Diseases of the Tricuspid Valve

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... stenosis. Tricuspid Regurgitation Tricuspid regurgitation is also called tricuspid insufficiency or tricuspid incompetence. It means there is a ... require valve surgery. Tags: heart valves , tricuspid incompetence , ... tricuspid regurgitation , tricuspid stenosis , valve disease Related Links ...

Transcatheter aortic valve-in-valve treatment of degenerative stentless supra-annular Freedom Solo valves: A single centre experience.

Science.gov (United States)

Cockburn, James; Dooley, Maureen; Parker, Jessica; Hill, Andrew; Hutchinson, Nevil; de Belder, Adam; Trivedi, Uday; Hildick-Smith, David

2017-02-15

Redo surgery for degenerative bioprosthetic aortic valves is associated with significant morbidity and mortality. Report results of valve-in-valve therapy (ViV-TAVI) in failed supra-annular stentless Freedom Solo (FS) bioprostheses, which are the highest risk for coronary occlusion. Six patients with FS valves (mean age 78.5 years, 50% males). Five had valvular restenosis (peak gradient 87.2 mm Hg, valve area 0.63 cm 2 ), one had severe regurgitation (AR). Median time to failure was 7 years. Patients were high risk (mean STS/Logistic EuroScore 10.6 15.8, respectively). FS valves ranged from 21 to 25 mm. Successful ViV-TAVI was achieved in 4/6 patients (67%). Of the unsuccessful cases, (patient 1 and 2 of series) patient 1 underwent BAV with simultaneous aortography which revealed left main stem occlusion. The procedure was stopped and the patient went forward for repeat surgery. Patient 2 underwent successful ViV-TAVI with a 26-mm CoreValve with a guide catheter in the left main, but on removal coronary obstruction occurred, necessitating valve snaring into the aorta. Among the successful cases, (patients 3, 4, 5, 6) the TAVIs used were CoreValve Evolut R 23 mm (n = 3), and Lotus 23 mm (n = 1). In the successful cases the peak gradient fell from 83.0 to 38.3 mm Hg. No patient was left with >1+ AR. One patient had a stroke on Day 2, with full neurological recovery. Two patients underwent semi-elective pacing for LBBB and PR >280 ms. ViV-TAVI in stentless Freedom Solo valves is high risk. The risk of coronary occlusion is high. The smallest possible prosthesis (1:1 sizing) should be used, and strategies to protect the coronary vessels must be considered. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

A theoretical adaptive model of thermal comfort - Adaptive Predicted Mean Vote (aPMV)

Energy Technology Data Exchange (ETDEWEB)

Yao, Runming [School of Construction Management and Engineering, The University of Reading (United Kingdom); Faculty of Urban Construction and Environmental Engineering, Chongqing University (China); Li, Baizhan [Key Laboratory of the Three Gorges Reservoir Region' s Eco-Environment (Ministry of Education), Chongqing University (China); Faculty of Urban Construction and Environmental Engineering, Chongqing University (China); Liu, Jing [School of Construction Management and Engineering, The University of Reading (United Kingdom)

2009-10-15

This paper presents in detail a theoretical adaptive model of thermal comfort based on the ''Black Box'' theory, taking into account factors such as culture, climate, social, psychological and behavioural adaptations, which have an impact on the senses used to detect thermal comfort. The model is called the Adaptive Predicted Mean Vote (aPMV) model. The aPMV model explains, by applying the cybernetics concept, the phenomena that the Predicted Mean Vote (PMV) is greater than the Actual Mean Vote (AMV) in free-running buildings, which has been revealed by many researchers in field studies. An Adaptive coefficient ({lambda}) representing the adaptive factors that affect the sense of thermal comfort has been proposed. The empirical coefficients in warm and cool conditions for the Chongqing area in China have been derived by applying the least square method to the monitored onsite environmental data and the thermal comfort survey results. (author)

Colombian experience with transcatheter aortic valve implantation of medtronic CoreValve.

Science.gov (United States)

Dager, Antonio E; Nuis, Rutger-Jan; Caicedo, Bernardo; Fonseca, Jaime A; Arana, Camilo; Cruz, Lidsa; Benitez, Luis M; Nader, Carlos A; Duenas, Eduardo; de Marchena, Eduardo J; O'Neill, William W; de Jaegere, Peter P

2012-01-01

At our institutions, increasing numbers of aortic stenosis patients were not candidates for surgical aortic valve replacement. Accordingly, we initiated the Cali Colombian Transcatheter Aortic Valve Implantation (TAVI) program. From March 2008 through January 2011, 53 consecutive patients (mean age, 79 ± 6 yr; men, 58%) underwent TAVI with the Medtronic CoreValve System, and data were prospectively collected. Our study's endpoints conformed with Valve Academic Research Consortium recommendations. We report our clinical results.Predicted mortality rates were 25% (interquartile range, 17%-34%) according to logistic EuroSCORE and 6% (interquartile range, 3%-8%) according to the Society of Thoracic Surgeons score. The 30-day mortality rate was 9% (3 intraprocedural deaths, 5 total). The combined 30-day safety endpoint was 30% (major vascular sequelae, 23%; life-threatening bleeding, 12%; myocardial infarction, 4%; major stroke, 4%; and acute kidney injury [stage 3], 2%). Eight patients (15%) required post-implantation balloon dilation and 2 (4%) required valve-in-valve implantation, for a technical device success rate of 77%. Mean peak transvalvular gradient decreased from 74 ± 29 to 17 ± 8 mmHg and mean transvalvular gradient from 40 ± 17 to 8 ± 4 mmHg (both P=0.001). Moderate or severe aortic regurgitation decreased from 32% to 18% (P=0.12) and mitral regurgitation from 32% to 13% (P=0.002). The 1-year survival rate was 81%.We found that TAVI with the CoreValve prosthesis was safe and feasible, with sustained long-term results, for treating aortic stenosis in patients at excessive surgical risk; nonetheless, serious adverse events occurred in 30% of the patients.

Door valve for fuel handling path

International Nuclear Information System (INIS)

Makishima, Katsuhiko.

1969-01-01

A door valve is provided which seals cover gas from a liquid metal cooled reactor without leakage therefrom. A threaded shaft is screwed into a heavy box press which is packed with lead. The shaft is adapted to be rotated by an electric motor or a manually operated wheel which is disposed outside of the door valve. From the box press a valve plate is suspended by four linkage bars, one for each corner. Each linkage bar is provided with two wheels which are respectively mounted at the connections with the box press and the valve plate. The wheels are carried on the horizontal grooves formed in a door valve casing. In operation the shaft rotates and travels to permit the box press and the valve plate to move into the door valve casing while the valve plate does not contact the casing. When the box press reaches the home position, the wheels drop into the recesses which are disposed at the ends of the grooves, the valve plate is carried on the valve opening, and the box press presses the valve plate to increase the tightness. The valve plate does not suffer wear as it does not over other parts. (Yamaguchi, T.)

Multifunctional four-port directional control valve constructed from logic valves

International Nuclear Information System (INIS)

Lisowski, E.; Czyżycki, W.; Rajda, J.

2014-01-01

Highlights: • Directional valve with standard ISO 440-08 has been constructed from logic valves. • Only one innovative valve may replace whole family of the standard valves. • CFD analysis and bench tests of the innovative valve has been carried. • Parameters of the innovative valve are equaling or surpassing the standard ones. • The innovative valve has additional possibilities of pressure and flow control. - Abstract: The paper refers to four-port solenoid pilot operated valves, which are subplate mounted in a hydraulic system in accordance with the ISO 4401 standard. Their widespread use in many machines and devices causes a continuing interest in the development of their design by both the scientific centers and the industry. This paper presents an innovative directional control valve based on the use of logic valves and a methodology followed for the design of it by using Solid Edge CAD and ANSYS/Fluent CFD software. The valve design methodology takes into account the need to seek solutions that minimize flow resistance through the valve. For this purpose, the flow paths are prepared by means of CAD software and pressure-flow curves are determined as a result of CFD analysis. The obtained curves are compared with the curves available in the catalogs of spool type directional control valves. The new solution allows to replace the whole family of spool type four-port directional control valves by one valve built of logic valves. In addition, the innovative directional control valve provides leak-proof shutting the flow paths off and also it can control flow rate and even pressure of working liquid. A prototype of the valve designed by the presented method has been made and tested on the test bench. The results quoted in the paper confirm that the developed logic type directional control valve is able to meet all designed connection configurations, and the obtained pressure-flow curves show very good conformity with the results of CFD analysis

Aortic valve function after bicuspidization of the unicuspid aortic valve.

Science.gov (United States)

Aicher, Diana; Bewarder, Moritz; Kindermann, Michael; Abdul-Khalique, Hashim; Schäfers, Hans-Joachim

2013-05-01

Unicuspid aortic valve (UAV) anatomy leads to dysfunction of the valve in young individuals. We introduced a reconstructive technique of bicuspidizing the UAV. Initially we copied the typical asymmetry of a normal bicuspid aortic valve (BAV) (I), later we created a symmetric BAV (II). This study compared the hemodynamic function of the two designs of a bicuspidized UAV. Aortic valve function was studied at rest and during exercise in 28 patients after repair of UAV (group I, n = 8; group II, n = 20). There were no differences among the groups I and II with respect to gender, age, body size, or weight. All patients were in New York Heart Association class I. Six healthy adults served as control individuals. All patients were studied with transthoracic echocardiography between 4 and 65 months postoperatively. Systolic gradients were assessed by continuous wave Doppler while patients were at rest and exercising on a bicycle ergometer. Aortic regurgitation was grade I or less in all patients. Resting gradients were significantly elevated in group I compared with group II and control individuals (group I, peak 33.8 ± 7.8 mm Hg; mean 19.1 ± 5.4 mm Hg; group II, peak 15.8 ± 5.4, mean 8.2 ± 2.8 mm Hg; control individuals, peak 6.0 ± 1.6, mean 3.2 ± 0.8 mm Hg; p competence. A symmetric repair design leads to improved systolic aortic valve function at rest and during exercise. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

The Double-Orifice Valve Technique to Treat Tricuspid Valve Incompetence.

Science.gov (United States)

Hetzer, Roland; Javier, Mariano; Delmo Walter, Eva Maria

2016-01-01

A straightforward tricuspid valve (TV) repair technique was used to treat either moderate or severe functional (normal valve with dilated annulus) or for primary/organic (Ebstein's anomaly, leaflet retraction/tethering and chordal malposition/tethering, with annular dilatation) TV incompetence, and its long-term outcome assessed. A double-orifice valve technique was employed in 91 patients (mean age 52.6 ± 23.2 years; median age 56 years; range: 0.6-82 years) with severe tricuspid regurgitation. Among the patients, three had post-transplant iatrogenic chordal rupture, five had infective endocarditis, 11 had mitral valve insufficiency, 23 had Ebstein's anomaly, and 47 had isolated severe TV incompetence. The basic principle was to reduce the distance between the coapting leaflets, wherein the most mobile leaflet could coapt to the opposite leaflet, by creating two orifices, ensuring valve competence. The TV repair was performed through a median sternotomy or right anterior thoracotomy in the fifth intercostal space under cardiopulmonary bypass. The degree and extent of creating a double-valve orifice was determined by considering the minimal body surface area (BSA)-related acceptable TV diameter. Repair was accomplished by passing pledgeted mattress sutures from the middle of the true anterior annulus to a spot on the opposite septal annulus, located approximately two-thirds of the length of the septal annulus to avoid injury to the bundle of His. The annular apposition divides the TV into a larger anterior and a smaller posterior orifices, enabling valve closure, on both sides. In adults, the diameter of the anterior valve orifice should be 23-25 mm, and the posterior orifice 15-18 mm; thus, the total valve orifice area is 5-6 cm2. In children, the total valve orifice should be a standard deviation of 1.7 mm for a BSA of 1.0m2. During a mean follow up of 8.7 ± 1.34 years (median 10 years; range: 1.5-25.9 years) there have been no reoperations for TV insufficiency

Evaluation of steady flow torques and pressure losses in a rotary flow control valve by means of computational fluid dynamics

International Nuclear Information System (INIS)

Okhotnikov, Ivan; Noroozi, Siamak; Sewell, Philip; Godfrey, Philip

2017-01-01

Highlights: • A novel design of a rotary flow control valve driven by a stepper motor is proposed. • The intended use of the valve in the high flow rate independent metering hydraulic system is suggested. • Pressure drops, steady flow torques of the valve for various flow rates and orifice openings are studied by means of computational fluid dynamics. • The discharge coefficient and flow jet angles dependencies on the orifice opening are obtained. • A design method to decrease the flow forces without reducing the flow rate in single-staged valves is demonstrated. - Abstract: In this paper, a novel design of a rotary hydraulic flow control valve has been presented for high flow rate fluid power systems. High flow rates in these systems account for substantial flow forces acting on the throttling elements of the valves and cause the application of mechanically sophisticated multi-staged servo valves for flow regulation. The suggested design enables utilisation of single-stage valves in power hydraulics operating at high flow rates regimes. A spool driver and auxiliary mechanisms of the proposed valve design were discussed and selection criteria were suggested. Analytical expressions for metering characteristics as well as steady flow torques have been derived. Computational fluid dynamics (CFD) analysis of steady state flow regimes was conducted to evaluate the hydraulic behaviour of the proposed valve. This study represents a special case of an independent metering concept applied to the design of power hydraulic systems with direct proportional valve control operating at flow rates above 150 litres per minute. The result gained using parametric CFD simulations predicted the induced torque and the pressure drops due to a steady flow. Magnitudes of these values prove that by minimising the number of spool's mobile metering surfaces it is possible to reduce the flow-generated forces in the new generation of hydraulic valves proposed in this study

Regression in left ventricular mass after aortic valve replacement for chronic aortic regurgitation is unrelated to prosthetic valve size.

