Copyright © 1990 by the European Society of Cardiology.
© 1990 The European Society of Cardiology
Normal and stenotic human aortic valve opening: in vitro assessment of orifice area changes with flow
*Departments of Cardiology, Guy's Hospital London, U.K.
Clinical Physics, Guy's Hospital London, U.K.
Cardiothoracic Surgery, Guy's Hospital London, U.K.
Received 13 February 1989; revised 6 September 1989; .
Address for correspondence: Dr Eric Rosenthal, Cardiac Department, Guy's Hospital, St Thomas Street, London, SE 1 9RT, U.K.
Address fo reprints: Dr Joseph K. Montarello, Cardiovascular Investigational Unit, Royal Adelaide Hospital, North Terrace, Adeliade, 5000, South Australia
Abstract
The ability to measure aortic valve area clinically has emphasized the need to understand the changes in aortic valve orifice area during flow. To compare the performance of normal and stenotic human aortic valves we used a pulsatile flow model that simulated in vivo flow conditions. Five normal autopsy specimens and 15 stenotic valves removed at operation were mounted into the model. Valve function was assessed by analysis of video recordings of valve leaflet motion during flow. Over the flow rates tested normal valves demonstrated a linear increase in orifice area. There was no resistance to leaflet opening and valve closure was rapid. The majority of stenotic valves demonstrated an increase in orifice area at low flow rates. No valve showed any increase in maximal area beyond flow rates of 31 min–1. Increased leaflet resistance of these abnormal valves resulted in notably slower opening and closing rates. In patients with a high cardiac output and severe stenosis, overesti-mation of the anatomic orifice area derived by the Gorlin equation can result. This is not related to variability in maximal orifice area.
Key Words: Pulsatile • aortic stenosis • flow model • aortic valve area
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