Experimental study of the effects of sinotubular junction taper on artificial bioprosthesis valve in pulsatile flow condition_Journal of Biomedical Engineering

Authors：

JIA Rongxi ¹ , MA Yunfei ¹ , GU Zhaoyong ¹ , PAN Youlian ¹ , LIU Sicong ¹ ,  QIAO Aike ¹ , GUO Chao ² , DONG Nianguo ² , LI Xiaofeng ³ , LIU Yinglong ³

1. College of Life Science and Bio-Engineering, Beijing University of Technology, Beijing 100124, P.R.China;
2. Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, P.R.China;
3. Center of Infant Heart, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P.R.China;

Corresponding author：

QIAO Aike, Email: qak@bjut.edu.cn

Keywords：

sinotubular junction diameter; taper; pulsatile flow; bioprosthesis valve

DOI：

10.7507/1001-5515.201605021

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The aim of the present experimental study is to determine the effects of sinotubular junction diameter on artificial bioprosthesis valves. An experimental study was performed for aortic root models with different sinotubular junction taper under pulsatile flow condition. The sinotubular junction diameters were modified to create four models with different sinotubular junction tapers with 0, 1, 3 and 5 degrees, respectively, using three dimensional printing techniques. After installing the testing bioprosthesis valve on the aortic root models, we conducted experiments of the pulsatile flow testing with different stroke volume in the pulsatile circulation simulation system. The testing condition was set at the pulse frequency of 70 beats/min and the stroke volume of 2–7 L/min. The status of the valves in 10 continuous pulse cycles was tested and the average results were obtained for each stroke volume. The results of testing showed that the mean transvalvular pressure gradients agreed well with the national standard, and all smaller than 10 mm Hg. The sinotubular junction taper had an influence on regurgitation fraction of the artificial bioprosthesis valve. The smaller sinotubular junction taper showed beneficial effect to decrease the regurgitation fraction. In the case of smaller stroke volume, the smaller sinotubular junction taper was beneficial to increase the effective valve orifice area. In the case of larger stroke volume, the larger sinotubular junction taper was beneficial to increase the effective valve orifice area. This study indicates that a doctor should consider the smaller sinotubular junction taper in the case of smaller stroke volume more. In the case of larger stroke volume, the doctor should consider the larger sinotubular junction taper more.

Citation： JIA Rongxi, MA Yunfei, GU Zhaoyong, PAN Youlian, LIU Sicong, QIAO Aike, GUO Chao, DONG Nianguo, LI Xiaofeng, LIU Yinglong. Experimental study of the effects of sinotubular junction taper on artificial bioprosthesis valve in pulsatile flow condition. Journal of Biomedical Engineering, 2017, 34(3): 365-370. doi: 10.7507/1001-5515.201605021 Copy

1.	潘湘斌, 胡盛寿, 李守军, 等. 动脉调转术后中期主动脉瓣反流的危险因素分析. 中国循环杂志, 2009, 24(4): 296-299.
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4.	de Kerchove L, Glineur D, Poncelet A, et al. Repair of aortic leaflet prolapse: a ten-year experience. Eur J Cardiothorac Surg, 2008, 34(4): 785-791.
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6.	Gharaie S, Morsi Y. A novel design of a polymeric aortic valve. Int J Artif Organs, 2015, 38(5): 259-270.
7.	Haj-Ali R, Marom G, Ben Zekry S, et al. A general three-dimensional parametric geometry of the native aortic valve and root for biomechanical modeling. J Biomech, 2012, 45(14): 2392-2397.
8.	Marom G, Haj-Ali R, Rosenfeld M, et al. Aortic root numeric model: Annulus diameter prediction of effective height and coaptation in post-aortic valve repair. Journal of Thoracic and Cardiovascular Surgery, 2013, 145(2): 406-411.
9.	Marom G, Halevi R, Haj-Ali R, et al. Numerical model of the aortic root and valve: Optimization of graft size and sinotubular junction to annulus ratio. Journal of Thoracic and Cardiovascular Surgery, 2013, 146(5): 1227-1231.
10.	Weltert L, de Tullio M, Afferrante L, et al. Annular dilatation and loss of sino-tubular junction in aneurysmatic aorta: implications on leaflet quality at the time of surgery. A finite element study. Interact Cardiovasc Thorac Surg, 2013, 17(1): 8-12.
11.	乔爱科, 潘友联, 董念国. 窦管交界和窦部直径对主动脉瓣关闭功能影响. 北京工业大学学报, 2014, 40(5): 776-780.
12.	Nötzold A, Scharfschwerdt M, Thiede L, et al. In-vitro study on the relationship between progressive sinotubular junction dilatation and aortic regurgitation for several stentless aortic valve substitutes. Eur J Cardiothorac Surg, 2005, 27(1): 90-93.
13.	汤京龙, 王硕, 刘丽, 等. 一种新型介入瓣膜脉动流性能的初步研究. 生物医学工程学杂志, 2013(1): 166-169.
14.	Vismara R, Leopaldi A, Piola M, et al. In vitro assessment of mitral valve function in cyclically pressurized porcine hearts. Med Eng Phys, 2016, 38(4): 346-353.
15.	褚银平, 程金莲, 刘爱军, 等. 脉动流下机械心脏瓣膜瓣阀开启状态的评价. 中国组织工程研究, 2012(40): 7480-7485.
16.	Maselli D, De Paulis R, Scaffa R A, et al. Sinotubular junction size affects aortic root geometry and aortic valve function in the aortic valve reimplantation procedure: An in vitro study using the Valsalva graft. Ann Thorac Surg, 2007, 84(4): 1214-1218.
17.	周丰, 崔园园, 武亮亮, 等. 新型人工曲面机械双叶瓣体外脉动流实验. 功能材料, 2014(20): 20090-20094.
18.	陈雪娟, 林秀金. 人造心脏瓣膜的血流动力学特点. 中国组织工程研究与临床康复, 2009, 13(9): 1695-1698.
19.	张明柱, 李向欣, 李春亮. 不同类型人工心脏瓣膜质量及安全性的评价. 中国组织工程研究与临床康复, 2009, 13(21): 4149-4152.
20.	徐驰, 曹燕飞, 陈炜生, 等. 免缝合异种主动脉生物瓣膜的实验研究. 实用医学杂志, 2011, 27(3): 396-399.