Science.gov (United States)

Brown, Morgan L; Schaff, Hartzell V; Suri, Rakesh M; Li, Zhuo; Sundt, Thoralf M; Dearani, Joseph A; Enriquez-Sarano, Maurice

2011-08-01

We examined the role of prosthesis-patient mismatch on left ventricular mass regression after aortic valve replacement for chronic aortic valve regurgitation. We selected patients who had complete preoperative and follow-up echocardiograms with measurement of left ventricular mass. Patients were excluded who had moderate or greater aortic valve stenosis, concomitant coronary artery bypass grafting, or mitral valve procedures. Patients' mean age was 55 ± 17 years; 21% were female. The mean preoperative indexed left ventricular mass was 150 ± 45 g/m(2). Patients with mildly (n = 44; mean indexed mass, 126 ± 15 g/m(2)), moderately (n = 31; mean indexed mass, 168 ± 11 g/m(2)), or severely (n = 15; mean indexed mass, 241 ± 34 g/m(2)) increased preoperative indexed left ventricular mass, were similar, except for lower ejection fractions, larger end-diastolic dimensions, and larger ventricular wall thicknesses in the severely enlarged group (P regression was unrelated to labeled valve size, prosthesis-patient mismatch, or measured indexed effective aortic valve area. A greater preoperative indexed left ventricular mass (P regression. Despite having greater left ventricular mass regression, patients with severe preoperative indexed left ventricular mass did not return to normal values (mean, 142 ± 25 g/m(2)). Left ventricular mass regression after aortic valve replacement for chronic aortic regurgitation is unrelated to indexed prosthetic valve area. Although incomplete, regression is greatest in patients with the largest preoperative indexed left ventricular mass. Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Multidetector computed tomography sizing of bioprosthetic valves: guidelines for measurement and implications for valve-in-valve therapies

International Nuclear Information System (INIS)

Rajani, R.; Attia, R.; Condemi, F.; Webb, J.; Woodburn, P.; Hodson, D.; Nair, A.; Preston, R.; Razavi, R.; Bapat, V.N.

2016-01-01

Aim: To describe a technique for bioprosthetic multidetector computed tomography (MDCT) sizing and to compare MDCT-derived values against manufacturer-provided sizing. Materials and methods: Fourteen bioprosthetic stented valves commonly used in the aortic valve position were evaluated using a Philips 256 MDCT system. All valves were scanned using a dedicated cardiac CT protocol with a four-channel electrocardiography (ECG) simulator. Measurements were made of major and minor axes and the area and perimeter of the internal stent using varying reconstruction kernels and window settings. Measurements derived from MDCT (MDCT ID) were compared against the stent internal diameter (Stent ID) as provided by the valve manufacturer and the True ID (Stent ID + insertion of leaflets). All data were collected and analysed using SPSS for Mac (version 21). Results: The mean difference between the MDCT ID and Stent ID was 0.6±1.9 mm (r=0.649, p=0.012) and between MDCT ID and True ID 2.1±2 mm (r=0.71, p=0.005). There was no difference in the major (p=0.90), minor (p=0.87), area (p=0.92), or perimeter (p=0.92) measurements when sharp, standard, and detailed stent kernels were used. Similarly, the measurements remained consistent across differing windowing levels. Conclusion: Bioprosthetic stented valves may be reliably sized using MDCT in patients requiring valve-in-valve (VIV) interventions where the valve type and size are unknown. In these cases, clinicians should be aware that MDCT has a tendency to overestimate the True ID size. - Highlights: • Cardiac CT is likely to be ideally suited for bioprosthetic aortic valve sizing for valve in valve procedures. • We compared MDCT sizing for 14 varying bioprosthetic aortic valves across varying window settings and reconstruction kernels. • We provide “normal” MDCT sizing for varying valves and show their relationship to surgical sizing. • Bioprosthetic valves may be reliably sized by MDCT but require adjustment owing to

Turbulence downstream of subcoronary stentless and stented aortic valves.

Science.gov (United States)

Funder, Jonas Amstrup; Frost, Markus Winther; Wierup, Per; Klaaborg, Kaj-Erik; Hjortdal, Vibeke; Nygaard, Hans; Hasenkam, J Michael

2011-08-11

Regions of turbulence downstream of bioprosthetic heart valves may cause damage to blood components, vessel wall as well as to aortic valve leaflets. Stentless aortic heart valves are known to posses several hemodynamic benefits such as larger effective orifice areas, lower aortic transvalvular pressure difference and faster left ventricular mass regression compared with their stented counterpart. Whether this is reflected by diminished turbulence formation, remains to be shown. We implanted either stented pericardial valve prostheses (Mitroflow), stentless valve prostheses (Solo or Toronto SPV) in pigs or they preserved their native valves. Following surgery, blood velocity was measured in the cross sectional area downstream of the valves using 10MHz ultrasonic probes connected to a dedicated pulsed Doppler equipment. As a measure of turbulence, Reynolds normal stress (RNS) was calculated at two different blood pressures (baseline and 50% increase). We found no difference in maximum RNS measurements between any of the investigated valve groups. The native valve had significantly lower mean RNS values than the Mitroflow (p=0.004), Toronto SPV (p=0.008) and Solo valve (p=0.02). There were no statistically significant differences between the artificial valve groups (p=0.3). The mean RNS was significantly larger when increasing blood pressure (p=0.0006). We, thus, found no advantages for the stentless aortic valves compared with stented prosthesis in terms of lower maximum or mean RNS values. Native valves have a significantly lower mean RNS value than all investigated bioprostheses. Copyright © 2011 Elsevier Ltd. All rights reserved.

Analysis of aortic root surgery with composite mechanical aortic valve conduit and valve-sparing reconstruction.

Science.gov (United States)

Dias, Ricardo Ribeiro; Mejia, Omar Asdrubal Vilca; Fiorelli, Alfredo Inácio; Pomerantzeff, Pablo Maria Alberto; Dias, Altamiro Ribeiro; Mady, Charles; Stolf, Noedir Antonio Groppo

2010-01-01

Comparative analysis of early and late results of aortic root reconstruction with aortic valve sparing operations and the composite mechanical valve conduit replacement. From November 2002 to September 2009, 164 consecutive patients with mean age 54 ± 15 years, 115 male, underwent the aortic root reconstruction (125 mechanical valve conduit replacements and 39 valve sparing operations). Sixteen percent of patients had Marfan syndrome and 4.3% had bicuspid aortic valve. One hundred and forty-four patients (88%) were followed for a mean period of 41.1 ± 20.8 months. The hospital mortality was 4.9%, 5.6% in operations with valved conduits and 2.6% in the valve sparing procedures (P valve sparing operations, respectively (95% CI = 70% - 95%, P = 0.001), (95% CI = 82% - 95% P = 0.03) and (95% CI = 81% - 95%, P = 0.03). Multivariate analysis showed that creatinine greater than 1.4 mg/dl, Cabrol operation and renal dialysis were predictors of mortality, respectively, with occurrence chance of 6 (95% CI = 1.8 - 19.5, P = 0.003), 12 (95% CI = 3 - 49.7, P = 0.0004) and 16 (95% CI = 3.6 - 71.3, P = 0.0002). The aortic root reconstruction has a low early and late mortality, high survival free of complications and low need for reoperation. During the late follow-up, valve sparing aortic root reconstructions presented fewer incidences of bleeding, thromboembolic events and endocarditis.

Vascular complications associated with transcatheter aortic valve replacement.

Science.gov (United States)

Sardar, M Rizwan; Goldsweig, Andrew M; Abbott, J Dawn; Sharaf, Barry L; Gordon, Paul C; Ehsan, Afshin; Aronow, Herbert D

2017-06-01

Transcatheter aortic valve replacement (TAVR) is now an accepted pathway for aortic valve replacement for patients who are at prohibitive, severe and intermediate risk for traditional aortic valve surgery. However, with this rising uptrend and adaptation of this new technology, vascular complications and their management remain an Achilles heel for percutaneous aortic valve replacement. The vascular complications are an independent predictor of mortality for patients undergoing TAVR. Early recognition of these complications and appropriate management is paramount. In this article, we review the most commonly encountered vascular complications associated with currently approved TAVR devices and their optimal percutaneous management techniques.

Bioprosthetic Valve Fracture to Facilitate Transcatheter Valve-in-Valve Implantation.

Science.gov (United States)

Allen, Keith B; Chhatriwalla, Adnan K; Cohen, David J; Saxon, John T; Aggarwal, Sanjeev; Hart, Anthony; Baron, Suzanne; Davis, J Russell; Pak, Alex F; Dvir, Danny; Borkon, A Michael

2017-11-01

Valve-in-valve transcatheter aortic valve replacement is less effective in small surgical bioprostheses. We evaluated the feasibility of bioprosthetic valve fracture with a high-pressure balloon to facilitate valve-in-valve transcatheter aortic valve replacement. In vitro bench testing on aortic tissue valves was performed on 19-mm and 21-mm Mitroflow (Sorin, Milan, Italy), Magna and Magna Ease (Edwards Lifesciences, Irvine, CA), Trifecta and Biocor Epic (St. Jude Medical, Minneapolis, MN), and Hancock II and Mosaic (Medtronic, Minneapolis, MN). High-pressure balloons Tru Dilation, Atlas Gold, and Dorado (C.R. Bard, Murray Hill, NJ) were used to determine which valves could be fractured and at what pressure fracture occurred. Mitroflow, Magna, Magna Ease, Mosaic, and Biocor Epic surgical valves were successfully fractured using high-pressures balloon 1 mm larger than the labeled valve size whereas Trifecta and Hancock II surgical valves could not be fractured. Only the internal valve frame was fractured, and the sewing cuff was never disrupted. Manufacturer's rated burst pressures for balloons were exceeded, with fracture pressures ranging from 8 to 24 atmospheres depending on the surgical valve. Testing further demonstrated that fracture facilitated the expansion of previously constrained, underexpanded transcatheter valves (both balloon and self-expanding) to the manufacturer's recommended size. Bench testing demonstrates that the frame of most, but not all, bioprosthetic surgical aortic valves can be fractured using high-pressure balloons. The safety of bioprosthetic valve fracture to optimize valve-in-valve transcatheter aortic valve replacement in small surgical valves requires further clinical investigation. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Safety valve including a hydraulic brake and hydraulic brake that could be fitted into a valve

International Nuclear Information System (INIS)

Chabat-Courrede, Jean.

