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In-vitro hemodynamic assessment of newly developed stentless mitral valve (NORMO valve)
Susumu Manabe1, Hitoshi Kasegawa2, Moon Sojung3, Takahiro Okada3, Tetsuya Doi3, Kiyotaka Iwasaki3, Tetsuo Fujimoto3, Mitsuo Umezu3, Hirokuni Arai1.
1Department of Cardiovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan, 2Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan, 3Advanced Research Institute for Science and Engineering Waseda University, Tokyo, Japan.

OBJECTIVE:
We have developed a new stentless mitral valve (NORMO valve) made with a pericardium and a flexible artificial ring. The valve can be made by hand-sewing at the time of surgery. The purpose of this study is to compare the hemodynamic performance between NORMO valve and bioprosthesis.
METHODS:
The hemodynamic performance of NORMO valve was analyzed using a pulsatile in-vitro mitral valve simulator. The simulator is driven by LVAD. We measured the transvalvular flow volume and regurgitant volume at each heartbeat. NORMO valve (n=8) was compared with commercially available bioprosthetic valve (MOSAIC, Medtronic, Inc, Minneapolis, Minn) (n=8).
RESULTS:
The similator was preset at 70 beats / minute under systolic fraction of 35%. The aortic pressure and the atrial pressure were adjusted to 100 (120/80) mmHg and 10mmHg, respectively. There was no difference in cardiac output between the two groups (NORMO: 4.7 ± 0.4L/min, vs. bioprosthesis: 4.5 ± 0.3 L/min, p=0.28). The forward flow volume per beat was similar between the two groups (NORMO: 72.5 ± 6.8 mL/beat, vs. bioprosthesis: 68.7 ± 3.9 mL/beat, p=0.19), but the regurgitant volume was lower in NORMO valve than that in bioprosthesis (NORMO: 8.7 ± 1.6 mL/beat, vs. bioprosthesis: 13.1 ± 3.3 mL/beat, p<0.01).
CONCLUSIONS:
NORMO valve possesses an equivalent flow capacity with less regurgitation, compared with bioprosthetic valve of the same size. The results of this study suggested that NORMO valve can be an alternative to the bioprosthetic valve in short-term.


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