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In-vitro and in-vivo evaluation of a novel bioprosthetic pulmonary valve for use in congenital heart surgery

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Rasmussen, Jonas ; Skov, Søren Nielsen ; Nielsen, Ditte Bruus ; Jensen, Ida Lindhardt ; Tjørnild, Marcell Juan ; Johansen, Peter ; Hjortdal, Vibeke E. / In-vitro and in-vivo evaluation of a novel bioprosthetic pulmonary valve for use in congenital heart surgery. I: Journal of Cardiothoracic Surgery. 2019 ; Bind 14, Nr. 1.

Bibtex

@article{433fb4f8dccb4eda997ff8f9408f6762,
title = "In-vitro and in-vivo evaluation of a novel bioprosthetic pulmonary valve for use in congenital heart surgery",
abstract = "BACKGROUND: Management of congenital malformations of the pulmonary artery and valve can be challenging. The severity often demands early intervention, which is rarely definitive due to the natural growth and multiple surgeries may be required. An artificial valve made entirely from biodegradable materials that will serve as a bioscaffold for host recellularization would be an attractive solution for these patients. Such valves have been experimentally evaluated with various results. In this study, a simple valve design supported by an absorbable proximal stabilization ring is evaluated both in-vitro and in-vivo.METHODS: From a 6.7 × 5.0 cm sheet of CorMatrix{\textregistered} tissue we created the valve as an inverted tubegraft with three sutured commissures. A non-closed ring of LactoSorb{\textregistered} basally supported the valve. The commissure height was 2 cm. Inserted as an interposition graft the valve was tested in an in-vitro model and an acute porcine model. Right ventricular and pulmonary artery pressures were recorded.RESULTS: The in-vitro testing indicated a proper opening and closure function of valve at physiological simulated hemodynamic conditions. The in-vivo evaluation showed a peak right ventricular pressure of 38 mmHg and a peak pulmonary artery pressure of 27 mmHg and thereby a peak valve gradient of 11 mmHg. The pulmonary pressure wave demonstrated a dicrotic notch indicating competence of the valve.CONCLUSION: This new pulmonary valve made entirely from biodegradable tissue worked in an acute setting and displayed a good hemodynamic profile. The valve gradient observed is equal to or superior of today's surgical treatment options.",
author = "Jonas Rasmussen and Skov, {S{\o}ren Nielsen} and Nielsen, {Ditte Bruus} and Jensen, {Ida Lindhardt} and Tj{\o}rnild, {Marcell Juan} and Peter Johansen and Hjortdal, {Vibeke E}",
year = "2019",
month = jan,
doi = "10.1186/s13019-019-0830-1",
language = "English",
volume = "14",
journal = "Journal of Cardiothoracic Surgery",
issn = "1749-8090",
publisher = "BioMed Central Ltd",
number = "1",

}

RIS

TY - JOUR

T1 - In-vitro and in-vivo evaluation of a novel bioprosthetic pulmonary valve for use in congenital heart surgery

AU - Rasmussen, Jonas

AU - Skov, Søren Nielsen

AU - Nielsen, Ditte Bruus

AU - Jensen, Ida Lindhardt

AU - Tjørnild, Marcell Juan

AU - Johansen, Peter

AU - Hjortdal, Vibeke E

PY - 2019/1

Y1 - 2019/1

N2 - BACKGROUND: Management of congenital malformations of the pulmonary artery and valve can be challenging. The severity often demands early intervention, which is rarely definitive due to the natural growth and multiple surgeries may be required. An artificial valve made entirely from biodegradable materials that will serve as a bioscaffold for host recellularization would be an attractive solution for these patients. Such valves have been experimentally evaluated with various results. In this study, a simple valve design supported by an absorbable proximal stabilization ring is evaluated both in-vitro and in-vivo.METHODS: From a 6.7 × 5.0 cm sheet of CorMatrix® tissue we created the valve as an inverted tubegraft with three sutured commissures. A non-closed ring of LactoSorb® basally supported the valve. The commissure height was 2 cm. Inserted as an interposition graft the valve was tested in an in-vitro model and an acute porcine model. Right ventricular and pulmonary artery pressures were recorded.RESULTS: The in-vitro testing indicated a proper opening and closure function of valve at physiological simulated hemodynamic conditions. The in-vivo evaluation showed a peak right ventricular pressure of 38 mmHg and a peak pulmonary artery pressure of 27 mmHg and thereby a peak valve gradient of 11 mmHg. The pulmonary pressure wave demonstrated a dicrotic notch indicating competence of the valve.CONCLUSION: This new pulmonary valve made entirely from biodegradable tissue worked in an acute setting and displayed a good hemodynamic profile. The valve gradient observed is equal to or superior of today's surgical treatment options.

AB - BACKGROUND: Management of congenital malformations of the pulmonary artery and valve can be challenging. The severity often demands early intervention, which is rarely definitive due to the natural growth and multiple surgeries may be required. An artificial valve made entirely from biodegradable materials that will serve as a bioscaffold for host recellularization would be an attractive solution for these patients. Such valves have been experimentally evaluated with various results. In this study, a simple valve design supported by an absorbable proximal stabilization ring is evaluated both in-vitro and in-vivo.METHODS: From a 6.7 × 5.0 cm sheet of CorMatrix® tissue we created the valve as an inverted tubegraft with three sutured commissures. A non-closed ring of LactoSorb® basally supported the valve. The commissure height was 2 cm. Inserted as an interposition graft the valve was tested in an in-vitro model and an acute porcine model. Right ventricular and pulmonary artery pressures were recorded.RESULTS: The in-vitro testing indicated a proper opening and closure function of valve at physiological simulated hemodynamic conditions. The in-vivo evaluation showed a peak right ventricular pressure of 38 mmHg and a peak pulmonary artery pressure of 27 mmHg and thereby a peak valve gradient of 11 mmHg. The pulmonary pressure wave demonstrated a dicrotic notch indicating competence of the valve.CONCLUSION: This new pulmonary valve made entirely from biodegradable tissue worked in an acute setting and displayed a good hemodynamic profile. The valve gradient observed is equal to or superior of today's surgical treatment options.

U2 - 10.1186/s13019-019-0830-1

DO - 10.1186/s13019-019-0830-1

M3 - Journal article

C2 - 30626416

VL - 14

JO - Journal of Cardiothoracic Surgery

JF - Journal of Cardiothoracic Surgery

SN - 1749-8090

IS - 1

M1 - 6

ER -

ID: 65022383