1981-01-01

Making of a safety valve that can be fitted to a containment vessel filled with a non compressible fluid, such as the water system of a nuclear power station. It includes a hydraulic brake located between the valve and the elastic means, close to the valve which completely suppresses the high frequency oscillations of the equipment [fr

Fast-Valving of Large Steam Turbine Units as a Means of Power System Security Enhancement

Directory of Open Access Journals (Sweden)

Bogdan Sobczak

2014-03-01

Full Text Available Fast-valving assists in maintaining system stability following a severe transmission system fault by reducing the turbine mechanical power. Fast-valving consists in rapid closing and opening of steam valves in an adequate manner to reduce the generator accelerating power following the recognition of a severe fault. FV can be an effective and economical method of meeting the performance requirements of a power system in the presence of an increase in wind and solar generation in the power system, newly connected large thermal units and delaying of building new transmission lines. The principle of fast-valving and advantages of applying this technique in large steam turbine units was presented in the paper. Effectiveness of fast-valving in enhancing the stability of the Polish Power Grid was analyzed. The feasibility study of fast-valving application in the 560 MW unit in Kozienice Power Station (EW SA was discussed.

Double-disc gate valve

International Nuclear Information System (INIS)

Wheatley, S.J.

1979-01-01

The invention relates to an improvement in a conventional double-disc gate valve having a vertically movable gate assembly including a wedge, spreaders slidably engaged therewith, a valve disc carried by the spreaders. When the gate assembly is lowered to a selected point in the valve casing, the valve discs are moved transversely outward to close inlet and outlet ports in the casing. The valve includes hold-down means for guiding the disc-and-spreader assemblies as they are moved transversely outward and inward. If such valves are operated at relatively high differential pressures, they sometimes jam during opening. Such jamming has been a problem for many years in gate valves used in gaseous diffusion plants for the separation of uranium isotopes. The invention is based on the finding that the above-mentioned jamming results when the outlet disc tilts about its horizontal axis in a certain way during opening of the valve. In accordance with the invention, tilting of the outlet disc is maintained at a tolerable value by providing the disc with a rigid downwardly extending member and by providing the casing with a stop for limiting inward arcuate movement of the member to a preselected value during opening of the valve

Bentall Procedure Using Cryopreserved Valved Aortic Homografts

Science.gov (United States)

Christenson, Jan T.; Sierra, Jorge; Trindade, Pedro T.; Didier, Dominique; Kalangos, Afksendiyos

2004-01-01

The Bentall procedure is the standard operation for patients who have lesions of the ascending aorta associated with aortic valve disease. In many cases, however, mechanical prosthetic conduits are not suitable. There are few reports in the English-language medical literature concerning the mid- to long-term outcome of Bentall operations with cryopreserved homografts. Therefore, we reviewed our experience with this procedure and valved homografts. From January 1997 through December 2002, 21 patients underwent a Bentall operation with cryopreserved homografts at our institution. There were 14 males and 7 females; the mean age was 36 ± 21 years (range, 15–74 years). Eleven patients had undergone previous aortic valve surgery. All patients had aortic dilatation or aneurysms involving the ascending aorta. Indications for surgery included aortic valve stenosis or insufficiency, and aortic valve endocarditis (native valve or prosthetic). One patient had Takayasu's arteritis and 3 had Marfan syndrome. There was 1 hospital death (due to sepsis), but no other major postoperative complications. The mean hospital stay was 14 ± 7 days. Follow-up echocardiographic and computed tomographic scans were performed yearly. The mean follow-up was 34 months (6–72 months). Follow-up imaging revealed no calcifications or degenerative processes related to the homograft. Four patients had minimal valve regurgitation. Two patients died during follow-up. The 3-year actuarial survival rate was 85.7%. Our data suggest that the Bentall procedure with a valved homograft conduit is a safe procedure with excellent mid- to long-term results, comparable to results reported with aortic valve replacement with a homograft. PMID:15745290

MANAGEMENT OF FAILED MITRAL VALVE REPLACEMENT. THE DURBAN EXPERIENCE.

Science.gov (United States)

Kistan, D; Booysen, M; Alexander, G; Madiba, T E

2017-06-01

Mitral valve replacement is the procedure of choice in patients with severe mitral valve disease. However, these patients are surviving longer and are thus at an increased risk of prosthesis failure or valve-related complications. Study setting: Inkosi Albert Luthuli Central Hospital, a tertiary referral Hospital in Durban. Study population: All patients undergoing redo mechanical mitral valve replacement surgery between January 2005 and December 2014. Study design: Retrospective analysis of patients undergoing redo mitral valve replacement. Patients were identified from theatre record books, their files were electronically accessed and pertinent information extracted onto a data capture sheet. Information documented included demographics, duration to failure, INR, Albumin, HIV status, clinical findings and outcome. The data was stored on an Excel datasheet. Fifty-eight patients were documented (mean age 32 ± 15.81 years; M:F 1:3). Ten patients (17%) were HIV positive (median CD4 count 478). Mean duration between first surgery and redo was 8.8 years. Thirty-five patients (60%) had no co-morbidities. Presenting features at redo surgery were congestive cardiac failure (27), chest pain (11) and palpitations (17). Mean preoperative Ejection Fraction was 51.65 %. Twenty-nine patients (55%) had emergency redo surgery. Twenty-two patients (75%) had acute prosthetic valve thrombosis. Thirty-two patients had tricuspid regurgitation. Original pathology was documented in 23 patients (40%) as Rheumatic valve disease. Prosthetic valve thrombosis was documented in 31 patients (54%). The most commonly used valve was the On-X. Mean presenting INR was 1.96 + 1.2 and mean presenting serum albumin was 36.7 + 7.8 g/l. Forty-one patients (71%) were found to be compliant to Warfarin therapy prior to redo surgery. Mean ICU stay was 6 +9 days. Two patients died postoperatively. Mean followup was 32 + 26.6 months. Twelve patients (20.7%) developed postoperative complications. Patients

Stent valve implantation in conventional redo aortic valve surgery to prevent patient-prosthesis mismatch.

Science.gov (United States)

Ferrari, Enrico; Franciosi, Giorgio; Clivio, Sara; Faletra, Francesco; Moccetti, Marco; Moccetti, Tiziano; Pedrazzini, Giovanni; Demertzis, Stefanos

2017-03-01

The goal was to show the technical details, feasibility and clinical results of balloon-expandable stent valve implantation in the aortic position during conventional redo open-heart surgery in selected obese patients with a small aortic prosthesis and severe patient-prosthesis mismatch. Two symptomatic overweight patients (body mass index of 31 and 38), each with a small aortic prosthesis (a 4-year-old, 21-mm Hancock II biological valve and a 29-year-old, 23-mm Duromedic mechanical valve), increased transvalvular gradients (59/31 and 74/44 mmHg) and a reduced indexed effective orifice area (0.50 and 0.43 cm 2 /m 2 ) underwent implantation of two 26-mm balloon-expandable Sapien 3 valves during standard on-pump redo valve surgery. Using full re-sternotomy, cardiopulmonary bypass and cardioplegic arrest, the two balloon-expandable stent valves were implanted under direct view using a standard aortotomy, after prosthesis removal and without annulus enlargement. Aortic cross-clamp times were 162 and 126 min; cardiopulmonary bypass times were 178 and 180 min; total surgical times were 360 and 318 min. At discharge, echocardiograms showed transvalvular peak and mean gradients of 13/9 and 23/13 mmHg and indexed effective orifice areas of 0.64 and 1.08 cm 2 /m 2 . The 3-month echocardiographic follow-up showed transvalvular peak and mean gradients of 18/9 and 19/11 mmHg and indexed effective orifice areas of 0.78 cm 2 /m 2 and 0.84 cm 2 /m 2 , with improved symptoms (New York Heart Association class 1). Implantation of a balloon-expandable stent valve during redo aortic valve surgery is feasible in selected cases and prevents patient-prosthesis mismatch in obese patients without need for aortic annulus enlargement. Moreover, in the case of stent valve degeneration, this approach permits additional valve-in-valve procedures with large stent valves and prevents re-redo surgery. © The Author 2016. Published by Oxford University Press on behalf of the

Cellular regulation of the structure and function of aortic valves

Directory of Open Access Journals (Sweden)

Ismail El-Hamamsy

2010-01-01

Full Text Available The aortic valve was long considered a passive structure that opens and closes in response to changes in transvalvular pressure. Recent evidence suggests that the aortic valve performs highly sophisticated functions as a result of its unique microscopic structure. These functions allow it to adapt to its hemodynamic and mechanical environment. Understanding the cellular and molecular mechanisms involved in normal valve physiology is essential to elucidate the mechanisms behind valve disease. We here review the structure and developmental biology of aortic valves; we examine the role of its cellular parts in regulating its function and describe potential pathophysiological and clinical implications.

Valve system incorporating single failure protection logic

Science.gov (United States)

Ryan, Rodger; Timmerman, Walter J. H.

1980-01-01

A valve system incorporating single failure protective logic. The system consists of a valve combination or composite valve which allows actuation or de-actuation of a device such as a hydraulic cylinder or other mechanism, integral with or separate from the valve assembly, by means of three independent input signals combined in a function commonly known as two-out-of-three logic. Using the input signals as independent and redundant actuation/de-actuation signals, a single signal failure, or failure of the corresponding valve or valve set, will neither prevent the desired action, nor cause the undesired action of the mechanism.

Adaptive phase k-means algorithm for waveform classification

Science.gov (United States)

Song, Chengyun; Liu, Zhining; Wang, Yaojun; Xu, Feng; Li, Xingming; Hu, Guangmin

2018-01-01

Waveform classification is a powerful technique for seismic facies analysis that describes the heterogeneity and compartments within a reservoir. Horizon interpretation is a critical step in waveform classification. However, the horizon often produces inconsistent waveform phase, and thus results in an unsatisfied classification. To alleviate this problem, an adaptive phase waveform classification method called the adaptive phase k-means is introduced in this paper. Our method improves the traditional k-means algorithm using an adaptive phase distance for waveform similarity measure. The proposed distance is a measure with variable phases as it moves from sample to sample along the traces. Model traces are also updated with the best phase interference in the iterative process. Therefore, our method is robust to phase variations caused by the interpretation horizon. We tested the effectiveness of our algorithm by applying it to synthetic and real data. The satisfactory results reveal that the proposed method tolerates certain waveform phase variation and is a good tool for seismic facies analysis.

Additively Manufactured Main Fuel Valve Housing

Science.gov (United States)

Eddleman, David; Richard, Jim

2015-01-01

Selective Laser Melting (SLM) was utilized to fabricate a liquid hydrogen valve housing typical of those found in rocket engines and main propulsion systems. The SLM process allowed for a valve geometry that would be difficult, if not impossible to fabricate by traditional means. Several valve bodies were built by different SLM suppliers and assembled with valve internals. The assemblies were then tested with liquid nitrogen and operated as desired. One unit was also burst tested and sectioned for materials analysis. The design, test results, and planned testing are presented herein.

[Ministernotomy: a preliminary experience in heart valve surgery].

