CARDIOROOT VS VALSALVA: A COMPARATIVE STUDY IN PATIENTS UNDERGOING DAVID WITH 4D FLOW METHOD

Introduction: This study compares the fluid dynamics of two vascular prostheses used in Tirone-David procedures, aiming to evaluate their performance in terms of blood flow patterns and hemodynamic parameters within the aortic root. Matherial and Results: This study compared twelve patients underwent valve-sparing surgery using either Valsalva Graft Terumo or CardioRoot Gentinge. The procedural success rate was 100%. All patients successfully underwent 4D magnetic resonance imaging. The bulk flow parameters evaluated were: peak velocity, Wall share stress, Volume of blood. Each parameter was evaluated on three sections: mid neo-sinus of Valsalva (P1), mid ascending aorta (P2), distal native ascending aorta (P3). No significant statistical difference was found in peak velocity, wall shear stress and blood volume at P1 P2 between the prostheses. The volume at P3 was statistically different (p-value=0.04), probably influenced by anatomical variability. Simulation of engineered models confirmed the presence of vorticity at level of the neo-sinuses of Valsalva without significant differences between the two different prostheses Conclusion: 4D flow MRI and computational fluid dynamics simulations revealed similar flow patterns and hemodynamic characteristics within the aortic root, suggesting that both grafts offer comparable performance in terms of fluid dynamics. The statistical analysis data revealed no significant differences in flow, wall shear stress, or velocity between the two vascular grafts. Streamline observations showed similar turbulence patterns. These findings suggest that the choice of graft may have minimal impact on postoperative outcomes in valve- sparing surgery.