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PubMed2003

[Hemodynamics and microcirculation in a rat poisoned by scorpion venom]].

The clinic table of serious scorpionic envenimation is dominated by cardiovascular and pulmonary perturbations. The physiopathology of cardiac failure in man as well as at animal is again badly elucidated. The aim of our study has consisted in evaluating the hemodynamic variations of the Rat poisoned by the venom of the Buthus occitanus scorpion and to contribute through the analyse of plasmatic concentrations of catecholamines and by an histomorphometric study of muscular microcirculation to explain the mechanism of the hemodynamic perturbations and cardiac failure. 51 rats corresponding to 9 groups (witness and poisoned) have been used. The venom of the scorpion Buthus occitanus has been administrated at 850 micrograms/kg. Two groups have been served for hemodynamic study, three groups for the dosage of catecholamines and four groups for histomorphometric study. It has been observed a biphasic variation of arterial pressure and cardiac frequency after venom injection. Four minutes after envenimation, the plasmatic level of catecholamines was strongly higher in the poisoned according to the witness one. Histomorphometric study of muscular skeletal microcirculation has shown a decrease of relative vascular volume contemporary with the increase of plasmatic catecholamines concentration and the peak of arteriel pressure appeared just after envenimation. 10 and 20 minutes after envenimation, the relative vascular volume has significantly increased as well as that interstitium according to witness lot. These hemodynamic perturbations can be attributed to the important dump in catecholamines. This hyperadrenergy was contemporary with decrease of relative muscular vascular volume. This decrease would be explained by a constriction of vessels. On the other hand, the second increase of the vascular relative volume suggests the possibility of development of venous stasis at the muscular microcirculation. It would be induced by a cardiac failure and/or the effect of vasoplegic mediators being able to entail an interstitial oedema in the muscular skeletal that would led to increase the relative interstitial volume observed in this study.

Animals↗
PubMed2002

Comparative analysis of the gasometric and hemodynamic parameters in preoperative evaluation of patients with lung cancer.

Measurements including spirographic examination, arterial blood gas tensions, standard electrocardiogram are routinely used to define risk factors for patients undergoing lung tissue resection. In some instances routine functional check-ups should be accompanied by the assessment of the hemodynamics of pulmonary circulation. The purpose of the study was to evaluate the correlations between gasometric and hemodynamic parameters measured at rest and after exercise. In case of the presence of such correlations I wanted to find the principles to provide pulmonary artery hypertension in order to avoid right heart catheterization. The gasometric parameters in systemic and in mixed venous blood (pH, PaO2, PaCO2, SaO2) as well as hemodynamic parameters of pulmonary circulation (PAP, PCWP, CVP) were measured in 50 male patients with lung carcinoma. All measurements were taken at rest and after an exercise test--5 minutes, 50 W workload on cycle ergometer in supine position. CI, PVR and SVR were calculated. The study proved statistically significant correlations between gasometric and hemodynamic parameters and made possible to calculate the regression lines equations, which help to predict pulmonary artery pressure before tissue resection.

Adult↗
PubMed1992

[Glaucomatous hemodynamic changes in central retinal artery and ocular artery].

The hemodynamics of ocular artery (OA) and central retinal artery (CRA) in 100 eyes of 50 normal subjects and 61 eyes of 39 patients with glaucoma were studied with colour doppler image technique. The results showed the hemodynamic characteristics about normal and glaucomatous eyes and that the ischemic change of CRA was one of the high risk factors in glaucomatous visual functional damages. We propose a new classification of glaucomatous hemodynamics and the clinical application of hemodynamic parameters in glaucoma diagnosis. We also, for the first time, make use of hydrodynamic pressure to calculate the retinal perfusion pressure, which explain the phenomena of intraocular pressure increasing with blood flow decreasing and the effect of hyperviscosity as well as cardiovascular disease on glaucoma. A new approach to the research of glaucoma is presented.

Adolescent↗
PubMed1992

Plasma norepinephrine is a major determinant of hemodynamic alterations with sodium loading.

