Effect of aortic valve replacement on coronary flow velocity during metabolic stress in a patient with aortic stenosis

Takeuchi, Masaaki; Nakashima, Yasuhide

doi:10.1002/(sici)1097-0304(199703)40:3<287::aid-ccd16>3.0.co;2-m

Cited by 3 publications

(1 citation statement)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several clinical studies have demonstrated dramatic changes in coronary blood flow in patients with aortic stenosis, as well as in those with aortic regurgitation, which normalize to a certain extent after aortic valve replacement 21,22 but remain pathologic under stress conditions. 23 It was demonstrated that aortic valve replacement, including extracorporeal circulation and administration of cardioplegic solution, immediately leads to increased coronary flow, which persists for at least 20 hours postoperatively. 17,24 This can be explained by a lower coronary artery resistance after extracorporeal circulation, which depends on the type of cardioplegic solution.…”

Section: Discussionmentioning

confidence: 99%

Effect of mechanical aortic valve orientation on coronary artery flow: Comparison of tilting disc versus bileaflet prostheses in pigs

Kleine

Scherer

Abdel-Rahman

et al. 2002

The Journal of Thoracic and Cardiovascular Surgery

View full text Add to dashboard Cite

Coronary blood flow was significantly influenced by mechanical aortic valve implantation and the orientation of prostheses. For both valve designs, the previously defined optimum orientation with respect to pressure gradients and turbulence demonstrated the highest left anterior descending flow rates. Even in its optimum orientation, the St Jude Medical valve showed significantly lower coronary flow than the other valves.

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of mechanical aortic valve orientation on coronary artery flow: Comparison of tilting disc versus bileaflet prostheses in pigs

Kleine

Scherer

Abdel-Rahman

et al. 2002

The Journal of Thoracic and Cardiovascular Surgery

View full text Add to dashboard Cite

show abstract

Impact of aortic valve stenosis on left coronary artery flow: An in vitro study

et al. 2009

View full text Add to dashboard Cite

In Vitro Investigation of the Impact of Aortic Valve Stenosis Severity on Left Coronary Artery Flow

Gaillard

Garcia

Kadem

et al. 2010

Journal of Biomechanical Engineering

View full text Add to dashboard Cite

Patients with aortic valve stenosis (AS) may experience angina pectoris even if they have angiographically normal coronary arteries. Angina is associated with a marked increase in the risk of sudden death in AS patients. Only a few in vitro models describing the interaction between the left ventricular and aortic pressures, and the coronary circulation have been reported. These models were designed for specific research studies and they need to be improved or modified when other specific studies are required. Consequently, we have developed an in vitro model that is able to mimic the coronary circulation in presence of aortic stenosis. First, we have validated the model under physiological conditions. Then, we have examined and quantified the hemodynamic effects of different degrees of AS (from normal to severe AS) on the coronary flow using a model of the normal left coronary artery. In the coronary in vitro model without AS (normal valve), the amplitude and shape of coronary flow were similar to those observed in in vivo measurements obtained under physiological conditions, as described by Hozumi et al. (1998, "Noninvasive Assessment of Significant Left Anterior Descending Coronary Artery Stenosis by Coronary Flow Velocity Reserve With Transthoracic Color Doppler Echocardiography," Circulation, 97, pp. 1557-1562). The presence of an AS induced an increase in the maximum and mean coronary flow rates (97% and 73%, respectively, for a very severe AS). Furthermore, when AS was very severe, a retrograde flow occurred during systole. This study allowed us to validate our coronary in vitro model under physiological conditions, both in the absence and presence of AS. These changes could explain the fact that even if patients have angiographically normal epicardial coronary arteries, we can observe the occurrence of angina pectoris in these patients in the presence of an AS.

show abstract

Effect of aortic valve replacement on coronary flow velocity during metabolic stress in a patient with aortic stenosis

Cited by 3 publications

References 13 publications

Effect of mechanical aortic valve orientation on coronary artery flow: Comparison of tilting disc versus bileaflet prostheses in pigs

Effect of mechanical aortic valve orientation on coronary artery flow: Comparison of tilting disc versus bileaflet prostheses in pigs

Impact of aortic valve stenosis on left coronary artery flow: An in vitro study

In Vitro Investigation of the Impact of Aortic Valve Stenosis Severity on Left Coronary Artery Flow

Contact Info

Product

Resources

About