title: Aortic interleaflet triangles reshaping: hydrodynamic, kinematic and morphological effects in in-vitro analysis.
abstract: OBJECTIVE
  Subcommissural triangles reshaping is a reparative technique used to remodel the ventriculo-aortic junction. The study aim was to evaluate, by means of in-vitro testing, the effects of this technique on hemodynamics, leaflet kinematics and aortic root functional unit morphology.
  
  
  METHODS
  Twenty-one porcine aortic roots were tested in a pulsatile mock loop under basal conditions and after subcommissural triangles reshaping performed at 50% of the interleaflet triangles height. During each test, hydrodynamic quantities, high-speed digital videos and echocardiographic images were recorded.
  
  
  RESULTS
  The comparison between pre- and post-surgery data showed a statistically significant increase in coaptation height (p < 0.01) and length (p < 0.01). Significant reductions were found in the virtual basal ring diameter (p < 0.01), sinus of Valsalva diameters (p < 0.01), maximum leaflet opening (p < 0.01), leaflet opening before rapid valve closing time (p < 0.01) and maximum opening area (p < 0.01). An opened valve time reduction (p <0.01) was observed due to an opening time reduction (p < 0.01), offset by a closed valve time increase (p < 0.01). A slow closing period increase (p < 0.07) and a rapid closing phase reduction (p < 0.01), were also highlighted without influence on the total closing time. A statistical, but not clinically significant, increase in pressure drop across the valve (p < 0.01) and an effective orifice area reduction (p < 0.01) were observed.
  
  
  CONCLUSIONS
  Subcommissural triangles reshaping performed at 50% of the interleaflet triangles' height determines an increase in leaflet coaptation by remodeling the ventriculo-aortic junction. Some hydrodynamic and kinematic changes also occur, without any acute clinically threatening alterations.
authors: Claudia
authors: C
authors: Romagnoni
authors: Andrea
authors: A
authors: Mangini
authors: Riccardo
authors: R
authors: Vismara
authors: Alberto Maria
authors: AM
authors: Leopaldi
authors: Monica
authors: M
authors: Contino
authors: Massimo Giovanni
authors: MG
authors: Lemma
authors: Gianfranco Beniamino
authors: GB
authors: Fiore
authors: Carlo
authors: C
authors: Antona
mesh_terms: D000818:Animals; D001021:Aortic Valve / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D001696:Biomechanical Phenomena; D058385:Cardiac Valve Annuloplasty / Q000379:methods*; D006439:Hemodynamics; D057446:Hydrodynamics; D066298:In Vitro Techniques; D013552:Swine