{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T13:43:51Z","timestamp":1781876631972,"version":"3.54.5"},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T00:00:00Z","timestamp":1692748800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Aortic valve repair procedures are technically challenging, and current intraoperative evaluation methods often fail to predict the final echocardiographic result. We have developed a novel intraoperative aortic valve visualization and pressurization (AVP) device, enabling valve inspection under physiological conditions, and measuring aortic valve insufficiency (AI) during cardioplegic arrest.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>The AVP device is attached to the (neo)aorta, after any type of aortic valve repair, while the heart is arrested. The root is pressurized (60\u201380 mmHg) using a saline solution and an endoscope is introduced. The valve is inspected, and the amount of valvular leakage is measured. Postoperative \u2018gold standard\u2019 transesophageal echocardiogram measurements of AI are performed and compared against regurgitation volume measured.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>In 24 patients undergoing valve-sparing root replacement, the AVP device was used. In 22 patients, postoperative echocardiographic AI was \u2264 grade 1. The median leakage was 90\u2009ml\/min, IQR 60\u2013120\u2009ml\/min. In 3 patients, additional adjustments after visual inspection was performed. In 2 patients, with complex anatomy, the valve was replaced. In one, after evaluation with the device, there was undesirable result visually and residual AI of 330\u2009ml\/min, and in another, 260\u2009ml\/min residual AI was measured and valve restriction on visual inspection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>The novel AVP device enables intraoperative evaluation of the valve under physiological conditions, while still on arrested heart, and allows for targeted adjustments. The AVP device can be an important aid for intraoperative evaluation of the aortic valve, during valve repair and valve-sparing procedures, thereby making the operative result more predictable and the operation more efficient.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezad291","type":"journal-article","created":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T18:35:10Z","timestamp":1692815710000},"source":"Crossref","is-referenced-by-count":4,"title":["Aortic valve visualization and pressurization device: a novel device for intraoperative evaluation of aortic valve repair procedures"],"prefix":"10.1093","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3754-8558","authenticated-orcid":false,"given":"Bardia","family":"Arabkhani","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic surgery, Leiden University Medical Center (LUMC) , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan C","family":"Sandker","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic surgery, Leiden University Medical Center (LUMC) , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry","family":"Braun","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic surgery, Leiden University Medical Center (LUMC) , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6722-918X","authenticated-orcid":false,"given":"Jesper","family":"Hjortnaes","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic surgery, Leiden University Medical Center (LUMC) , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J","family":"van Brakel","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic surgery, Leiden University Medical Center (LUMC) , Leiden, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1297-5716","authenticated-orcid":false,"given":"Dave R","family":"Koolbergen","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic surgery, Amsterdam UMC , Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6507-3855","authenticated-orcid":false,"given":"Robert J M","family":"Klautz","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic surgery, Leiden University Medical Center (LUMC) , Leiden, Netherlands"},{"name":"Department of Cardiothoracic surgery, Amsterdam UMC , Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark G","family":"Hazekamp","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic surgery, Leiden University Medical Center (LUMC) , Leiden, 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