OBJECTIVE: To assess hemodynamic responses to 3 weeks of sodium loading and to evaluate factors which contribute to hemodynamic alterations. DESIGN: Analysis of patients' central hemodynamic and laboratory variables before and after sodium loading. SETTING: A referral centre. PATIENTS: Thirty-one elderly hypertensives. INTERVENTIONS: Doppler flowmetry and laboratory examinations were performed during different sodium intake; 120 mmol/day for 8 weeks and 344 mmol/day for 3 weeks. RESULTS: Patients were divided into three groups; those in whom sodium loading increased total peripheral resistance (SST); those in whom salt repletion increased cardiac index (SCC); a non-salt-sensitive group (NSS). The overwhelming reaction to salt loading is that, with time, the NSS and SSC groups became part of the SST group. When the SSC patients became SST with sodium loading, serum sodium and plasma arginine vasopressin decreased and haematocrit increased, suggesting that the excretion of sodium and water accompanied with a decrease in circulating plasma volume may be responsible for the hemodynamic alteration from SSC to SST. In those who remained in the SSC group throughout the 3 weeks of salt repletion, plasma norepinephrine decreased on all of days 7, 14 and 21 of the high-sodium diet compared with the regular-sodium regimen, whilst in patients in the SST group on day 21 of the high-sodium diet plasma norepinephrine remained unchanged throughout the 3 weeks of salt loading. CONCLUSIONS: We confirmed a changing pattern of initially high cardiac index giving way to a persistently elevated total peripheral resistance with sodium loading. Plasma norepinephrine proved to be the best predictor of which subjects were or became SST.

Aged↗
PubMed1992

[Diagnosis of disorders of rheological properties of blood and central and cerebral hemodynamics in infants with complicated pneumonia].

A study was made of the rheological blood properties, microcirculation, central and cerebral hemodynamics in children of the first year of life with complicated pneumonia. On admission to the department of intensive care and resuscitation the patients demonstrated pronounced hemorheological and hemodynamic disorders which might in many respects determine the disease gravity. Based on an analysis of the clinical observations and hemodynamic findings 3 periods of complicated pneumonia were distinguished in such children: the critical period, stabilization and repair. Each period is characterized by different compensatory adaptive and non-adaptive erythrocytic and hemodynamic reactions.

Acute Disease↗
PubMedDate not supplied

[Evaluation of hemodynamic parameters by transcranial Doppler in patients with leukoaraiosis].

INTRODUCTION: Leukoaraiosis is commonly found in neuroimaging in ancient people. The pathogenic theory that most suitably explains its origin is the vascular one, mainly linked to cerebral hemodynamic abnormalities. The techniques most frequently used in cerebral hemodynamic evaluation (PET and SPECT) are expensive and not widespread. Transcranial Doppler instead is cheaper and much more widespread. OBJECTIVE: Our aim has been to show whether transcranial Doppler is a useful tool for cerebral hemodynamic evaluation in leukoaraiosis. PATIENTS AND METHODS: We have prospectively included 116 patients aged 60-90 who came to the Neurology department with unspecific complaints such as dizziness or mild headache. Patients with recent history of stroke or moderate to severe cognitive impairment were excluded. RESULTS: Mean age was 74.4 +/- 6.3 years old. The prevalence of leukoaraiosis was 68.7%. Leukoaraiosis was significantly correlated with older age, lacunar infarctions, past history of stroke, cognitive impairment and to lower systolic and diastolic velocities in middle cerebral artery (MCA) and higher pulsatility index. Multivariate analysis only retained the lower diastolic velocity in MCA in the model. CONCLUSIONS: Transcranial Doppler can detect hemodynamic abnormalities in patients with leukoaraiosis and is therefore a very useful technique for the evaluation of this entity.

Aged↗
PubMed2003

[Hemodynamic basis for the development of varicose ulcers and their therapy].

The prevalence of leg ulcers is about 1%, approximately 75% of them are of venous origin. The precondition for the development of venous ulcers is ambulatory venous hypertension. It is assumed than a linear correlation exists between the severity of ambulatory venous hypertension and the incidence of venous ulcers. Venous ulcers caused by superficial vein reflux are called varicose ulcers and are more frequent than postthrombotic ones. Crossectomy removes the hemodynamic disorder responsible for the development of varicose ulcers and creates conditions for a quick and mostly definitive ulcer healing. In cases with simultaneous reflux in the saphenous and femoral veins the saphenous reflux is responsible for the severity of venous disorder, whereas femoral reflux is hemodynamically unimportant. Selective abolition of saphenous reflux restores normal hemodynamic conditions in such cases. Compressive therapy continues to be the most frequently used therapeutic procedure in the treatment of venous ulcers; it must be considered as a symptomatic measure, because it is not able to substantially affect the underlying venous disorder in spite of the fact that the correctly lying bandage positively influences venous hemodynamics. The diagnostic procedure in patients with leg ulcers should screen out cases with varicose ulcers; abolition of superficial vein reflux can deliver these patients from their annoying disease.