Science.gov (United States)

Kovarević, Pavle; Mihajlović, Bogoljub; Velicki, Lazar; Redzek, Aleksandar; Ivanović, Vladimir; Komazec, Nikola

2011-05-01

The last decade of the 20th century brought up a significant development in the field of minimally invasive approaches to the valvular heart surgery. Potential benefits of this method are: good esthetic appearance, reduced pain, reduction of postoperative hemorrhage and incidence of surgical site infection, shorter postoperative intensive care units (ICU) period and overall in-hospital period. Partial upper median stemotomy currently presents as a state-of-the art method for minimally invasive surgery of cardiac valves. The aim of this study was to report on initial experience in application of this surgical method in the surgery of mitral and aortic valves. The study was designed and conducted in a prospective manner and included all the patients who underwent minimally invasive cardiac valve surgery through the partial upper median stemotomy during the period November 2008 - August 2009. We analyzed the data on mean age of patients, mean extubation time, mean postoperative drainage, mean duration of hospital stay, as well as on occurance of postoperative complications (postoperative bleeding, surgical site infection and cerebrovascular insult). During the observed period, in the Institute for Cardiovascular Diseases of Vojvodina, Clinic for Cardiovascular Surgery, 17 ministernotomies were performed, with 14 aortic valve replacements (82.35%) and 3 mitral valve replacements (17.65%). Mean age of the patients was 60.78 +/- 12.99 years (64.71% males, 35.29% females). Mean extubation time was 12.53 +/- 8.87 hours with 23.5% of the patients extubated in less than 8 hours. Mean duration of hospital stay was 12.35 +/- 10.17 days (in 29.4% of the patients less than 8 days). Mean postoperative drainage was 547.06 +/- 335.2 mL. Postoperative complications included: bleeding (5.88%) and cerebrovascular insult (5.88%). One patient (5.88%) required conversion to full stemotomy. Partial upper median sternotomy represents the optimal surgical method for the interventions on the

Novel Active Combustion Control Valve

Science.gov (United States)

Caspermeyer, Matt

2014-01-01

This project presents an innovative solution for active combustion control. Relative to the state of the art, this concept provides frequency modulation (greater than 1,000 Hz) in combination with high-amplitude modulation (in excess of 30 percent flow) and can be adapted to a large range of fuel injector sizes. Existing valves often have low flow modulation strength. To achieve higher flow modulation requires excessively large valves or too much electrical power to be practical. This active combustion control valve (ACCV) has high-frequency and -amplitude modulation, consumes low electrical power, is closely coupled with the fuel injector for modulation strength, and is practical in size and weight. By mitigating combustion instabilities at higher frequencies than have been previously achieved (approximately 1,000 Hz), this new technology enables gas turbines to run at operating points that produce lower emissions and higher performance.

Effects of valve timing, valve lift and exhaust backpressure on performance and gas exchanging of a two-stroke GDI engine with overhead valves

International Nuclear Information System (INIS)

Dalla Nora, Macklini; Lanzanova, Thompson Diórdinis Metzka; Zhao, Hua

2016-01-01

Highlights: • Two-stroke operation was achieved in a four-valve direct injection gasoline engine. • Shorter valve opening durations improved torque at lower engine speeds. • The longer the valve opening duration, the lower was the air trapping efficiency. • Higher exhaust backpressure and lower valve lift reduced the compressor work. - Abstract: The current demand for fuel efficient and lightweight powertrains, particularly for application in downsized and hybrid electric vehicles, has renewed the interest in two-stroke engines. In this framework, an overhead four-valve spark-ignition gasoline engine was modified to run in the two-stroke cycle. The scavenging process took place during a long valve overlap period around bottom dead centre at each crankshaft revolution. Boosted intake air was externally supplied at a constant pressure and gasoline was directly injected into the cylinder after valve closure. Intake and exhaust valve timings and lifts were independently varied through an electrohydraulic valve train, so their effects on engine performance and gas exchanging were investigated at 800 rpm and 2000 rpm. Different exhaust backpressures were also evaluated by means of exhaust throttling. Air trapping efficiency, charging efficiency and scavenge ratio were calculated based on air and fuel flow rates, and exhaust oxygen concentration at fuel rich conditions. The results indicated that longer intake and exhaust valve opening durations increased the charge purity and hence torque at higher engine speeds. At lower speeds, although, shorter valve opening durations increased air trapping efficiency and reduced the estimated supercharger power consumption due to lower air short-circuiting. A strong correlation was found between torque and charging efficiency, while air trapping efficiency was more associated to exhaust valve opening duration. The application of exhaust backpressure, as well as lower intake/exhaust valve lifts, made it possible to increase

Minimally invasive aortic valve replacement

DEFF Research Database (Denmark)

Foghsgaard, Signe; Schmidt, Thomas Andersen; Kjaergard, Henrik K

2009-01-01

In this descriptive prospective study, we evaluate the outcomes of surgery in 98 patients who were scheduled to undergo minimally invasive aortic valve replacement. These patients were compared with a group of 50 patients who underwent scheduled aortic valve replacement through a full sternotomy...... operations were completed as mini-sternotomies, 4 died later of noncardiac causes. The aortic cross-clamp and perfusion times were significantly different across all groups (P replacement...... is an excellent operation in selected patients, but its true advantages over conventional aortic valve replacement (other than a smaller scar) await evaluation by means of randomized clinical trial. The "extended mini-aortic valve replacement" operation, on the other hand, is a risky procedure that should...

Fast-Valving of Large Steam Turbine Units as a Means of Power System Security Enhancement

OpenAIRE

Bogdan Sobczak; Robert Rink; Rafał Kuczyński; Robert Trębski

2014-01-01

Fast-valving assists in maintaining system stability following a severe transmission system fault by reducing the turbine mechanical power. Fast-valving consists in rapid closing and opening of steam valves in an adequate manner to reduce the generator accelerating power following the recognition of a severe fault. FV can be an effective and economical method of meeting the performance requirements of a power system in the presence of an increase in wind and solar generation in the power syst...

Experimental investigation of the fluid dynamic efficiency of a high performance multi-valve internal combustion engine during the intake phase: Influence of valve-valve interference phenomena

Directory of Open Access Journals (Sweden)

Algieri Angelo

2013-01-01

Full Text Available The purpose of the present work is the analysis of the fluid dynamic behavior of a high performance internal combustion engine during the intake phase. In particular, a four-valve spark-ignition engine has been characterized at the steady flow rig. Dimensionless discharge coefficients have been used to define the global fluid dynamic efficiency of the intake system, while the Laser Doppler Anemometry (LDA technique has been employed to evaluate the mean flow in the valve curtain area and to characterise the interference phenomena between the two intake valves. The investigation has shown the significant influence of the valve lift on the volumetric efficiency of the intake apparatus. Moreover, the experimental analysis has highlighted that the valve-valve interference phenomena have a relevant impact on the head breathability, on the flow development within the combustion chamber and on the velocity standard deviations.

Mechanical Aortic Valve Replacement in Octogenarian

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Irfan Tasoglu

2013-10-01

Full Text Available Aim: This study analyzes the long-term outcomes of mechanical aortic valve replacement in octogenarian patients. Material and Method: A retrospective review was performed on 23 octogenarian patients who underwent mechanical aortic valve replacement. Hospital mortality, postoperative intensive care unit stay, hospital stay and long-term results was examined. Estimates of the cumulative event mortality rate were calculated by the Kaplan-Meier method. Results: The mean age of all patients was 82.9±2.3 years and most were men (65.22%. The median ejection fraction was 45%. 73.91% of patients were in New York Heart Association class III-IV. Thirteen patients (56.52% in this study underwent combined procedure, the remaining 10 (43.48% patients underwent isolated aortic valve replacement. The most common valve size was 23 mm. The mean intensive care unit stay was 1.76±1.14 days. The mean hospital stay was 9.33±5.06 days. No complications were observed in 56.52% patients during their hospital stay. The overall hospital mortality was 8.7%. Follow-up was completed for all 23 patients. Median follow-up time was 33 months (1-108 months. Actuarial survival among discharged from hospital was 59% at 5 years. Discussion: Mechanical aortic valve replacement is a safe procedure in octogenarian patients and can be performed safely even in combined procedure.

Unicuspid aortic valve disease: a magnetic resonance imaging study

Energy Technology Data Exchange (ETDEWEB)

Debl, K.; Buchner, S.; Heinicke, N.; Riegger, G.; Luchner, A. [Klinik und Poliklinik fuer Innere Medizin II, Universitaetsklinikum Regensburg (Germany); Djavidani, B.; Poschenrieder, F.; Feuerbach, S. [Inst. fuer Roentgendiagnostik, Universitaetsklinikum Regensburg (Germany); Schmid, C.; Kobuch, R. [Klinik und Poliklinik fuer Herz-, Thorax- und herznahe Gefaesschirurgie, Universitaetsklinikum Regensburg (Germany)

2008-11-15

Purpose: congenitally malformed aortic valves are a common finding in adults with aortic valve disease. Most of these patients have bicuspid aortic valve disease. Unicuspid aortic valve disease (UAV) is rare. The aim of our study was to describe valve morphology and the dimensions of the proximal aorta in a cohort of 12 patients with UAV in comparison to tricuspid aortic valve disease (TAV) using magnetic resonance imaging (MRI). Materials and methods/results: MRI studies were performed on a 1.5 T scanner in a total of 288 consecutive patients with aortic valve disease. 12 aortic valves were retrospectively classified as UAV. Annulus areas and dimensions of the thoracic aorta were retrospectively compared to a cohort of 103 patients with TAV. In UAV, valve morphology was unicuspid unicommissural with a posterior commissure in all patients. Mean annulus areas and mean diameters of the ascending aorta were significantly greater in UAV compared to TAV (12.6 {+-} 4.7 cm{sup 2} vs. 8.7 {+-} 2.3 cm{sup 2}, p < 0.01 and 4.6 {+-} 0.7 cm vs. 3.6 {+-} 0.5 cm, p < 0.0001, respectively), while no differences were observed in the mean diameters of the aortic arch (2.3 {+-} 0.6 cm vs. 2.3 {+-} 0.4 cm, p = 0.69). The diameters of the descending aorta were slightly smaller in UAV compared to TAV (2.2 {+-} 0.5 cm vs. 2.6 {+-} 0.3 cm, p < 0.05). (orig.)

The influence of Marfans and bicuspid valves on outcomes following aortic valve reimplantation.

Science.gov (United States)

Martín, Carlos E; García Montero, Carlos; Serrano, Santiago-Fiz; González, Ana; Mingo, Susana; Moñivas, Vanessa; Centeno, Jorge; Forteza, Alberto

2017-10-01

We analyzed our early and midterm results with aortic valve reimplantation surgery to determine the influence of Marfan syndrome and bicuspid valves on outcomes with this technique. Between March 2004 and December 2015, 267 patients underwent aortic valve reimplantation operations. The mean diameter of the sinuses of Valsalva was 50 ± 3 mm and moderate/severe aortic regurgitation was present in 34.4% of these patients. A bicuspid aortic valve was present in 21% and 40% had Marfan syndrome. Overall 30-day mortality was 0.37% (1/267). Mean follow-up was 59.7 ± 38.7 months. Overall survival at 1, 3, and 5 years was 98 ± 8%, 98 ± 1%, and 94 ± 2%, respectively. Freedom from reoperation and aortic regurgitation >II was 99 ± 5%, 98 ± 8%, 96.7 ± 8%, and 99 ± 6%, 98 ± 1%, 98 ± 1%, respectively at 1, 3, and 5 years follow-up, with no differences between Marfan and bicuspid aortic valve groups. (p = 0.94 and p = 0.96, respectively). No endocarditis or thromboembolic complications were documented, and 93.6% of the patients did not receive any anticoagulation therapy. The reimplantation technique for aortic root aneurysms is associated with excellent clinical and functional outcomes at short and mid-term follow-up. © 2017 Wiley Periodicals, Inc.

Statins for aortic valve stenosis

Directory of Open Access Journals (Sweden)

Luciana Thiago

Full Text Available ABSTRACT BACKGROUND: Aortic valve stenosis is the most common type of valvular heart disease in the USA and Europe. Aortic valve stenosis is considered similar to atherosclerotic disease. Some studies have evaluated statins for aortic valve stenosis. OBJECTIVES: To evaluate the effectiveness and safety of statins in aortic valve stenosis. METHODS: Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, MEDLINE, Embase, LILACS - IBECS, Web of Science and CINAHL Plus. These databases were searched from their inception to 24 November 2015. We also searched trials in registers for ongoing trials. We used no language restrictions. Selection criteria: Randomized controlled clinical trials (RCTs comparing statins alone or in association with other systemic drugs to reduce cholesterol levels versus placebo or usual care. Data collection and analysis: Primary outcomes were severity of aortic valve stenosis (evaluated by echocardiographic criteria: mean pressure gradient, valve area and aortic jet velocity, freedom from valve replacement and death from cardiovascular cause. Secondary outcomes were hospitalization for any reason, overall mortality, adverse events and patient quality of life. Two review authors independently selected trials for inclusion, extracted data and assessed the risk of bias. The GRADE methodology was employed to assess the quality of result findings and the GRADE profiler (GRADEPRO was used to import data from Review Manager 5.3 to create a 'Summary of findings' table. MAIN RESULTS: We included four RCTs with 2360 participants comparing statins (1185 participants with placebo (1175 participants. We found low-quality evidence for our primary outcome of severity of aortic valve stenosis, evaluated by mean pressure gradient (mean difference (MD -0.54, 95% confidence interval (CI -1.88 to 0.80; participants = 1935; studies = 2, valve area (MD -0.07, 95% CI -0.28 to 0.14; participants = 127; studies = 2

Statins for aortic valve stenosis.

