JTCS Tips for Better Browsing
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Richard P. Cochran
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Grande-Allen, K. J.
Right arrow Articles by Kunzelman, K. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Grande-Allen, K. J.
Right arrow Articles by Kunzelman, K. S.

J Thorac Cardiovasc Surg 2000;119:753-762
© 2000 The American Association for Thoracic Surgery

SURGERY FOR ACQUIRED CARDIOVASCULAR DISEASE

RE-CREATION OF SINUSES IS IMPORTANT FOR SPARING THE AORTIC VALVE: A FINITE ELEMENT STUDY

K. Jane Grande-Allen, PhDa, Richard P. Cochran, MDb, Per G. Reinhall, PhDc, Karyn S. Kunzelman, PhDb

From the Department of Biomedical Engineering, Cleveland Clinic Foundation, Cleveland, Ohioa; Division of Cardiothoracic Surgery, University of Wisconsin, Madison, Wisb; and Department of Mechanical Engineering, University of Washington, Seattle, Wash.c

Supported by the Whitaker Foundation and the National Partnership for Advanced Computational Infrastructure.

Address for reprints: Karyn S. Kunzelman, PhD, University of Wisconsin, CSC H4/368, 600 Highland Ave, Madison, WI 53792-3236 (E-mail: karynk{at}surgery.wisc.edu ).

Objective: The treatment of choice for aortic valve insufficiency due to root dilatation has become root replacement with aortic valve sparing. However, root replacement with a synthetic graft may result in altered valve stresses. The purpose of this study was to compare the stress/strain patterns in the spared aortic valve in different root replacement procedures by means of finite element modeling.
Methods: Our finite element model of the normal human root and valve was modified to simulate and evaluate three surgical techniques: (1) "cylindrical" graft sutured below the valve at the anulus, (2) "tailored" graft sutured just above the valve, and (3) "pseudosinus" graft, tailored and sutured below the valve at the anulus. Simulated diastolic pressures were applied, and stresses and strains were calculated for the valve, root, and graft. Leaflet coaptation was also quantified.
Results: All three root replacement models demonstrated significantly altered leaflet stress patterns as compared with normal patterns. The cylindrical model showed the greatest increases in stress (16%-173%) and strain (10%-98%), followed by the tailored model (stress +10%-157%, strain +9%-36%). The pseudosinus model showed the smallest increase in stress (9%-28%) and strain (2%-31%), and leaflet coaptation was closest to normal.
Conclusion: Valve-sparing techniques that allow the potential for sinus space formation (tailored, pseudosinus) result in simulated leaflet stresses that are closer to normal than the cylindrical technique. Normalized leaflet stresses in the clinical setting may result in improved longevity of the spared valve.




This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
N. D. Patel, E. S. Weiss, D. E. Alejo, L. U. Nwakanma, J. A. Williams, H. C. Dietz, P. J. Spevak, V. L. Gott, L. A. Vricella, and D. E. Cameron
Aortic root operations for marfan syndrome: a comparison of the bentall and valve-sparing procedures.
Ann. Thorac. Surg., June 1, 2008; 85(6): 2003 - 2011.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
N. Gundiah, K. Kam, P. B. Matthews, J. Guccione, H. A. Dwyer, D. Saloner, T. A.M. Chuter, T. S. Guy, M. B. Ratcliffe, and E. E. Tseng
Asymmetric mechanical properties of porcine aortic sinuses.
Ann. Thorac. Surg., May 1, 2008; 85(5): 1631 - 1638.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
T. E. David
Aortic Valve Repair and Aortic Valve Sparing Operations
Card. Surg. Adult, January 1, 2008; 3(2008): 935 - 948.
[Full Text]