Hemodynamics↗
PubMedDate not supplied

Experimental conditions determine effects of ascorbic acid on reperfusion injury: comparison of tissue damage with hemodynamic parameters in rat isolated hearts.

Restoration of coronary blood flow after myocardial ischemia is always a matter of urgency, but the resulting surgical or drug-induced reperfusion of ischemic tissue is often associated with myocardial functional disturbances and tissue injury. The present study was carried out to select experimental conditions under which optimal effects of antioxidants can be observed on the adverse effects of reperfusion of ischemic myocardium. The release of lactate dehydrogenase (LDH) and changes in hemodynamic parameters were compared in two models of cardiac reperfusion injury in rat isolated hearts. LDH release from electrically-stimulated hearts perfused under constant flow and with initial (5 min) reperfusion in calcium-free buffer was greater than that from hearts perfused under constant pressure in which ischemia was induced by reduced flow. Combined SOD+catalase was a weak inhibitor of LDH release in both models, ascorbic acid being more potent under constant pressure than under constant flow conditions. A longer ischemic period enhanced the inhibitory effect of ascorbate. Contractility and ventricular end-diastolic pressure recovered slowly during perfusion under constant flow and brief calcium removal, but remained unphysiological under constant pressure. SOD+catalase had no effect on hemodynamic parameters. Ascorbic acid exacerbated ischemia+reperfusion-induced changes in contractility, ventricular pressure, heart rate and coronary flow under constant pressure, but facilitated recovery of contractility on reperfusion under constant flow and brief calcium removal. In studies on antioxidants, different experimental conditions appear to be necessary to observe beneficial effects on tissue damage on the one hand and on hemodynamics on the other. Mild to moderate ischemia, with sustained pacemaker activity, appears to be the condition under which antioxidants provide hemodynamic improvement. In isolated rat hearts, biochemical parameters of tissue damage may be misleading for the effects of antioxidants.

Animals↗
PubMed2003

Improving hemodynamics by atrial pacing during off-pump bypass surgery.

BACKGROUND: To avoid hemodynamic deterioration during tilting of the heart in off-pump surgery, we perform atrial pacing. We describe hemodynamic evaluation of this simple maneuver. METHODS: Eleven consecutive patients (8 men, 3 women; age, 68.14 +/- 10.3 years; left ventricular ejection fraction, 51.17% +/- 18.6%) admitted for coronary artery bypass grafting were equipped with a PiCCO catheter (Pulsion Medical Systems, Munich, Germany) for monitoring of cardiac output (CO), cardiac index (CI), stroke volume (SV), heart rate (HR), and systemic vascular resistance. In addition, mean and systolic arterial pressure (RRm, RRs) as well as left atrial pressure (LAP) were monitored. During the procedure, temporary pacemaker wires were installed, and hemodynamic monitoring was performed before and after atrial pacing. All procedures were performed with the same standardized offpump technique. RESULTS: All patients survived the procedure without inotropic support. In all cases a branch of the circumflex artery was grafted. The number of grafts per patient was 2.7. There was a statistically significant increase in RRs (11.12 mm Hg), RRm (9.72 mm Hg), HR (31.6 beats/min), CO (1.09 L/min), and CI (0.61 L/min per m2) (P <.005). SV decreased statistically significantly (11.8 mL, P <.005) as did LAP (6 mm Hg, P < .05). CONCLUSIONS: Atrial pacing increases intraoperative RRs, RRm, CO, and CI and decreases SV and LAP significantly, thus offering stable hemodynamics during off-pump surgery. In the last 400 consecutive off-pump coronary artery bypass grafting procedures, there was only 1 (0.25%) conversion to cardiopulmonary bypass.

Aged↗
PubMed1978

[Hemodynamics and cardiac electrical activity in ventricular myocardial hypertrophy].

Comparison of the electrocardiographic characteristics of hypertrophy of the ventricular myocardium with the hemodynamic indices of systemic and pulmonary circulation and the indices of intracardiac hemodynamics provides testimony to the significance of the hemodynamic factor in the genesis of the electrophysiological changes. With due account for the role of the morphologic factor, these data allow the essence of myocardial hypertrophy to be placed in the electrophysiologic, hemodynamic, and morphologic category.