Science.gov (United States)

Thiago, Luciana; Tsuji, Selma Rumiko; Nyong, Jonathan; Puga, Maria Eduarda Dos Santos; Góis, Aécio Flávio Teixeira de; Macedo, Cristiane Rufino; Valente, Orsine; Atallah, Álvaro Nagib

2016-01-01

Aortic valve stenosis is the most common type of valvular heart disease in the USA and Europe. Aortic valve stenosis is considered similar to atherosclerotic disease. Some studies have evaluated statins for aortic valve stenosis. To evaluate the effectiveness and safety of statins in aortic valve stenosis. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, LILACS - IBECS, Web of Science and CINAHL Plus. These databases were searched from their inception to 24 November 2015. We also searched trials in registers for ongoing trials. We used no language restrictions.Selection criteria: Randomized controlled clinical trials (RCTs) comparing statins alone or in association with other systemic drugs to reduce cholesterol levels versus placebo or usual care. Data collection and analysis: Primary outcomes were severity of aortic valve stenosis (evaluated by echocardiographic criteria: mean pressure gradient, valve area and aortic jet velocity), freedom from valve replacement and death from cardiovascular cause. Secondary outcomes were hospitalization for any reason, overall mortality, adverse events and patient quality of life.Two review authors independently selected trials for inclusion, extracted data and assessed the risk of bias. The GRADE methodology was employed to assess the quality of result findings and the GRADE profiler (GRADEPRO) was used to import data from Review Manager 5.3 to create a 'Summary of findings' table. We included four RCTs with 2360 participants comparing statins (1185 participants) with placebo (1175 participants). We found low-quality evidence for our primary outcome of severity of aortic valve stenosis, evaluated by mean pressure gradient (mean difference (MD) -0.54, 95% confidence interval (CI) -1.88 to 0.80; participants = 1935; studies = 2), valve area (MD -0.07, 95% CI -0.28 to 0.14; participants = 127; studies = 2), and aortic jet velocity (MD -0.06, 95% CI -0.26 to 0

Textile for heart valve prostheses: fabric long-term durability testing.

Science.gov (United States)

Heim, Frederic; Durand, Bernard; Chakfe, Nabil

2010-01-01

The rapid developments and success in percutaneous vascular surgery over the last two decades with the now common stent grafts implantation, make the noninvasive surgery technique today attractive even for heart valve replacement. Less traumatic for the patient and also less time consuming, percutaneous heart valve replacement is however at its beginning and restricted to end of life patients. The noninvasive procedure expects from the heart valve prosthesis material to be resistant and adapted to folding requirements of the implantation process (catheter). Polyester fabric could be a suited material for heart valve implanted percutaneously. Highly flexible and resistant, polyester fabric proved to be well adapted to the dynamic behavior of a valve and polyester (Dacron) is also widely used for vascular grafts implantation and shows good biocompatibility and durability. However, today there's no data available on long-term durability of fabric used as heart valve material. The purpose of this work is to study the long term behavior of a microdenier polyester fabric construction under combined in vitro flexure and tension fatigue stress. In the novel in vitro testing technique presented, a fabric specimen was subjected to combined flexural and tensile fatigue generated by fluid flow under physiological pressure conditions. The results obtained show how flexural properties change with fatigue time, which reflects directly on the suitability of a fabric in such devices. It was also observed that these fabric structural changes directly influence the in vitro behavior of the textile heart valve prosthesis. (c) 2009 Wiley Periodicals, Inc.

Ministernotomy: A preliminary experience in heart valve surgery

Directory of Open Access Journals (Sweden)

Kovačević Pavle

2011-01-01

Full Text Available Background/Aim. The last decade of the 20th century brought up a significant development in the field of minimally invasive approaches to the valvular heart surgery. Potential benefits of this method are: good esthetic appearance, reduced pain, reduction of postoperative hemorrhage and incidence of surgical site infection, shorter postoperative intensive care units (ICU period and overall in-hospital period. Partial upper median sternotomy currently presents as a state-of-the art method for minimally invasive surgery of cardiac valves. The aim of this study was to report on initial experience in application of this surgical method in the surgery of mitral and aortic valves. Methods. The study was designed and conducted in a prospective manner and included all the patients who underwent minimally invasive cardiac valve surgery through the partial upper median sternotomy during the period November 2008 - August 2009. We analyzed the data on mean age of patients, mean extubation time, mean postoperative drainage, mean duration of hospital stay, as well as on occurance of postoperative complications (postoperative bleeding, surgical site infection and cerebrovascular insult. Results. During the observed period, in the Institute for Cardiovascular Diseases of Vojvodina, Clinic for Cardiovascular Surgery, 17 ministernotomies were performed, with 14 aortic valve replacements (82.35% and 3 mitral valve replacements (17.65%. Mean age of the patients was 60.78 ± 12.99 years (64.71% males, 35.29% females. Mean extubation time was 12.53 ± 8.87 hours with 23.5% of the patients extubated in less than 8 hours. Mean duration of hospital stay was 12.35 ± 10.17 days (in 29.4% of the patients less than 8 days. Mean postoperative drainage was 547.06 ± 335.2 mL. Postoperative complications included: bleeding (5.88% and cerebrovascular insult (5.88%. One patient (5.88% required conversion to full sternotomy. Conclusion. Partial upper median sternotomy represents

Adaptation to Physical Disabilities: The Role of Meaning in Life and Depression

Directory of Open Access Journals (Sweden)

Evangelia Psarra

2013-03-01

Full Text Available Depression is one of the most frequent psychological symptoms in people with physical disabilities, as the acquisition of a physical disability is a stressful situation, demanding an individual’s adjustment to a new distressing reality. While some individuals manage to adapt to their physical disability’s implications, others fail to accept this new situation, manifesting depressive symptoms. One factor that seems to facilitate adaptation process to physical disabilities and thus prevent from depression prevalence is meaning of life. Viktor Frankl has emphasized the importance of experiencing meaning of life in the maintenance of physical and psychological health, especially in painful and distressing situations. The present study focused initially on the assessment of meaning in life and depressive symptomatology in individuals with physical disabilities. Moreover, the relationship of meaning in life and depression with adaptation to physical disability was examined. A sample of 522 participants with various types of physical disabilities completed three questionnaires on depressive symptomatology, meaning in life and adaptation to disability. Our assumptions regarding the negative relationship between meaning of life and depression were confirmed. Additionally, meaning of life was found, as expected, to play in important role in facilitating individuals’ adaptation to their physical disabilities, a finding indicating the great utility of Frankl’s existential theory as a psychotherapeutic tool for people with physical disabilities.

Lymphangiogenesis is increased in heart valve endocarditis.

Science.gov (United States)

Niinimäki, Eetu; Mennander, Ari A; Paavonen, Timo; Kholová, Ivana

2016-09-15

Inflammation-associated lymphangiogenesis (IAL) has been identified as part of several acute and chronic inflammation. Sparse data exist on lymphatics during endocarditis. Fifty-two patients with surgically resected valves were included. Endocarditis was present in 18 aortic and 10 mitral valves. Controls consisted of 15 degenerative aortic and 9 degenerative mitral valves. There were 22 males with endocarditis and 17 males in controls. The mean age was 58 (SD 15) years with endocarditis vs. 62 (SD 13) years for controls. Lymphatics were detected by podoplanin antibody immunohistochemistry and morphometrical analysis was performed. The lymphatic density in endocarditis was 833 (SD 529) vessels/mm(2) (range 0-1707) as compared with 39 (SD 60) vessels/mm(2) (range 0-250) in controls (p=0.000). In endocarditis, the mean lymphatic size was 153 (SD 372) μm(2) ranging from 1 to 2034μm(2), whereas it was 30 (SD 29) μm(2), with maximum 90μm(2) and minimum 2μm(2) in controls (p=0.000). IAL is increased in valves with endocarditis as compared with controls. Lymphatics in heart valves may provide a novel means for treatment strategies against endocarditis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Adaptive Sliding Mode Control for Hydraulic Drives

DEFF Research Database (Denmark)

Schmidt, Lasse; Andersen, Torben Ole; Pedersen, Henrik C.

2013-01-01

This paper presents a new adaptive sliding mode controller generally applicable for position tracking control of electro-hydraulic valve-cylinder drives (VCD’s). The proposed control scheme requires limited knowledge on system parameters, and employs only piston- and valve spool position feedback...... employing parameter adaption through a recursive algorithm is presented. This is based on a reduced order model approximation of a VCD with unmatched valve flow- and cylinder asymmetries. Bounds on parameters are obtained despite lack of parameter knowledge, and the proposed controller demonstrates improved...

Unicuspid aortic valve disease: a magnetic resonance imaging study

International Nuclear Information System (INIS)

Debl, K.; Buchner, S.; Heinicke, N.; Riegger, G.; Luchner, A.; Djavidani, B.; Poschenrieder, F.; Feuerbach, S.; Schmid, C.; Kobuch, R.

2008-01-01

Purpose: congenitally malformed aortic valves are a common finding in adults with aortic valve disease. Most of these patients have bicuspid aortic valve disease. Unicuspid aortic valve disease (UAV) is rare. The aim of our study was to describe valve morphology and the dimensions of the proximal aorta in a cohort of 12 patients with UAV in comparison to tricuspid aortic valve disease (TAV) using magnetic resonance imaging (MRI). Materials and methods/results: MRI studies were performed on a 1.5 T scanner in a total of 288 consecutive patients with aortic valve disease. 12 aortic valves were retrospectively classified as UAV. Annulus areas and dimensions of the thoracic aorta were retrospectively compared to a cohort of 103 patients with TAV. In UAV, valve morphology was unicuspid unicommissural with a posterior commissure in all patients. Mean annulus areas and mean diameters of the ascending aorta were significantly greater in UAV compared to TAV (12.6 ± 4.7 cm 2 vs. 8.7 ± 2.3 cm 2 , p < 0.01 and 4.6 ± 0.7 cm vs. 3.6 ± 0.5 cm, p < 0.0001, respectively), while no differences were observed in the mean diameters of the aortic arch (2.3 ± 0.6 cm vs. 2.3 ± 0.4 cm, p = 0.69). The diameters of the descending aorta were slightly smaller in UAV compared to TAV (2.2 ± 0.5 cm vs. 2.6 ± 0.3 cm, p < 0.05). (orig.)

ASME XI stroke time testing of solenoid valves at Connecticut Yankee Station

Energy Technology Data Exchange (ETDEWEB)

Martin, C.W.

1996-12-01

Connecticut Yankee Atomic Power Company has developed the capability of measuring the stroke times of AC and DC solenoid valves. This allows the station to measure the stroke time of any solenoid valve in the plant, even those valves which do not have valve stem position indicators. Connecticut Yankee has adapted the ITI MOVATS Checkmate 3 system, using a signal input from a Bruel and Kjaer (B&K) Model 4382 acoustic accelerometer and the Schaumberg Campbell Associates (SCA) Model SCA-1148 dual sensor, which is a combined accelerometer and gaussmeter.

ASME XI stroke time testing of solenoid valves at Connecticut Yankee Station

International Nuclear Information System (INIS)

Martin, C.W.

1996-01-01

Connecticut Yankee Atomic Power Company has developed the capability of measuring the stroke times of AC and DC solenoid valves. This allows the station to measure the stroke time of any solenoid valve in the plant, even those valves which do not have valve stem position indicators. Connecticut Yankee has adapted the ITI MOVATS Checkmate 3 system, using a signal input from a Bruel and Kjaer (B ampersand K) Model 4382 acoustic accelerometer and the Schaumberg Campbell Associates (SCA) Model SCA-1148 dual sensor, which is a combined accelerometer and gaussmeter

Modernizing the 5G 100/8 piston compressor by means of directly streaming valves

Energy Technology Data Exchange (ETDEWEB)

Tsvetanov, Ts.; Stoyanov, I.

