Open AccessA Novel Aortic Regurgitation Model from Cusp Prolapse with Hemodynamic Validation Using an Ex Vivo Left Heart Simulator
Author(s) -
Yuanjia Zhu,
Annabel M. Imbrie-Moore,
Michael J. Paulsen,
Bryant Priromprintr,
Matthew H. Park,
Shuangfeng Wang,
Haley J. Lucian,
Justin M. Farry,
Y. Joseph Woo
Publication year - 2020
Publication title -
journal of cardiovascular translational research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.028
H-Index - 51
eISSN - 1937-5395
pISSN - 1937-5387
DOI - 10.1007/s12265-020-10038-z
Subject(s) - regurgitation (circulation) , hemodynamics , cardiology , medicine , biomechanics , cusp (singularity) , aortic valve , ex vivo , biomedical engineering , in vivo , anatomy , mathematics , biology , geometry , microbiology and biotechnology
Although ex vivo simulation is a valuable tool for surgical optimization, a disease model that mimics human aortic regurgitation (AR) from cusp prolapse is needed to accurately examine valve biomechanics. To simulate AR, four porcine aortic valves were explanted, and the commissure between the two largest leaflets was detached and re-implanted 5 mm lower to induce cusp prolapse. Four additional valves were tested in their native state as controls. All valves were tested in a heart simulator while hemodynamics, high-speed videography, and echocardiography data were collected. Our AR model successfully reproduced cusp prolapse with significant increase in regurgitant volume compared with that of the controls (23.2 ± 8.9 versus 2.8 ± 1.6 ml, p = 0.017). Hemodynamics data confirmed the simulation of physiologic disease conditions. Echocardiography and color flow mapping demonstrated the presence of mild to moderate eccentric regurgitation in our AR model. This novel AR model has enormous potential in the evaluation of valve biomechanics and surgical repair techniques. Graphical Abstract.