Cardiomegaly↗
PubMedDate not supplied

[Monitoring and computer control of the status of the central and regional hemodynamics in patients with diffuse forms of peritonitis].

Changes in basic central and regional hemodynamic parameters have been studied in 46 patients with diffuse peritonitis using an automated system of constant intensive circulation monitoring. It has been established that the type of circulation did not reflect the severity of the condition in patients with peritonitis, but a characteristic combination of central hemodynamic parameters makes it possible to assess compensatory reserves within each circulation type, as well as to identify unfavourable hemodynamic tendencies. Analysis of changes in the circulation parameters in the course of peritonitis development is necessary to predict the course of the disease and its outcome. There was a considerable difference in circulation parameters patterns of patients who recovered and died of the disease. The principal differences manifested on day 2 postoperatively. Abdominal hemodynamic changes are specific and characterize the severity of peritonitis beginning from the first day of observation.

Adolescent↗
PubMed2003

[Venous dysfunction in patients with hypertension and different hemodynamic variants of disease].

AIM: To identify variants of venous dysfunction in patients with arterial hypertension (AH) in respect of the disease hemodynamic profile. MATERIAL AND METHODS: The assessment of central hemodynamics and peripheral venous circulation in the veins of the lower limbs was made in 60 patients with different hemodynamic variants of primary AH. RESULTS: Patients with ejection hypertension were characterized by high extensibility of the peripheral veins and low tolerance to orthostatic loads. In patients with hypertension of resistance venous dysfunction was characterized by signs of venous hypertension in rigidity of the venous wall as well as low and inadequate reactivity of peripheral large vessels. CONCLUSION: The results of the orthostatic test show different response of venous hemodynamics in patients with hypertension of ejection and resistance. This provides adequate activity of the heart in erect position.

Adult↗
PubMed2004

Preclinical hemodynamic assessment of a new trileaflet mechanical valve in the aortic position in a bovine model.

BACKGROUND AND AIM OF THE STUDY: The hemodynamic characteristics of a new trileaflet mechanical heart valve (TTV) (TriFlo Inc., Costa Mesa, CA, USA) in the aortic position were evaluated in a bovine model. The TTV was designed to combine the durability of mechanical heart valves with the central flow characteristics of a bioprosthesis. METHODS: Using nine calves, the native aortic valve was replaced with a 21-mm TTV (n = 6) or a St. Jude Medical (SJM) valve (n = 3). Hemodynamic values were assessed with echocardiography at implantation and with catheterization at explantation. All calves underwent a necropsy, followed by gross pathology and light microscopy studies. RESULTS: The mean implant duration was 159 +/- 55 days for the TTV and 102 +/- 67 days for the SJM valve. Immediately before euthanasia, the peak and mean pressure gradients were respectively 35 +/- 14 and 24 +/- 9 mmHg for the TTV, and 100 +/- 72 and 59 +/- 38 mmHg for the SJM valve (p = 0.03). Two of the SJM-valve animals were electively sacrificed after showing symptoms of aortic stenosis. At necropsy, all nine valves were free from thrombi, pannus, occlusive tissue, or mechanical impairment of leaflet motion. The prematurely sacrificed SJM-valve animals had concentric myocardial hypertrophy consistent with severe functional aortic stenosis. CONCLUSION: The significantly higher gradients and left ventricular hypertrophy in the SJM-valve animals were related to a smaller effective orifice area, which precluded adaptation to increasing transvalvular volumes in the growing animal. This problem was not seen with the TTV, which performed hemodynamically as well as the SJM valve. The high transvalvular gradients seen with the SJM valve at study end may suggest that the hemodynamic characteristics of the TTV may be superior, though additional studies are needed to confirm this.

Animals↗
PubMedDate not supplied

[Disorders of pulmonary hemodynamics in patients with diabetic nephroangiopathy and its correction with antioxidants].

Hemodynamic changes of lesser circulation were investigated in 108 patients with diabetic nephroangiopathy. They were also given vitamin E therapy (8 micrograms/kg of body mass) for 2 weeks to correct metabolic derangements and indices of pulmonary hemodynamics. Partial renal function was determined with 131I-hippuran and 99mTc-DTPA renoscintigraphy. Pulmonary hemodynamics was assessed with pulmonary scintigraphy (MAA 99mTc). The results have shown that vascular renal lesions in diabetes mellitus cause hypertension of lesser circulation and disorders in pulmonary microcirculation, and disorders of lipid metabolism and activation of lipid peroxidation (LPO) progress with augmentation of severity of disease. Vitamin E therapy improves pulmonary hemodynamics, lipid metabolism and LPO. Antioxidant correction was most effective at the initial stages of diabetic nephroangiopathy.