1988-02-01

Deals with 5G 100/8 air compressors which, despite long service and lack of spare parts, are still widely used in Bulgarian underground coal mines. K-4-10 ring-type valves are in particularly short supply; maintenance engineers have been forced to modify the compresors. Initially, Bulgarian KP-3.1 valves with direct air streaming replaced the K-4-10; these were later replaced by PIK-220 and PIK-220A valves. Tests on overhauled compressors have shown that replacing the KP-3.1 with the PIK-220 or PIK-220A can result in a saving of up to 100,000 kWh of electricity per compressor. Details of reconstruction and testing of piston compressors are included. 10 refs.

Efficiency of aortic valve commissurotomy for congenital aortic valve stenosis in pediatric population

Directory of Open Access Journals (Sweden)

А. А. Лукьянов

2015-10-01

Full Text Available Background. This study was designed to evaluate short-term and long-term outcomes after open aortic valve commissurotomy in the pediatric patients at our center over a period of 10 years. Methods. A retrospective study of 94 patients who underwent open surgical commissurotomy because of aortic valve stenosis between 2003 and 2013 is presented. Follow-up time was in the range of 1 to 7 years. Results. The open aortic valve commissurotomy combined with debridement of leaflet free edge 36.1 %, LVOT myectomy 11.7%, leaflet suture plastic 7.4%, modified Konno procedure 6.3%, Brom's aortoplasty 4.2% was performed for all patients. Average cardiopulmonary bypass time was 59.2 30.7 min. Median aortic cross-clamping time was 31.52 15.1 min. Hospital complications were observed in 38.2% of cases. ICU time was in the range of 1 to 31 (mean 3.2 5.1 day. Artificial lung ventilation time varied from 2 to 76 (mean 15.3 18.3 hours. Inotropic support was needed in 26.5% of cases. Mean hospital stay time was 17.1 7.3 days. At follow-up between 2 and 7 years, reoperations were required for 3 patients who underwent a Ross procedure. Conclusions. The results evidence that open surgical commissurotomy is an effective way of treatment for aortic valve stenosis, considering the accuracy of plasty and additional techniques of leaflet correction. The best children age group for this type of operation is from first to five years of life.

Flow Rate Analysis of 3/2 Directional Pneumatic Valve by Means Of Ansys Cfx Software

Directory of Open Access Journals (Sweden)

Slawomir BLASIAK

2014-12-01

Full Text Available The main purpose of this paper was to develop a selection method of the pneumatic connectors for directional 3/2 valve. The method was established to minimize resistance and loss of pressure in the valve with mounted pneumatic connections for the selected pipe diameters. Directional valve was modeled in 3D CAD software SolidWorks while 3D models of the air connections have been downloaded from the website of one of the leading suppliers of pneumatic. Based on developed solid model the simulation of compressed air flow in the software for computational fluid dynamics Ansys CFX was conducted. The studies using CFD methods helped to determine which air connections best meet the assumptions. Performed numerical tests enable proper selection of items to the newly designed pneumatic systems for a particular group of valves. As a consequence, this translates into a reduction in energy consumption and improve the efficiency of the entire pneumatic complex system.

Depth of valve implantation, conduction disturbances and pacemaker implantation with CoreValve and CoreValve Accutrak system for Transcatheter Aortic Valve Implantation, a multi-center study.

Science.gov (United States)

Lenders, Guy D; Collas, Valérie; Hernandez, José Maria; Legrand, Victor; Danenberg, Haim D; den Heijer, Peter; Rodrigus, Inez E; Paelinck, Bernard P; Vrints, Christiaan J; Bosmans, Johan M

2014-10-20

Transcatheter Aortic Valve Implantation (TAVI) is now considered an indispensable treatment strategy in high operative risk patients with severe, symptomatic aortic stenosis. However, conduction disturbances and the need for Permanent Pacemaker (PPM) implantation after TAVI with the CoreValve prosthesis still remain frequent. We aimed to evaluate the implantation depth, the incidence and predictors of new conduction disturbances, and the need for PPM implantation within the first month after TAVI, using the new Accutrak CoreValve delivery system (ACV), compared to the previous generation CoreValve (non-ACV). In 5 experienced TAVI-centers, a total of 120 consecutive non-ACV and 112 consecutive ACV patients were included (n=232). The mean depth of valve implantation (DVI) was 8.4±4.0 mm in the non-ACV group and 7.1±4.0 mm in the ACV group (p=0.034). The combined incidence of new PPM implantation and new LBBB was 71.2% in the non-ACV group compared to 50.5% in the ACV group (p=0.014). DVI (p=0.002), first degree AV block (p=0.018) and RBBB (p<0.001) were independent predictors of PPM implantation. DVI (p<0.001) and pre-existing first degree AV-block (p=0.021) were identified as significant predictors of new LBBB. DVI is an independent predictor of TAVI-related conduction disturbances and can be reduced by using the newer CoreValve Accutrak delivery system, resulting in a significantly lower incidence of new LBBB and new PPM implantation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Postoperative Outcomes of Mitral Valve Repair for Mitral Restenosis after Percutaneous Balloon Mitral Valvotomy

Directory of Open Access Journals (Sweden)

Seong Lee

2015-10-01

Full Text Available Background: There have been a number of studies on mitral valve replacement and repeated percutaneous mitral balloon valvotomy for mitral valve restenosis after percutaneous mitral balloon valvotomy. However, studies on mitral valve repair for these patients are rare. In this study, we analyzed postoperative outcomes of mitral valve repair for mitral valve restenosis after percutaneous mitral balloon valvotomy. Methods: In this study, we assessed 15 patients (mean age, 47.7±9.7 years; 11 female and 4 male who underwent mitral valve repair between August 2008 and March 2013 for symptomatic mitral valve restenosis after percutaneous mitral balloon valvotomy. The mean interval between the initial percutaneous mitral balloon valvotomy and the mitral valve repair was 13.5±7 years. The mean preoperative Wilkins score was 9.4±2.6. Results: The mean mitral valve area obtained using planimetry increased from 1.16±0.16 cm2 to 1.62±0.34 cm2 (p=0.0001. The mean pressure half time obtained using Doppler ultrasound decreased from 202.4±58.6 ms to 152±50.2 ms (p=0.0001. The mean pressure gradient obtained using Doppler ultrasound decreased from 9.4±4.0 mmHg to 5.8±1.5 mmHg (p=0.0021. There were no early or late deaths. Thromboembolic events or infective endocarditis did not occur. Reoperations such as mitral valve repair or mitral valve replacement were not performed during the follow-up period (39±16 months. The 5-year event-free survival was 56.16% (95% confidence interval, 47.467–64.866. Conclusion: On the basis of these results, we could not conclude that mitral valve repair could be an alternative for patients with mitral valve restenosis after percutaneous balloon mitral valvotomy. However, some patients presented with results similar to those of mitral valve replacement. Further studies including more patients with long-term follow-up are necessary to determine the possibility of this application of mitral valve repair.

Check valves aging assessment

International Nuclear Information System (INIS)

Haynes, H.D.

1991-01-01

In support of the NRC Nuclear Plant Aging Research (NPAR) program, the Oak Ridge National Laboratory (ORNL) has carried out an assessment of several check value diagnostic monitoring methods, in particular, those based on measurements of acoustic emission, ultrasonics, and magnetic flux. The evaluations have focussed on the capabilities of each method to provide information useful in determining check valve aging and service wear effects, check valve failures, and undesirable operating modes. This paper describes the benefits and limitations associated with each method and includes recent laboratory and field test data, including data obtained from the vendors who recently participated in a comprehensive series of tests directed by a nuclear industry users group. In addition, as part of the ORNL Advanced Diagnostic Engineering Research and Development Center (ADEC), two novel nonintrusive monitoring methods were developed that provide several unique capabilities. These methods, based on external ac- an dc-magnetic monitoring are also described. None of the examined methods could, by themselves, monitor both the instantaneous position and motion of check valve internals and valve leakage; however, the combination of acoustic emission monitoring with one of the other methods provides the means to determine vital check valve operational information

Fabrication of micro metallic valve and pump

Science.gov (United States)

Yang, Ming; Kabasawa, Yasunari; Ito, Kuniyoshi

2010-03-01

Fabrication of micro devices by using micro metal forming was proposed by the authors. We developed a desktop servo-press machine with precise tooling system. Precise press forming processes including micro forging and micro joining has been carried out in a progressive die. In this study, micro metallic valve and pump were fabricated by using the precise press forming. The components are made of sheet metals, and assembled in to a unit in the progressive die. A micro check-valve with a diameter of 3mm and a length of 3.2mm was fabricated, and the property of flow resistance was evaluated. The results show that the check valve has high property of leakage proof. Since the valve is a unit parts with dimensions of several millimeters, it has advantage to be adapted to various pump design. Here, two kinds of micro pumps with the check-valves were fabricated. One is diaphragm pump actuated by vibration of the diaphragm, and another is tube-shaped pump actuated by resonation. The flow quantities of the pumps were evaluated and the results show that both of the pumps have high pumping performance.

Isolating valve, especially in main-steam pipes of power plants

International Nuclear Information System (INIS)

Karpenko, A.N.

1977-01-01

The valve for PWRs and BWRs, with diameters up to 1.25 m, for temperatures from -180 0 C to about 600 0 C and pressures up to over 50 bar, is designed for high reliability and long useful life. Two circular valve discs are moved as isolating elements in their plane across the steam direction and brought before the valve seat within a valve chamber. Shortly before reaching this final position, each disc is rotated by a small amount about its axis. Only after reaching the final position a double-wedge, further pushed forward between both discs, produces the necessary contact pressure. By revolving and frictionless closing caking together at high stresses and temperature variation is prevented and permanent tightness assured. The valve body is moved in a cylinder, cast on the valve housing, by means of a stepped piston. Its larger diameter is guided in a second cylinder flanged on above. In the cover of the second cylinder a pilot valve is mounted being controlled over 2 parallel solenoid valves by means of compressed air. In normal operation process steam from the valve chamber serves to move the stepped piston with the valve chamber. On closing of a bore, connecting both cylinder spaces, by the pilot valve the main valve is opened. If the pilot valve is opened the steam through the connecting bore is acting on both piston stages and closing the main valve. On loss of steam (pipe break) or for testing purposes one or the other cylinder space over solenoid valves is acted upon by auxiliary energy or evacuated, the main valve thus being controlled. (HP) [de

Plastik på trikuspidalklappen (Tricuspid valve annuloplasty. The neglected valve)

DEFF Research Database (Denmark)

Pedersen, Thais A L; Wierup, Per; Pedersen, Lia Mendes

2010-01-01

INTRODUCTION: Tricuspid valve regurgitation (TVR) is often secondary to left-sided or congenital heart disease (CHD). Surgical correction of TVR is indicated when the primary abnormalities require operation. MATERIAL AND METHODS: Retrospective analysis of all 50 patients (mean age: 65 years (rang...

Reduced-impact sliding pressure control valve for pneumatic hammer drill

Science.gov (United States)

Polsky, Yarom [Oak Ridge, TN; Grubelich, Mark C [Albuquerque, NM; Vaughn, Mark R [Albuquerque, NM

2012-05-15

A method and means of minimizing the effect of elastic valve recoil in impact applications, such as percussive drilling, where sliding spool valves used inside the percussive device are subject to poor positioning control due to elastic recoil effects experienced when the valve impacts a stroke limiting surface. The improved valve design reduces the reflected velocity of the valve by using either an energy damping material, or a valve assembly with internal damping built-in, to dissipate the compression stress wave produced during impact.

Transfemoral implantation of an Edwards SAPIEN valve in a tricuspid bioprosthesis without fluoroscopic landmarks.

