title: A novel rigid annuloplasty ring for aortic valve reconstruction: an in vitro investigation.
abstract: BACKGROUND
  Remodeling of the dilated valve annulus with a prosthetic ring for repair of valve insufficiency is a well-established concept in mitral and tricuspid valve surgery and may also be suitable for aortic valve reconstruction. A novel rigid aortic annuloplasty ring was tested in vitro.
  
  
  METHODS
  Ten fresh porcine aortic roots were investigated in a pulsatile flow simulator before surgery (group N), after patch dilatation of the annulus (group D), and after reconstruction using a rigid annuloplasty ring (group R). The ring was designed to (1) prevent contact with the leaflets, reducing the risk of contact injury, (2) be applicable to all valve phenotypes, (3) prevent injury to the conduction bundle, and (4) be implantable from inside the aortic root (subvalvular). For each group pressure gradient, leakage volume, and coaptation height were measured.
  
  
  RESULTS
  With the annuloplasty ring, regurgitation volume decreased from -8.50 ± 1.91 mL (group D) to -4.75 ± 1.66 mL (group R; p < 0.0003), not different from group N. Coaptation height of the leaflets increased from 0.62 ± 0.08 mm (group D) to 0.77 ± 0.11 mm (group R; p < 0.005), similar to group N. Mean pressure gradient increased from 2.98 ± 0.38 mm Hg (group D) to 3.72 ± 0.40 mm Hg (group R; p < 0.0001).
  
  
  CONCLUSIONS
  This novel aortic annuloplasty ring has the potential for supporting aortic valve reconstruction by remodeling the subvalvular area.
authors.affiliation: Department of Cardiac and Thoracic Vascular Surgery, University of Luebeck, Luebeck, Germany. Electronic address: drichardt@gmx.net.
authors.forename: Doreen
authors.initials: D
authors.lastname: Richardt
authors.affiliation: Department of Cardiac and Thoracic Vascular Surgery, University of Luebeck, Luebeck, Germany.
authors.forename: Bence
authors.initials: B
authors.lastname: Bucsky
authors.affiliation: Department of Cardiac and Thoracic Vascular Surgery, University of Luebeck, Luebeck, Germany.
authors.forename: Efstratios I
authors.initials: EI
authors.lastname: Charitos
authors.affiliation: Department of Cardiac and Thoracic Vascular Surgery, University of Luebeck, Luebeck, Germany.
authors.forename: Hans-Hinrich
authors.initials: HH
authors.lastname: Sievers
authors.affiliation: Department of Cardiac and Thoracic Vascular Surgery, University of Luebeck, Luebeck, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Scharfschwerdt
mesh_terms: D000818:Animals; D001021:Aortic Valve / Q000601:surgery*; D058385:Cardiac Valve Annuloplasty / Q000295:instrumentation*; D066298:In Vitro Techniques; D011474:Prosthesis Design; D013552:Swine