Antioxidants↗
PubMed2004

[Early-stage hemodynamic changes in dogs with gunshot wound in seawater].

OBJECTIVE: To investigate the hemodynamic changes in the early stages of gunshot wound of dogs in seawater for exploring early treatment protocol. METHOD: Fourteen conventional Beagles models undergoing gunshot wound in seawater were used along with another 2 dogs receiving the wound on land to serve as control. After the dogs were rescued from the seawater, the respiration (R), heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), central venous pressure (CVP), pulmonary arterial wedge pressure (PAWP), and cardiac output (CO) were measured continuously in the early stages of the wound (53.62+/-12.19 min following injury), followed by statistical analysis of the results. RESULTS: Compared with the control group, the hemodynamic disturbance of the dogs receiving the wound in seawater was relatively severe during the first 15 min of the wound. The mortality tended to descend relevant to the position of the wounds, in the order of the head, chest, abdomen and limbs. CONCLUSIONS: Gunshot wound in seawater may cause severe hemodynamic changes, resulting in progressive dysfunction of circulation and high mortality rate. Early treatment should be targeted at hemodynamic stabilization in accordance to the characteristic changes during the early stages of the wound.

Animals↗
PubMed1992

[Effects of R80122. The influence of a new phosphodiesterase inhibitor on global and intestinal hemodynamics in coronary surgery patients].

Phosphodiesterase III inhibitors have been established in recent years in the therapy of congestive heart failure. Many disadvantages, such as extensive vasodilation and the lack of proven positive inotropic properties combined with thrombepenia and elevation of transaminases, have complicated the handling of the drug in clinical practice. Enoximone, an imidazole derivative, has been demonstrated to be more cardioselective and vasodilation has been found to be less pronounced than with amrinone. As a consequence, research was performed to enhance the cardioselectivity of phosphodiesterase III inhibitors by reduction of non-specific cross-reactivity with other phosphodiesterases, and R80122 (Janssen Pharmaceutics, Belgium) was introduced into clinical practice. R80122 ((E)-Ncyclohexal-N-methyl-2[[[phenyl (1,2,3,5-tetrahydro-2 oxoimidazo [2,1b]-quinazolin-7-yl)methylene] amino] oxy] acetamide) is a selective inhibitor of phosphodiesterase (PDE) IIIc, which is localized in the myocardium. Thus, its inhibition leads to a positive inotropic effect, whereas phosphodiesterase IIIRo is found in the vessel wall and causes vasodilation. This study was performed to investigate the hemodynamic profile of R80122 under clinical conditions. Additionally, the intestinal hemodynamics were recorded and changes in intestinal perfusion compared with changes in global hemodynamics. METHODS. The study was thoroughly discussed and approved by the local ethics committee; all patients gave written informed consent. The investigation was performed on ten male patients who were about to undergo elective coronary artery bypass surgery. History, physical examination and laboratory results were within the normal limits and revealed no evidence of liver disease. The usual medication was continued until the day before the operation. Premedication consisted of 2 mg flunitrazepam p.o. in the evening before the operation and 1.5 h before induction of anaesthesia. The determination of hepatic plasma flow was performed by the indocyanine green (ICG) infusion extraction technique using liver vein catheterization. After induction of anaesthesia (MP1), after application of a bolus dose of R80122 (0.3 mg/kg BW) (MP2) and at sternotomy (MP3), hemodynamic data (heart rate, arterial pressure, cardiac output) were recorded and blood samples for the determination of hepatic plasma flow by the concentration of ICG were collected. Anaesthesia was induced with a bolus dose of 0.2 mg/kg BW etomidate, 7 micrograms/kgBW fentanyl and 0.1 mg/kgBW pancuronium and maintained with a continuous infusion of 20 micrograms/min fentanyl, 300 micrograms/min midazolam and mechanical ventilation with O2/N2O at an FiO2 of 0.5. Statistical analysis was performed using the Wilcoxon-Mann-Whitney U test comparing the results after induction of anesthesia (MPI) with those after application of R80122 (MPII) and the results of MPII with those at sternotomy (MPIII). Statistical significance was assumed at P less than 0.05. RESULTS. After the induction of anaesthesia, the median heart rate (HR) was 56/min and did not change after administration of R80122. During sternotomy there was a significant increase in the HR from 64 to 78/min (P less than 0.05). Median arterial blood pressure (MAP) tended to decreased from 91 mm Hg after induction of 77 mm Hg after administration of R80122, although there was no statistical significance because of interindividual differences in the tendencies. At sternotomy, MAP remained unchanged. Cardiac output (CO) increased by 60% after administration of R80122 (P less than 0.01) and did not change during sternotomy. As a consequence of the changes in HR and CO, stroke volume (SV) increased by 22% after administration of R80122 (P less than 0.025) and decreased to control values during sternotomy.

