瓣膜选择标准.pptVIP

Valve Selection and Performance Criteria Marc Sportsman September 2003 Valve Selection and Performance Criteria Thrombogenesis Hemodynamics Durability Implantability Quality of Life Thrombogenesis Thrombogenesis Thrombogenesis Thrombogenesis Dr. Arno Krian: Four Years Results of a Prospective Randomized Study Comparing the ATS and ST. Jude Medical Bileaflet Valves, World Symposium on Heart Valve Disease, 1999, London Thrombogenesis “Echo Doppler evaluation: The SJM valve shows three distinct jets, one at each pivot site and one in the center of the valve. These leakage jets are holo-systolic and are responsible for red cell damage and hemolysis in the SJM valve. These jets are not evident on the ATS valve.” “LDH levels: 350 international units is the upper normal limit at our laboratory:” The upper normal limit was not exceeded by any ATS valves. The upper normal limit was exceeded in nearly all SJM valves. Thrombogenesis Thrombogenesis Thrombogenesis Hemodynamics Hemodynamics Orifice to Annulus Ratio The ratio of Flow Orifice (GOA) to Valve Mounting Area (TAD) is the primary determinant of forward flow hemodynamics. The ideal O:A ratio would be 1.00 The AP Series design improves flow area by three valve sizes versus standard aortic design Effective Orifice Area (sq. cm)In-Vivo Data by Valve Size RegurgitationEchocardiographic Data for all Valve Sizes Predictors of Performance Prosthetic heart valve hydrodynamic performance is primarily determined by three design characteristics: The Ratio of Flow Orifice to Tissue Annulus Area Occluder Opening Angle, Travel Arc and Mass Occluder Pivot Axis Design Together, these design characteristics determine performance in the following areas: Blood flow turbulence, shear stress, and stasis Pressure Gradient Effective Orifice Area Regurgitation Hemodynamics Hemodynamics Hemodynamics Hemodynamics Hemodynamics Durability Durability Accelerated Component on Component Wear Study DurabilityClinical Experience Durabilit