Trileaflet Semilunar Valve Reconstruction: Acute Porcine in Vivo Evaluation

• Published in: World journal for pediatric & congenital heart surgery 2023-07, Vol.14 (4), p.509-515
• Main Authors: Hanse, Lisa Carlson, Tjørnild, Marcell Juan, Karunanithi, Zarmiga, Høgfeldt Jedrzejczyk, Johannes, Islamagič, Lejla, Hummelshøj, Nynne Emilie, Enevoldsen, Malene, Lugones, Germán, Høj Lauridsen, Mette, Hjortdal, Vibeke Elisabeth, Lugones, Ignacio
• Format: Article
• Language: English
• Subjects: Animals; Aortic Valve - surgery; Heart Defects, Congenital - surgery; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation - methods; Humans; Pulmonary Valve - diagnostic imaging; Pulmonary Valve - surgery; Swine
• ISSN: 2150-1351; 2150-136X
• DOI: 10.1177/21501351231166662

Objective: The surgical treatment of malformed semilunar valves in congenital heart defects is challenging in terms of providing both longevity and the potential to grow with the recipient. We investigated a new surgical technique “Trileaflet Semilunar Valve Reconstruction” in an acute porcine model, a technique with geometrical properties that could remain sufficient and allow for some growth with the child. Methods: An acute 60-kg porcine model was used. With echocardiography, baseline pulmonary valvular geometry and hemodynamics were investigated. On cardiopulmonary bypass, the pulmonary leaflets were explanted, and the Trileaflet Semilunar Valve Reconstruction was performed with customized homograft-treated pericardial neo-leaflets. Off bypass, hemodynamics was reassessed. Results: Twelve animals were investigated. The neo-valves were found sufficient in ten animals and with minimal regurgitation in two animals. The neo-valve had a peak gradient of 3 ± 2 mm Hg with a peak velocity of 0.8 ± 0.2 m/s. The coaptation in the neo-valve had a mean increase of 4 ± 3 mm, P