Home page
 Ann. Thorac. Surg.Home page
A. G. Cerillo, P. A. Farneti, M. Mariani, T. Gasbarri, M. Solinas, and M. Glauber
Valve-Sparing Replacement of the Noncoronary Sinus of Valsalva in Patients With a Bicuspid Aortic Valve
Ann. Thorac. Surg., November 1, 2007; 84(5): 1774 - 1776.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
A. G. Cerillo, P. A. Farneti, and M. Glauber
Selective replacement of the noncoronary sinus of Valsalva: Preserving the sinus geometry to spare the bicuspid aortic valve.
J. Thorac. Cardiovasc. Surg., October 1, 2007; 134(4): 1094 - 1095.
[Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
Y. Kato, H. Ohashi, Y. Tsutsumi, and T. Kawai
Emergent David-V operation for a ruptured aortic root aneurysm in a 9-year-old child
Eur. J. Cardiothorac. Surg., April 1, 2007; 31(4): 744 - 746.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
M. Matsumori, H. Tanaka, Y. Kawanishi, T. Onishi, K. Nakagiri, T. Yamashita, K. Okada, and Y. Okita
Comparison of distensibility of the aortic root and cusp motion after aortic root replacement with two reimplantation techniques: Valsalva graft versus tube graft
Interactive CardioVascular and Thoracic Surgery, April 1, 2007; 6(2): 177 - 181.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. E. David, C. M. Feindel, G. D. Webb, J. M. Colman, S. Armstrong, and M. Maganti
Aortic Valve Preservation in Patients With Aortic Root Aneurysm: Results of the Reimplantation Technique
Ann. Thorac. Surg., February 1, 2007; 83(2): S732 - S735.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. C. Miller
Valve-Sparing Aortic Root Replacement: Current State of the Art and Where Are We Headed?
Ann. Thorac. Surg., February 1, 2007; 83(2): S736 - S739.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
F. Settepani, W. Y. Szeto, D. Pacini, R. De Paulis, L. Chiariello, R. Di Bartolomeo, R. Gallotti, and J. E. Bavaria
Reimplantation Valve-Sparing Aortic Root Replacement in Marfan Syndrome Using the Valsalva Conduit: An Intercontinental Multicenter Study
Ann. Thorac. Surg., February 1, 2007; 83(2): S769 - S773.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. Pacini, F. Settepani, R. De Paulis, A. Loforte, S. Nardella, D. Ornaghi, R. Gallotti, L. Chiariello, and R. Di Bartolomeo
Early results of valve-sparing reimplantation procedure using the Valsalva conduit: a multicenter study.
Ann. Thorac. Surg., September 1, 2006; 82(3): 865 - 871.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
N. D. Patel, J. A. Williams, C. J. Barreiro, B. T. Bethea, T. P. Fitton, H. C. Dietz, J. A.C. Lima, P. J. Spevak, V. L. Gott, L. A. Vricella, et al.
Valve-Sparing Aortic Root Replacement: Early Experience With the De Paulis Valsalva Graft in 51 Patients
Ann. Thorac. Surg., August 1, 2006; 82(2): 548 - 553.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. E. David, C. M. Feindel, G. D. Webb, J. M. Colman, S. Armstrong, and M. Maganti
Long-term results of aortic valve-sparing operations for aortic root aneurysm.
J. Thorac. Cardiovasc. Surg., August 1, 2006; 132(2): 347 - 354.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
R. Di Bartolomeo, D. Pacini, S. Martin-Suarez, A. Loforte, A. Dell'Amore, M. Ferlito, G. Bracchetti, and G. Bozzetti
Valsalva prosthesis in aortic valve-sparing operations
Interactive CardioVascular and Thoracic Surgery, June 1, 2006; 5(3): 294 - 298.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
S. Y. Hahm, S. J. Choo, J. W. Lee, J. B. Seo, T. H. Lim, J. K. Song, J. K. Shin, and M. G. Song
Novel technique of aortic valvuloplasty.
Eur. J. Cardiothorac. Surg., April 1, 2006; 29(4): 530 - 536.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
S. Hashim and D. Richens
Finite element method in cardiac surgery
Interactive CardioVascular and Thoracic Surgery, February 1, 2006; 5(1): 5 - 8.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
D. Maselli and G. Minzioni
A technique to reposition sinotubular junction in aortic valve reimplantation procedures with the De Paulis Valsalva graft
Eur. J. Cardiothorac. Surg., January 1, 2006; 29(1): 107 - 109.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
D. Maselli, G. Borelli, A. Amerini, P. Bajona, L. Bellieni, M. Croccia, and G. Minzioni
The ideal theoretical graft oversizing in valve-sparing aortic operations with a standard tubular or a Valsalva graft
Eur. J. Cardiothorac. Surg., December 1, 2005; 28(6): 845 - 849.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
R. De Paulis, C. Schmitz, R. Scaffa, P. Nardi, L. Chiariello, and H. Reul
In vitro evaluation of aortic valve prosthesis in a novel valved conduit with pseudosinuses of Valsalva
J. Thorac. Cardiovasc. Surg., October 1, 2005; 130(4): 1016 - 1021.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. G. Gleason
New graft formulation and modification of the David reimplantation technique
J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 601 - 603.
[Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
D. Maselli, A. Montalto, G. Santise, G. Minardi, C. Manzara, and F. Musumeci
A normogram to anticipate dimension of neo-sinuses of valsalva in valve-sparing aortic operations
Eur. J. Cardiothorac. Surg., May 1, 2005; 27(5): 831 - 835.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
J.-P. E. Kvitting, T. Ebbers, L. Wigstrom, J. Engvall, C. L. Olin, and A. F. Bolger
Flow patterns in the aortic root and the aorta studied with time-resolved, 3-dimensional, phase-contrast magnetic resonance imaging: Implications for aortic valve-sparing surgery
J. Thorac. Cardiovasc. Surg., June 1, 2004; 127(6): 1602 - 1607.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
V. C. Sripathi, R. K. Kumar, and K. R. Balakrishnan
Further insights into normal aortic valve function: role of a compliant aortic root on leaflet opening and valve orifice area
Ann. Thorac. Surg., March 1, 2004; 77(3): 844 - 851.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. Handke, G. Heinrichs, F. Beyersdorf, M. Olschewski, C. Bode, and A. Geibel
In vivo analysis of aortic valve dynamics by transesophageal 3-dimensional echocardiography with high temporal resolution
J. Thorac. Cardiovasc. Surg., June 1, 2003; 125(6): 1412 - 1419.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
D. C. Miller
Valve-sparing aortic root replacement in patients with the Marfan syndrome
J. Thorac. Cardiovasc. Surg., April 1, 2003; 125(4): 773 - 778.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
N. C. de Oliveira, T. E. David, J. Ivanov, S. Armstrong, M. J. Eriksson, H. Rakowski, and G. Webb
Results of surgery for aortic root aneurysm in patients with Marfan syndrome
J. Thorac. Cardiovasc. Surg., April 1, 2003; 125(4): 789 - 796.
[Abstract] [Full Text] [PDF]

