초록접수 현황
| 16F-112 | 구연 발표 |
An In-Vitro Study for Comparison of Artificial Heart Valve Prostheses by Using Hemodynamic Energy
Jong Tae Lee¹, Duck Hee Lee¹,³, Jae-Seung Jung¹,², Chi Bum Ahn⁴, Yeon Soo Shin¹, Ho Sung Son¹,², Kyung Sun¹,²
¹Department of Korea Artificial Organ Center, Korea University College of Medicine, Seoul, Korea, ²Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea, ³Department of Biomedical Engineering R&D Center, Asan Institute for Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea, ⁴Department of Molecular Medicine, Gachon University College of Medicine, Incheon, Korea
Background : Hemodynamic energy(HE), comprised of kinetic energy(KE) and pressure energy(PE). We hypothesized that artificial heart valve prostheses with the same orifice size may generate different HE due to the differences in valve opening mechanism, materials, and so on. The goal of this study was to compare HE differences between mechanical (MEC) and tissue(BIO) heart valve by using the mock system.
Methods : Two artificial heart valve prostheses were compared – MEC (BiCarbon 21mm, Sorin Group, Milano) and BIO (Edwards3000 Perimount Magna 21mm, Edwards Lifesciences, Irvine). Pulsatile flow was generated by Korean external ventricular assist device (KH-VAD, KAOC, Seoul), and the mock system was primed with 40/60 glycerin/water solution.
Real-time flow rates and pressures were recorded at 50, 60, 70, 80, and 90 beats per minute (BPM) for five minutes. HE markers were surplus hemodynamic energy(SHE) and energy equivalent pressure(EEP).
Results : Despite both valves showing no significant differences in proximal(p) MAP, BIO showed significantly higher on the distal(d) MAP (64.85mmHg versus 63.99mmHg, p=0.0478). BIO showed higher pEEP than MEC in 50, 60, 70, and 90BPM and also showed higher dEEP in all pulse rate settings when adjusted for pump rate (pEEP 159.81mmHg versus 153.83mmHg, p<0.0001, dEEP 127.47mmHg versus 126.33mmHg, p<0.0001). BIO showed higher pSHE in 50, 60, 70, and 90BPM as well as higher dEEP than MEC in all pulse rate settings. BIO showed higher d%EEP across all pulse rate settings. Neither BIO nor MEC had %EEP higher than 10 % for the 50 and 60BPM settings
Conclusion : BIO showed higher proximal and distal MAP, EEP, SHE and %EEP except proximal MAP. The loss of energy also low in BIO that it better preserves the hemodynamic energy generated by the heart. Higher preservation of HE can be interpreted as higher preservation of pulsatility. Thus, BIO may preserve pulsatility and more benefits of pulsatile perfusion than MEC
Methods : Two artificial heart valve prostheses were compared – MEC (BiCarbon 21mm, Sorin Group, Milano) and BIO (Edwards3000 Perimount Magna 21mm, Edwards Lifesciences, Irvine). Pulsatile flow was generated by Korean external ventricular assist device (KH-VAD, KAOC, Seoul), and the mock system was primed with 40/60 glycerin/water solution.
Real-time flow rates and pressures were recorded at 50, 60, 70, 80, and 90 beats per minute (BPM) for five minutes. HE markers were surplus hemodynamic energy(SHE) and energy equivalent pressure(EEP).
Results : Despite both valves showing no significant differences in proximal(p) MAP, BIO showed significantly higher on the distal(d) MAP (64.85mmHg versus 63.99mmHg, p=0.0478). BIO showed higher pEEP than MEC in 50, 60, 70, and 90BPM and also showed higher dEEP in all pulse rate settings when adjusted for pump rate (pEEP 159.81mmHg versus 153.83mmHg, p<0.0001, dEEP 127.47mmHg versus 126.33mmHg, p<0.0001). BIO showed higher pSHE in 50, 60, 70, and 90BPM as well as higher dEEP than MEC in all pulse rate settings. BIO showed higher d%EEP across all pulse rate settings. Neither BIO nor MEC had %EEP higher than 10 % for the 50 and 60BPM settings
Conclusion : BIO showed higher proximal and distal MAP, EEP, SHE and %EEP except proximal MAP. The loss of energy also low in BIO that it better preserves the hemodynamic energy generated by the heart. Higher preservation of HE can be interpreted as higher preservation of pulsatility. Thus, BIO may preserve pulsatility and more benefits of pulsatile perfusion than MEC
책임저자: Jae-Seung Jung
Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
발표자: Jae-Seung Jung, E-mail : heartistcs@korea.ac.kr