{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T10:55:36Z","timestamp":1789556136159,"version":"build-2803163510"},"reference-count":32,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 HL089315-01"],"award-info":[{"award-number":["R01 HL089315-01"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","award":["18POST33990223"],"award-info":[{"award-number":["18POST33990223"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2TR003143"],"award-info":[{"award-number":["KL2TR003143"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["World J Pediatr Congenit Heart Surg"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neo-aortic pulmonary autografts often experience root dilation and valve regurgitation over time. This study seeks to understand the biomechanical differences between aortic and neo-aortic pulmonary roots using a heart simulator.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Porcine aortic, neo-aortic pulmonary, and pulmonary roots (n\u2009\u2009=\u2009\u20096) were mounted in a heart simulator (parameters: 100 mm Hg, 37 \u00b0C, 70 cycles per minute, 5.0 L\/min cardiac output). Echocardiography was used to study root distensibility (percentage change in luminal diameter between systole and diastole) and valve function. Leaflet motion was tracked with high-speed videography. After 30 min in the simulator, leaflet thickness (via cryosectioning), and multiaxial modulus (via lenticular hydrostatic deformation testing) were obtained.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were no significant differences between aortic and neo-aortic pulmonary leaflet motion, including mean opening velocity (218 vs 248 mm\/s, P\u2009\u2009=\u2009\u2009.27) or mean closing velocity (116 vs 157 mm\/s, P\u2009\u2009=\u2009\u2009.12). Distensibility was similar between aortic (8.5%, 1.56 mm) and neo-aortic pulmonary (7.8%, 1.12 mm) roots ( P\u2009\u2009=\u2009\u2009.59). Compared to virgin controls, native pulmonic roots exposed to systemic pressure for 30 min had reduced leaflet thickness (630 vs 385 \u00b5m, P\u2009\u2009=\u2009\u2009.049) and a reduced Young's modulus (3,125 vs 1,089 kPa, P\u2009\u2009=\u2009\u2009.077). In contrast, the aortic roots exposed to pressure displayed no significant difference in aortic leaflet thickness (1,317 vs 1,256 \u00b5m, P\u2009\u2009=\u2009\u2009.27) or modulus (5,931 vs 3,631 kPa, P\u2009\u2009=\u2009\u2009.56).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Neo-aortic pulmonary roots demonstrated equivalence in valve function and distensibility but did experience changes in biomechanical properties and morphology. These changes may contribute to long-term complications associated with the Ross procedure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21501351211070288","type":"journal-article","created":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T11:26:34Z","timestamp":1646306794000},"page":"166-174","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Biomechanical Analysis of the Ross Procedure in an Ex Vivo Left Heart Simulator"],"prefix":"10.1177","volume":"13","author":[{"given":"Amelia Y.","family":"Bryan","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA, USA"},{"name":"Department of Materials Science and Engineering, Stanford University, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Brandon Strong","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA, USA"},{"name":"Department of Materials Science and Engineering, Stanford University, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumanth","family":"Kidambi","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane","family":"Gilligan-Steinberg","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Bennett-Kennett","sequence":"additional","affiliation":[{"name":"Department of Materials Science and Engineering, Stanford University, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Y.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic 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