At all root levels, the distensibility was reduced in group A (P<0.001). Systolic contact of aortic cusps and wall occurred only in group A.
Near-normal opening and closing characteristics can be achieved by a technique that preserves the shape and independent mobility of the sinuses of Valsalva.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>10571974</pmid><doi>10.1161/01.cir.100.21.2153</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; American Heart Association Journals; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Aged Aortic Valve - physiology Aortic Valve - surgery Biological and medical sciences Blood Flow Velocity Coronary Circulation Echocardiography Female Humans Male Medical sciences Middle Aged Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart |
| title | Opening and closing characteristics of the aortic valve after different types of valve-preserving surgery |
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