1. 潘湘斌, 胡盛寿, 李守军, 等. 动脉调转术后中期主动脉瓣反流的危险因素分析. 中国循环杂志, 2009, 24(4): 296-299.
2. 张兴. 完全性大动脉转位的治疗进展. 心血管病学进展, 2015, 36(1): 11-15.
3. Lansac E, Di Centa I, Raoux F, et al. A lesional classification to standardize surgical management of aortic insufficiency towards valve repair. Eur J Cardiothorac Surg, 2008, 33(5): 872-880.
4. de Kerchove L, Glineur D, Poncelet A, et al. Repair of aortic leaflet prolapse: a ten-year experience. Eur J Cardiothorac Surg, 2008, 34(4): 785-791.
5. Conti C A, Votta E, Della Corte A, et al. Dynamic finite element analysis of the aortic root from MRI-derived parameters. Med Eng Phys, 2010, 32(2): 212-221.
6. Gharaie S, Morsi Y. A novel design of a polymeric aortic valve. Int J Artif Organs, 2015, 38(5): 259-270.
7. Haj-Ali R, Marom G, Ben Zekry S, et al. A general three-dimensional parametric geometry of the native aortic valve and root for biomechanical modeling. J Biomech, 2012, 45(14): 2392-2397.
8. Marom G, Haj-Ali R, Rosenfeld M, et al. Aortic root numeric model: Annulus diameter prediction of effective height and coaptation in post-aortic valve repair. Journal of Thoracic and Cardiovascular Surgery, 2013, 145(2): 406-411.
9. Marom G, Halevi R, Haj-Ali R, et al. Numerical model of the aortic root and valve: Optimization of graft size and sinotubular junction to annulus ratio. Journal of Thoracic and Cardiovascular Surgery, 2013, 146(5): 1227-1231.
10. Weltert L, de Tullio M, Afferrante L, et al. Annular dilatation and loss of sino-tubular junction in aneurysmatic aorta: implications on leaflet quality at the time of surgery. A finite element study. Interact Cardiovasc Thorac Surg, 2013, 17(1): 8-12.
11. 乔爱科, 潘友联, 董念国. 窦管交界和窦部直径对主动脉瓣关闭功能影响. 北京工业大学学报, 2014, 40(5): 776-780.
12. Nötzold A, Scharfschwerdt M, Thiede L, et al. In-vitro study on the relationship between progressive sinotubular junction dilatation and aortic regurgitation for several stentless aortic valve substitutes. Eur J Cardiothorac Surg, 2005, 27(1): 90-93.
13. 汤京龙, 王硕, 刘丽, 等. 一种新型介入瓣膜脉动流性能的初步研究. 生物医学工程学杂志, 2013(1): 166-169.
14. Vismara R, Leopaldi A, Piola M, et al. In vitro assessment of mitral valve function in cyclically pressurized porcine hearts. Med Eng Phys, 2016, 38(4): 346-353.
15. 褚银平, 程金莲, 刘爱军, 等. 脉动流下机械心脏瓣膜瓣阀开启状态的评价. 中国组织工程研究, 2012(40): 7480-7485.
16. Maselli D, De Paulis R, Scaffa R A, et al. Sinotubular junction size affects aortic root geometry and aortic valve function in the aortic valve reimplantation procedure: An in vitro study using the Valsalva graft. Ann Thorac Surg, 2007, 84(4): 1214-1218.
17. 周丰, 崔园园, 武亮亮, 等. 新型人工曲面机械双叶瓣体外脉动流实验. 功能材料, 2014(20): 20090-20094.
18. 陈雪娟, 林秀金. 人造心脏瓣膜的血流动力学特点. 中国组织工程研究与临床康复, 2009, 13(9): 1695-1698.
19. 张明柱, 李向欣, 李春亮. 不同类型人工心脏瓣膜质量及安全性的评价. 中国组织工程研究与临床康复, 2009, 13(21): 4149-4152.
20. 徐驰, 曹燕飞, 陈炜生, 等. 免缝合异种主动脉生物瓣膜的实验研究. 实用医学杂志, 2011, 27(3): 396-399.

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