Comparison of biomechanical and structural properties between human aortic and pulmonary valve.
OBJECTIVE
Pulmonary valve autografts have been reported as clinically effective for replacement of diseased aortic valve (Ross procedure). Published data about pulmonary valve mechanical and structural suitability as a long-term substitute for aortic valve are limited. The aim of this study was to compare aortic and pulmonary valve properties.


METHODS
Experimental studies of biomechanical properties and structure of aortic and pulmonary valves were carried out on pathologically unchanged human heart valves, collected from 11 cadaveric hearts. Biomechanical properties of 84 specimens (all valve elements: cusps, fibrous ring, commissures, sinotubular junction, sinuses) were investigated using uniaxial tensile tests. Ultrastructure was studied using transmission and scanning electron microscopy.


RESULTS
Ultimate stress in circumferential direction for pulmonary valve cusps is higher than for aortic valve (2.78+/-1.05 and 1.74+/-0.29 MPa, respectively). Ultimate stress in radial direction for pulmonary and aortic cusps is practically the same (0.29+/-0.06 and 0.32+/-0.04 MPa, respectively). In ultrastructural study, different layout and density in each construction element are determined. The aortic and pulmonary valves have common ultrastructural properties.


CONCLUSIONS
Mechanical differences between aortic and pulmonary valve are minimal. Ultrastructural studies show that the aortic and pulmonary valves have similar structural elements and architecture. This investigation suggests that the pulmonary valve can be considered mechanically and structurally suitable for use as an aortic valve replacement.
Stradins
Peteris
P
Pauls Stradins Clinical University Hospital, Center of Cardiac Surgery, 13 Pilsonu Street, LV-1002 Riga, Latvia. stradins@tl.lv
Lacis
Romans
R
Ozolanta
Iveta
I
Purina
Biruta
B
Ose
Velta
V
Feldmane
Laila
L
Kasyanov
Vladimir
V
D000328:Adult; D001021:Aortic Valve / Q000033:anatomy & histology* / Q000502:physiology / Q000648:ultrastructure; D004548:Elasticity; D006801:Humans; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D011664:Pulmonary Valve / Q000033:anatomy & histology* / Q000502:physiology / Q000648:ultrastructure; D013314:Stress, Mechanical