Science.gov (United States)

Calvert, Patrick A; Himbert, Dominique; Brochet, Eric; Radu, Costin; Iung, Bernard; Hvass, Ulrik; Darondel, Jean-Marc; Depoix, Jean-Pol; Nataf, Patrick; Vahanian, Alec

2012-03-01

We describe the first report of an Edwards SAPIEN valve implanted in a tricuspid bioprosthesis from the femoral vein. We highlight the feasibility of this previously avoided approach and the techniques involved. A 61-year-old woman with multiple valve replacements for rheumatic heart disease presented with NHYA IV dyspnoea secondary to a severely stenosed tricuspid bioprosthesis. After failed aggressive medical therapy and surgical turn down, an Edwards SAPIEN XT valve was deployed in the tricuspid bioprosthesis via the right femoral vein. Adaptations to the standard transfemoral transcatheter aortic valve implantation (TAVI) technique included: (1) crossing the tricuspid bioprosthesis with a balloon floatation catheter; (2) temporary pacing wire in the coronary sinus rather than the right ventricle; (3) mounting of the SAPIEN XT valve in the reverse orientation to transfemoral TAVI; and (4) fine positioning of the final valve position pre-deployment by 3D transoesophageal echocardiography (3D TOE) alone due to complete radiolucency of the tricuspid bioprosthesis. The procedure was completed without complication and resulted in significant symptomatic improvement. Deployment of an Edwards SAPIEN valve in a tricuspid bioprosthesis via the femoral vein is feasible and, with careful adaptations to established TAVI techniques, can be performed without complications and with good clinical response.

Transcatheter aortic valve implantation for failing surgical aortic bioprosthetic valve: from concept to clinical application and evaluation (part 2).

Science.gov (United States)

Piazza, Nicolo; Bleiziffer, Sabine; Brockmann, Gernot; Hendrick, Ruge; Deutsch, Marcus-André; Opitz, Anke; Mazzitelli, Domenico; Tassani-Prell, Peter; Schreiber, Christian; Lange, Rüdiger

2011-07-01

This study sought to review the acute procedural outcomes of patients who underwent transcatheter aortic valve (TAV)-in-surgical aortic valve (SAV) implantation at the German Heart Center, Munich, and to summarize the existing literature on TAV-in-SAV implantation (n = 47). There are several case reports and small case series describing transcatheter aortic valve implantation for a failing surgical aortic valve bioprosthesis (TAV-in-SAV implantation). From January 2007 to March 2011, 20 out of 556 patients underwent a TAV-in-SAV implantation at the German Heart Center Munich. Baseline characteristics and clinical outcome data were prospectively entered into a dedicated database. The mean patient age was 75 ± 13 years, and the mean logistic European System for Cardiac Operative Risk Evaluation and Society of Thoracic Surgeons' Risk Model scores were 27 ± 13% and 7 ± 4%, respectively. Of the 20 patients, 14 had stented and 6 had stentless surgical bioprostheses. Most cases (12 of 20) were performed via the transapical route using a 23-mm Edwards Sapien prosthesis (Edwards Lifesciences, Irvine, California). Successful implantation of a TAV in a SAV with the patient leaving the catheterization laboratory alive was achieved in 18 of 20 patients. The mean transaortic valve gradient was 20.0 ± 7.5 mm Hg. None-to-trivial, mild, and mild-to-moderate paravalvular aortic regurgitation was observed in 10, 6, and 2 patients, respectively. We experienced 1 intraprocedural death following pre-implant balloon aortic valvuloplasty ("stone heart") and 2 further in-hospital deaths due to myocardial infarction. TAV-in-SAV implantation is a safe and feasible treatment for high-risk patients with failing aortic bioprosthetic valves and should be considered as part of the armamentarium in the treatment of aortic bioprosthetic valve failure. Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Aortic Regurgitation in Patients Undergoing Transcatheter Aortic Valve Replacement With the Self-Expanding CoreValve Versus the Balloon-Expandable SAPIEN XT Valve.

Science.gov (United States)

Kiramijyan, Sarkis; Magalhaes, Marco A; Koifman, Edward; Didier, Romain; Escarcega, Ricardo O; Baker, Nevin C; Negi, Smita I; Minha, Sa'ar; Torguson, Rebecca; Jiaxiang, Gai; Asch, Federico M; Wang, Zuyue; Okubagzi, Petros; Gaglia, Michael A; Ben-Dor, Itsik; Satler, Lowell F; Pichard, Augusto D; Waksman, Ron

2016-05-01

The incidence of aortic regurgitation (AR) after transcatheter aortic valve replacement (TAVR) in a self-expanding and a balloon-expandable system is controversial. This study aimed to examine the incidence and severity of post-TAVR AR with the CoreValve (CV) versus the Edwards XT Valve (XT). Baseline, procedural, and postprocedural inhospital outcomes were compared. The primary end point was the incidence of post-TAVR AR of any severity, assessed with a transthoracic echocardiogram, in the CV versus XT groups. A multivariate logistic regression analysis was completed to evaluate for correlates of the primary end point. The secondary end points included the change in severity of AR at 30-day and 1-year follow-up. A total of 223 consecutive patients (53% men, mean age 82 years) who had transfemoral TAVR with either a CV (n = 119) or XT (n = 104) were evaluated. The rates of post-TAVR AR in the groups were similar, and there was no evidence of more-than-moderate AR in either group. There were significant differences in the rates of intraprocedural balloon postdilation with the CV (17.1%) versus XT valve (5.8%; p = 0.009) and in the rates of intraprocedural implantation of a second valve-in-valve prosthesis with the CV (9.9%) versus XT valve (2.2%; p = 0.036). There were no significant differences in inhospital safety outcomes between the 2 groups. In conclusion, the incidence of post-TAVR AR is similar between the CV and the XT valve when performed by experienced operators using optimal intraprocedural strategies, as deemed appropriate, to mitigate the severity of AR. Copyright © 2016 Elsevier Inc. All rights reserved.

Fracturing mechanics before valve-in-valve therapy of small aortic bioprosthetic heart valves.

Science.gov (United States)

Johansen, Peter; Engholt, Henrik; Tang, Mariann; Nybo, Rasmus F; Rasmussen, Per D; Nielsen-Kudsk, Jens Erik

2017-10-13

Patients with degraded bioprosthetic heart valves (BHV) who are not candidates for valve replacement may benefit from transcatheter valve-in-valve (VIV) therapy. However, in smaller-sized surgical BHV the resultant orifice may become too narrow. To overcome this, the valve frame can be fractured by a high-pressure balloon prior to VIV. However, knowledge on fracture pressures and mechanics are prerequisites. The aim of this study was to identify the fracture pressures needed in BHV, and to describe the fracture mechanics. Commonly used BHV of small sizes were mounted on a high-pressure balloon situated in a biplane fluoroscopic system with a high-speed camera. The instant of fracture was captured along with the balloon pressure. The valves were inspected for material protrusion and later dissected for fracture zone investigation and description. The valves with a polymer frame fractured at a lower pressure (8-10 atm) than those with a metal stent (19-26 atm). None of the fractured valves had elements protruding. VIV procedures in small-sized BHV may be performed after prior fracture of the valve frame by high-pressure balloon dilatation. This study provides tentative guidelines for expected balloon sizes and pressures for valve fracturing.

Radial Force: An Underestimated Parameter in Oversizing Transcatheter Aortic Valve Replacement Prostheses: In Vitro Analysis with Five Commercialized Valves.

Science.gov (United States)

Egron, Sandrine; Fujita, Buntaro; Gullón, Lucía; Désirée, Pott; Schmitz-Rode, Thomas; Ensminger, Stephan; Steinseifer, Ulrich

2017-09-05

The goal is to inform in depth on transcatheter aortic valve replacement (TAVR) prosthesis mechanical behavior, depending on frame type, design, and size, and how it crucially impacts the oversizing issue in clinical use, and ultimately the procedure outcome. Transcatheter aortic valve replacement is an established therapy for high-risk patients suffering from aortic stenosis, and the indication for TAVR is progressively expanding to intermediate-risk patients. Choosing the optimal oversizing degree is crucial to safely anchor the TAVR valve-which involves limiting the risks for embolism, aortic regurgitation, conductance disturbance, or annulus rupture-and to increase the valve prosthesis performance. The radial force (RF) profiles of five TAVR prostheses were measured in vitro: the CoreValve 23 and 26 (Medtronic, MN), the Acurate neo S (Symetis, Switzerland), and the SAPIEN XT 23 and 26 (Edwards Lifesciences, CA). Measurements were run with the RX Machine equipment (Machine Solutions Inc., AZ), which is used in ISO standard tests for intravascular stents. Test protocols were adapted for TAVR prostheses. With the prostheses RF profiles' results, mechanical behavior differences could be described and discussed in terms of oversizing strategy and clinical impact for all five valves. Besides, crossing the prostheses' RF profiles with their recommended size windows made the assessment of borderline size cases possible and helped analyze the risks when accurate measurement of patient aortic annulus proves difficult. The prostheses' RF profiles bring new support in clinical decision-making for valve type and size in patients.

A STUDY OF INDICATIONS, COMPLICATIONS OF PROSTHETIC VALVES AND PROGNOSIS AFTER TREATMENT OF STUCK VALVE

Directory of Open Access Journals (Sweden)

Y. V. Subba Reddy

2017-03-01

Full Text Available BACKGROUND Implantation of prosthetic cardiac valves to treat haemodynamically significant valvular diseases has become common; however, it is associated with complications. Thus, this study was intended to evaluate the indications for implantation of prosthetic valve and complications after its implantation and prognosis after treatment of one of its complication, i.e. stuck valve. MATERIALS AND METHODS This was a single-centered study wherein 50 patients who came to the emergency department with stuck valve were assessed. The 2D echocardiography was performed in all patients. Thrombolysis was done and the gradients were reassessed. Further response to treatment and development of complications before and after treatment were observed. RESULTS Of total patients, 60% were females. Mean age group was 30-40 yrs. Most of them were asymptomatic for 6 years and there was lack of compliance in 90% of patients. Most common indication for valve replacement was mitral stenosis (60% followed by mitral regurgitation (20%, aortic regurgitation and aortic stenosis (10% and combined mitral and tricuspid regurgitation (10%. Commonest valve was St. Jude (90%. Pannus was observed in 10% patients and thrombus was observed in 50% patients. Most patients had gradients 45/20 mmHg across mitral valve. In about 90% patients, gradients decreased after thrombolysis (12/5 mmHg. The complications after thrombolysis were hemiparesis (4%, death before thrombolysis (6% and death after thrombolysis (4%. CONCLUSION Considering these results, it can be concluded that prosthetic valves are seldom associated with some complications. Further, thrombolysis can be effective in patients with prosthetic valve thrombosis.

First report on a human percutaneous transluminal implantation of a self-expanding valve prosthesis for interventional treatment of aortic valve stenosis.

Science.gov (United States)

Grube, Eberhard; Laborde, Jean C; Zickmann, Bernfried; Gerckens, Ulrich; Felderhoff, Thomas; Sauren, Barthel; Bootsveld, Andreas; Buellesfeld, Lutz; Iversen, Stein

2005-12-01

Percutaneous aortic valve replacement is a new technology for the treatment of patients with significant aortic valve stenosis. We present the first report on a human implantation of a self-expanding aortic valve prosthesis, which is composed of three bovine pericardial leaflets inserted within a self-expanding nitinol stent. The 73-year-old woman presented with severe symptomatic aortic valve stenosis (mean transvalvular gradient of 45 mmHg; valve area of 0.7 cm2). Surgical valve replacement had been declined for the patient because of comorbidities, including previous bypass surgery. A retrograde approach via the common iliac artery was used for valve deployment. The contralateral femoral vessels were used for a temporary extracorporal circulation, unloading the left ventricle during the actual stent expansion. Clinical, hemodynamic, and echocardiographic outcomes were assessed serially during the procedure. Clinical and echocardiographic follow-up at day 1, 2, and 14 post procedure was performed to evaluate the short-term outcome. The prosthesis was successfully deployed within the native aortic valve, with accurate and stable positioning and with no impairment of the coronary artery or vein graft blood flow. 2D and doppler echo immediately after device deployment showed a significant reduction in transaortic mean pressure gradient (from 45 to 8 mmHg) without evidence of aortic or mitral valve insufficiency. The clinical status has then significantly improved. These results remained unchanged up to the day 14 follow-up. This case report demonstrates a successful percutaneous implantation of a self-expanding aortic valve prosthesis with remarkable functional and clinical improvements in the acute and short-term outcome. Copyright (c) 2005 Wiley-Liss, Inc.

