A method for the measurement of left ventricular overload for combined aortic valve pathology.

Background And Aim Of The Study: Patients with combined aortic valve pathology (stenosis and insufficiency) are often evaluated as if they had only a single pathology, because a means of evaluating the detrimental effects of combined insufficiency and stenosis does not yet exist. The study aim was to test the performance of a new hemodynamic index based on mechanical energy loss to measure the effects of combined valve disease on ventricular workload.

Methods: An intact and subsequently perforated and sutured aortic bioprosthesis was tested in an in vitro model of the left heart, varying cardiac output, average diastolic aortic pressure, and the type and combination of valve lesion.

A method for the measurement of left ventricular overload for aortic valve insufficiency.

Background: The degree of left ventricular overload in patients with aortic valve insufficiency (AI) plays an important role in determining the need and timing of surgical intervention. Because hemodynamic evaluation of AI may potentially predict the effects of an insufficient valve on the ventricle before they occur, it would be useful to guide valve surgery with such a diagnostic tool. The purpose of this study was to test the performance of a new hemodynamic index based on mechanical energy loss for the measurement of the effects of insufficiency on ventricular workload.

Aortic root dilatation may alter the dimensions of the valve leaflets.

Objective: Valve-sparing surgery can be used in patients with dilated aortic roots and aortic insufficiency (AI) but has not become a common practice, in part because the spared valve may be incompetent. Our goal was to study how the dimensions of the aortic root and leaflets have changed in such patients.

Methods: Fourteen patients with dilated aortic root and AI were examined by transesophageal echocardiography.

Does post-stenotic dilatation enhance collateral flow?

Our goal was to investigate whether post-stenotic dilatation (PSD) enhances collateral blood flow. In vitro experiments and computer modeling analysis were used to study the flow through stenotic segments and through collateral channels in the presence and absence of PSD. Pulsatile blood flow was provided by a left heart simulator primed with glycerol or normal saline.