Adult↗
PubMed2004

Early graft hemodynamics in living related liver transplantation evaluated by Doppler ultrasonography.

The aim of this study was to clarify the perioperative hemodynamics of liver grafts without vascular complications during and early after liver transplantation from living donors. This study was carried out in 4 child recipients (lateral segment left lobe grafts) and 6 adult recipients (right lobe grafts) of liver transplantation from living donors. The hemodynamics of the hepatic artery, portal vein, and hepatic vein of the grafts during and until 7 days after surgery were studied by Doppler ultrasonography. The maximum flow velocity of the hepatic artery, mean portal blood flow velocity, and pulsatility index (PI) of the hepatic artery increased in all 10 grafts with no vascular complication after vascular anastomosis. After surgery, the mean portal blood flow velocity showed a peak 3 days after surgery and reached a nadir 7 days after surgery in both the lateral segment left lobe grafts in children and the right lobe grafts in adults, but it was significantly higher in the right lobe grafts in adults (mean +/- SD 31.0 +/- 6.3 vs. 22.4 +/- 0.9 cm/sec). Also, as the hepatic artery blood flow velocity increased the portal blood flow velocity decreased, the hepatic blood flow during liver regeneration was suggested to be controlled by both the artery and portal vein. The range of PI of the hepatic artery was 0.60-1.86. The mean hepatic venous blood flow was stable throughout the observation period (30.4 +/- 8.8 cm/sec). Although the hepatic venous flow waves changed widely from pulsed waves to a flat flow, its changes did not suggest a vascular complication. Evaluation of changes by Doppler ultrasonography in the hemodynamics of the liver grafts without vascular complications during and early after liver transplantation from living donors is considered to be useful for accurate monitoring of the hemodynamics during liver regeneration and early detection of abnormalities.

Adult↗
PubMed2004

Hemodynamic characterization of calcified stenotic human aortic valves before and after treatment with a novel aortic valve repair system.

BACKGROUND AND AIM OF THE STUDY: The repair of calcified stenotic aortic valves may be a viable alternative to current valve treatments for early-stage aortic valve disease. To date, evaluation of valve repair feasibility on the benchtop has not been performed. A pulsatile flow system for testing intact human aortic valves was developed to perform quantitative hemodynamic and mechanical assessment of a new aortic valve repair approach. METHODS: Intact calcified human aortic valves were divided into two groups with effective orifice area (EOA) > or =2.0 cm2 (group I, n = 6) or <2.0 cm2 (group II, n = 6). All valves were chemically debrided in stages for up to 60 min. A subset of valves in each group was also surgically debrided. At each stage, pre- and post-treatment hemodynamic assessment and video motion analysis were performed in the pulsatile flow system at multiple levels of physiological loading. Mineral removed was quantified using atomic absorption spectroscopy. RESULTS: Progressive removal of mineral with both mechanical and chemical debridement was associated with improved hemodynamic function of calcified human aortic valves. Improvements in EOA of up to 40% and decreases in transvalvular pressure gradient (deltaP) of up to 46% were seen. No clinically relevant increases in regurgitation were observed. CONCLUSION: Repair of stenotic calcified aortic valves using surgical and chemical debridement showed that removal of calcific deposits was directly associated with improvements in valve hemodynamic function. The level of improvement was proportional to the degree of aortic valve stenosis, to the use of surgical debridement, and to the duration of chemical debridement treatment. The study results suggested that aortic valve repair warrants further investigation as an alternative to current valve treatments in patients with early to mid-stage calcific aortic valve disease.

Aortic Valve Insufficiency↗