Does valve size matter?

We had a great day doing valve surgery in our lab! A team from Leiden University Medical Center joined us to try and implant valves of different size into real hearts, and subsequently investigate the hemodynamic performance of these implantations on our Cardiac BioSimulator platforms!

It is commonly believed that a larger valve will have a lower pressure drop, and that therefore it would be better for the heart to implant the largest valve size that fits the aortic annulus. Sometimes it is even considered to surgically enlarge the aorta to fit an even larger valve size. But pressure drop is not the only thing to consider, as also the closing behavior of the valve - which is influenced by the size of the valve and the anatomy - is also of major importance to its efficacy.

Different valve sizes in one heart

There is a lot of interest in Patient-Prosthesis Mismatch (PPM) as this may lead to future complications in patients that have undergone valve replacements. The purpose of this particular study was to do implantations of valves in different sizes in one and the same heart, which provides information that is normally not that straightforward to obtain in clinical practice. With the Cardiac BioSimulator, however, it is possible to create a baseline setting with the heart's native heart valve, and repeatedly implant different valves to study the effect of valve size in that heart.

Working in parallel

During this field-day, the team of cardiac surgeons led by dr. de Weger, had been doing valve implantations and re-implantations in 6 hearts. Two Cardiac BioSimulator platforms were running in parallel, using endoscopic cameras to assess valve behavior and flow and pressure sensors to acquire the hemodynamic performance of both the native aortic heart valves and the implanted surgical valve prostheses. The detailed results are still being processed and analyzed, and if all goes well this study will lead to a scientific publication on the topic.

Let us know if we can support you!

The Cardiac BioSimulator platform, just like the PhysioHeart™ platform, has a very specific purpose: to simulate the environment in which a device (prototype) should be delivered and study it's performance in a clinically realistic setting. As such, these are very interesting platforms to use in R&D projects on device solutions and delivery techniques, or to train clinical teams in their first use of new device technologies prior to their first human cases. These technologies are not limited to cardiac applications; other models can be found in our "Cases, Papers, Platforms  & Services" page!  Please feel free to get in touch to learn how our ex-vivo organ platforms may be beneficial to your project!

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