Home page
 Card Surg AdultHome page
T. E. David
Aortic Valve Repair and Aortic Valve-Sparing Operations
Card. Surg. Adult, January 1, 2003; 2(2003): 811 - 824.
[Full Text]

Home page
 Ann. Thorac. Surg.Home page
T. E. David, J. Ivanov, S. Armstrong, C. M. Feindel, and G. D. Webb
Aortic valve-sparing operations in patients with aneurysms of the aortic root or ascending aorta
Ann. Thorac. Surg., November 1, 2002; 74(5): S1758 - 1761.
[Abstract] [Full Text] [PDF]

Home page
 CirculationHome page
R. G. Leyh, S. Fischer, K. Kallenbach, T. Kofidis, K. Pethig, W. Harringer, and A. Haverich
High Failure Rate After Valve-sparing Aortic Root Replacement Using the "Remodeling Technique" in Acute Type A Aortic Dissection
Circulation, September 24, 2002; 106(12_suppl_1): I-229 - I-233.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
R. De Paulis, G. M. De Matteis, P. Nardi, R. Scaffa, C. Bassano, and L. Chiariello
Analysis of valve motion after the reimplantation type of valve-sparing procedure (David I) with a new aortic root conduit
Ann. Thorac. Surg., July 1, 2002; 74(1): 53 - 57.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
R. Gnyaneshwar, R. K. Kumar, and K. R. Balakrishnan
Dynamic analysis of the aortic valve using a finite element model
Ann. Thorac. Surg., April 1, 2002; 73(4): 1122 - 1129.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
R. De Paulis, G. M. De Matteis, P. Nardi, R. Scaffa, D. F. Colella, C. Bassano, F. Tomai, and L. Chiariello
One-year appraisal of a new aortic root conduit with sinuses of Valsalva
J. Thorac. Cardiovasc. Surg., January 1, 2002; 123(1): 33 - 39.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
R. De Paulis, G. M. De Matteis, P. Nardi, R. Scaffa, M. M. Buratta, and L. Chiariello
Opening and closing characteristics of the aortic valve after valve-sparing procedures using a new aortic root conduit
Ann. Thorac. Surg., August 1, 2001; 72(2): 487 - 494.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. E. David, S. Armstrong, J. Ivanov, C. M. Feindel, A. Omran, and G. Webb
Results of aortic valve-sparing operations
J. Thorac. Cardiovasc. Surg., July 1, 2001; 122(1): 39 - 46.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
C. Bassano, G. M. De Matteis, P. Nardi, M. M. Buratta, J. Zeitani, R. De Paulis, and L. Chiariello
Mid-term follow-up of aortic root remodelling compared to Bentall operation
Eur. J. Cardiothorac. Surg., May 1, 2001; 19(5): 601 - 605.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
K. J. Zehr, M. J. Thubrikar, G. G. Gong, J. R. Headrick, and F. Robicsek
Clinical introduction of a novel prosthesis for valve-preserving aortic root reconstruction for annuloaortic ectasia
J. Thorac. Cardiovasc. Surg., October 1, 2000; 120(4): 692 - 698.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2000 by The American Association for Thoracic Surgery.