ISSN : 1301-5680
e-ISSN : 2149-8156
TURKISH JOURNAL OF
THORACIC AND
CARDIOVASCULAR SURGERY
Turkish Journal of Thoracic and Cardiovascular Surgery     
FLAP-VALVE METHOD: A NEW SURGICAL THERAPEUTIC APPROACH ON ISOLATED AORTIC VALVE INSUFFICIENCY (IN VITRO STUDY)
Mustafa ÜNAL, Cüneyt KONURALP, Mustafa İDİZ, İlyas KAYACIOĞLU, Mustafa YANGEL, Murat AKÇAR, * Kazım BEŞİRLİ
Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Merkezi, Kalp ve Damar Cerrahisi Kliniği, İSTANBUL
*İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Kalp ve Damar Cerrahisi Ana Bilim Dalı, İSTANBUL
Background: We tested a new surgical method that we performed using otogen material (it’s own wall) without replacement for isolated aortic valve insufficiency.

Methods: Eight adult sheep hearts were used for testing our technique`s reliability. After perferming of tests on these hearts with competent aortic valve (Group A), iatrogenic aortic valve insufficiency were created on the same hearts (Group B) and the tests were repeated. Then hearts with insufficient valves were repaired by flap-valve method (Group C) and the same tests were repeated.

Different stress conditions were simulated by applying three different hydrostatic pressures with order using centrifugal pump. The pressures were monitored in ventricular side of the aortic valve (P1), aortic lumen (P2) and the left coronary ostium (P3).
Condition 1: A pulsatile 140 mmHg pressure with 80 / min frequency was applied from the ventricular side of the valves.
Condition 2: A continuous 140 mmHg pressure was applied from the ventricular side of the valves.
Condition 3: A continuous hydrostatic pressure was applied as P2 = 180 mmHg, and P1 pressure was discontinued abruptly.

Results: From the pressure changes, it was understood that the aortic valve insufficiency was created in Group B. This insufficiency is improved in the group that treated by flap-valve method. While aortic valves opened 15 mmHg-gradient in Group A, this gradient increased to 30 mmHg in Group C. However, we assume that gradient is acceptable. Flap-valve did not interfere with coronary blood flow.

Conclusions: Flap-valve is found effective in vitro environment.

Keywords : Aortic insufficiency, flap-valve method, open heart surgery
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