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Eur J Cardiothorac Surg 2004;26:634-639
© 2004 Elsevier Science NL
a Pauls Stradins Clinical University Hospital, Center of Cardiac Surgery, 13 Pilsonu Street, LV-1002 Riga, Latvia
b Riga Stradins University, Riga, Latvia
Received 10 October 2003; received in revised form 21 May 2004; accepted 25 May 2004.
* Corresponding author. Address: Pauls Stradins Clinical University Hospital, Center of Cardiac Surgery, 13 Pilsonu Street, LV-1002 Riga, Latvia. Tel.: +371-945-7817; fax: +371-7069-546
e-mail: stradins{at}tl.lv
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.
Key Words: Aortic valve • Pulmonary valve • Biomechanical properties • Structural properties • Ross procedure
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