Myocardial Infarction Alters Adaptation of the Tethered Mitral Valve

NARCIS (Netherlands)

Dal-Bianco, Jacob P; Aikawa, Elena; Bischoff, Joyce; Guerrero, J Luis; Hjortnaes, Jesper; Beaudoin, Jonathan; Szymanski, Catherine; Bartko, Philipp E; Seybolt, Margo M; Handschumacher, Mark D; Sullivan, Suzanne; Garcia, Michael L; Mauskapf, Adam; Titus, James S; Wylie-Sears, Jill; Irvin, Whitney S; Chaput, Miguel; Messas, Emmanuel; Hagège, Albert A; Carpentier, Alain; Levine, Robert A

2016-01-01

BACKGROUND: In patients with myocardial infarction (MI), leaflet tethering by displaced papillary muscles induces mitral regurgitation (MR), which doubles mortality. Mitral valves (MVs) are larger in such patients but fibrosis sets in counterproductively. The investigators previously reported that

Experimental investigations on the fluid-mechanics of an electrospun heart valve by means of particle image velocimetry.

Science.gov (United States)

Del Gaudio, Costantino; Gasbarroni, Pier Luca; Romano, Giovanni Paolo

2016-12-01

End-stage failing heart valves are currently replaced by mechanical or biological prostheses. Both types positively contribute to restore the physiological function of native valves, but a number of drawbacks limits the expected performances. In order to improve the outcome, tissue engineering can offer an alternative approach to design and fabricate innovative heart valves capable to support the requested function and to promote the formation of a novel, viable and correctly operating physiological structure. This potential result is particularly critical if referred to the aortic valve, being the one mainly exposed to structural and functional degeneration. In this regard, the here proposed study presents the fabrication and in vitro characterization of a bioresorbable electrospun heart valve prosthesis using the particle image velocimetry technique either in physiological and pathological fluid dynamic conditions. The scaffold was designed to reproduce the aortic valve geometry, also mimicking the fibrous structure of the natural extracellular matrix. To evaluate its performances for possible implantation, the flow fields downstream the valve were accurately investigated and compared. The experimental results showed a correct functionality of the device, supported by the formation of vortex structures at the edge of the three cusps, with Reynolds stress values below the threshold for the risk of hemolysis (which can be comprised in the range 400-4000N/m(2) depending on the exposure period), and a good structural resistance to the mechanical loads generated by the driving pressure difference. Copyright © 2016 Elsevier Ltd. All rights reserved.

Aortic root surgery in Marfan syndrome: Bentall procedure with the composite mechanical valved conduit versus aortic valve reimplantation with Valsalva graft.

Science.gov (United States)

Nardi, Paolo; Pellegrino, Antonio; Versaci, Francesco; Mantione, Ludmilla; Polisca, Patrizio; Iorio, Fiore S; Chiariello, Luigi

2010-09-01

The aim of the study is to compare mid-term results of Bentall aortic root replacement with composite mechanical valved conduit and aortic valve reimplantation procedure using the Valsalva graft for the treatment of aortic root aneurysm in patients with Marfan syndrome. We retrospectively compared data of 23 patients (mean age 38 + or - 14 years) who had undergone the Bentall procedure (group B) to those of 24 patients (mean age 36 + or - 12 years) who had undergone aortic valve reimplantation (group R) during a 14-year period. Follow-up (mean duration 65 + or - 44 months) was 100% complete. There were no operative deaths in either group. In group B, as compared with group R, preoperative aortic insufficiency (3.2 + or - 1.1/4 vs. 1.7 + or - 1.4/4, P Marfan patients, the Bentall procedure is associated with excellent mid-term outcome. The reimplantation technique, adopted for less dilated aortas, provides similarly satisfactory results. The Valsalva graft seems, with time, to allow a stable aortic valve function.

Check valve

Science.gov (United States)

Upton, H.A.; Garcia, P.

1999-08-24

A check valve for use in a GDCS of a nuclear reactor and having a motor driven disk including a rotatable armature for rotating the check valve disk over its entire range of motion is described. In one embodiment, the check valve includes a valve body having a coolant flow channel extending therethrough. The coolant flow channel includes an inlet end and an outlet end. A valve body seat is located on an inner surface of the valve body. The check valve further includes a disk assembly, sometimes referred to as the motor driven disc, having a counterweight and a disk shaped valve. The disk valve includes a disk base having a seat for seating with the valve body seat. The disk assembly further includes a first hinge pin member which extends at least partially through the disk assembly and is engaged to the disk. The disk valve is rotatable relative to the first hinge pin member. The check valve also includes a motor having a stator frame with a stator bore therein. An armature is rotatably positioned within the stator bore and the armature is coupled to the disk valve to cause the disk valve to rotate about its full range of motion. 5 figs.

Check valve

International Nuclear Information System (INIS)

Upton, H.A.; Garcia, P.

1999-01-01

A check valve for use in a GDCS of a nuclear reactor and having a motor driven disk including a rotatable armature for rotating the check valve disk over its entire range of motion is described. In one embodiment, the check valve includes a valve body having a coolant flow channel extending therethrough. The coolant flow channel includes an inlet end and an outlet end. A valve body seat is located on an inner surface of the valve body. The check valve further includes a disk assembly, sometimes referred to as the motor driven disc, having a counterweight and a disk shaped valve. The disk valve includes a disk base having a seat for seating with the valve body seat. The disk assembly further includes a first hinge pin member which extends at least partially through the disk assembly and is engaged to the disk. The disk valve is rotatable relative to the first hinge pin member. The check valve also includes a motor having a stator frame with a stator bore therein. An armature is rotatably positioned within the stator bore and the armature is coupled to the disk valve to cause the disk valve to rotate about its full range of motion. 5 figs

Adaptive Noise Canceling Menggunakan Algoritma Least Mean Square (Lms)

OpenAIRE

Nardiana, Anita; Sumaryono, Sari Sujoko

2011-01-01

Noise is inevitable in communication system. In some cases, noise can disturb signal. It is veryannoying as the received signal is jumbled with the noise itself. To reduce or remove noise, filter lowpass,highpass or bandpass can solve the problems, but this method cannot reach a maximum standard. One ofthe alternatives to solve the problem is by using adaptive filter. Adaptive algorithm frequently used is LeastMean Square (LMS) Algorithm which is compatible to Finite Impulse Response (FIR). T...

Degenerative processes in bioprosthetic mitral valves in juvenile pigs

Directory of Open Access Journals (Sweden)

Pedersen Torben B

2011-05-01

Full Text Available Abstract Background Glutaraldehyde-treated bioprosthetic heart valves are commonly used for replacement of diseased heart valves. However, calcification and wear limit their durability, and the development of new and improved bioprosthetic valve designs is needed and must be evaluated in a reliable animal model. We studied glutaraldehyde-treated valves 6 months after implantation to evaluate bioprosthetic valve complications in the mitral position in juvenile pigs. Materials The study material comprised eight, 5-month old, 60-kg pigs. All pigs received a size 27, glutaraldehyde-treated, stented, Carpentier-Edwards S.A.V. mitral valve prosthesis. After six months, echocardiography was performed, and the valves explanted for gross examination, high resolution X-ray, and histological evaluation. Results Five pigs survived the follow-up period. Preexplant echocardiography revealed a median peak and mean velocity of 1.61 m/s (range: 1.17-2.00 and 1.20 (SD = ±0.25, respectively, and a median peak and mean pressure difference of 10.42 mmHg (range: 5.83-16.55 and 6.51 mmHg (SD = ±2.57, respectively. Gross examination showed minor thrombotic depositions at two commissures in two valves and at all three commissures in three valves. High resolution X-ray imaging revealed different degrees of calcification in all explanted valves, primarily in the commissural and belly areas. In all valves, histological evaluation demonstrated various degrees of fibrous sheath formation, limited immunological infiltration, and no overgrowth of host endothelium. Conclusions Bioprosthetic glutaraldehyde-treated mitral valves can be implanted into the mitral position in pigs and function after 6 months. Echocardiographic data, calcification, and histological examinations were comparable to results obtained in sheep models and human demonstrating the suitability of the porcine model.

NRC valve performance test program - check valve testing

International Nuclear Information System (INIS)

Jeanmougin, N.M.

1987-01-01

The Valve Performance Test Program addresses the current requirements for testing of pressure isolation valves (PIVs) in light water reactors. Leak rate monitoring is the current method used by operating commercial power plants to survey the condition of their PIVs. ETEC testing of three check valves (4-inch, 6-inch, and 12-inch nominal diameters) indicates that leak rate testing is not a reliable method for detecting impending valve failure. Acoustic emission monitoring of check valves shows promise as a method of detecting loosened internals damage. Future efforts will focus on evaluation of acoustic emission monitoring as a technique for determining check valve condition. Three gate valves also will be tested to evaluate whether the check valve results are applicable to gate type PIVs

Transcatheter, valve-in-valve transapical aortic and mitral valve implantation, in a high risk patient with aortic and mitral prosthetic valve stenoses

Directory of Open Access Journals (Sweden)

Harish Ramakrishna

2015-01-01

Full Text Available Transcatheter valve implantation continues to grow worldwide and has been used principally for the nonsurgical management of native aortic valvular disease-as a potentially less invasive method of valve replacement in high-risk and inoperable patients with severe aortic valve stenosis. Given the burden of valvular heart disease in the general population and the increasing numbers of patients who have had previous valve operations, we are now seeing a growing number of high-risk patients presenting with prosthetic valve stenosis, who are not potential surgical candidates. For this high-risk subset transcatheter valve delivery may be the only option. Here, we present an inoperable patient with severe, prosthetic valve aortic and mitral stenosis who was successfully treated with a trans catheter based approach, with a valve-in-valve implantation procedure of both aortic and mitral valves.

Transcatheter Replacement of Failed Bioprosthetic Valves

DEFF Research Database (Denmark)

Simonato, Matheus; Webb, John; Kornowski, Ran

2016-01-01

postprocedural gradients (mean >= 20 mm Hg). Optimal implantation depths were defined by receiver operating characteristic curve. A total of 292 consecutive patients (age, 78.9 +/- 8.7 years; 60.3% male; 157 CoreValve Evolut and 135 Sapien XT) were evaluated. High implantation was associated with significantly...... lower rates of elevated gradients in comparison with low implantation (CoreValve Evolut, 15% versus 34.2%; P=0.03 and Sapien XT, 18.5% versus 43.5%; P=0.03, respectively). Optimal implantation depths were defined: CoreValve Evolut, 0 to 5 mm; Sapien XT, 0 to 2 mm (0-10% frame height); sensitivities, 91...

Reoperation for non-structural valvular dysfunction caused by pannus ingrowth in aortic valve prosthesis.

Science.gov (United States)

Oh, Se Jin; Park, Samina; Kim, Jun Sung; Kim, Kyung-Hwan; Kim, Ki Bong; Ahn, Hyuk

2013-07-01

The authors' clinical experience is presented of non-structural valvular dysfunction of the prosthetic aortic valve caused by pannus ingrowth during the late postoperative period after previous heart valve surgery. Between January 1999 and April 2012, at the authors' institution, a total of 33 patients underwent reoperation for increased mean pressure gradient of the prosthetic aortic valve. All patients were shown to have pannus ingrowth. The mean interval from the previous operation was 16.7 +/- 4.3 years, and the most common etiology for the previous aortic valve replacement (AVR) was rheumatic valve disease. The mean effective orifice area index (EOAI) of the previous prosthetic valve was 0.97 +/- 0.11 cm2/m2, and the mean pressure gradient on the aortic prosthesis before reoperation was 39.1 +/- 10.7 mmHg. Two patients (6.1%) died in-hospital, and late death occurred in six patients (18.2%). At the first operation, 30 patients underwent mitral or tricuspid valve surgery as a concomitant procedure. Among these operations, mitral valve replacement (MVR) was combined in 24 of all 26 patients with rheumatic valve disease. Four patients underwent pannus removal only while the prosthetic aortic valve was left in place. The mean EOAI after reoperation was significantly increased to 1.16 +/- 0.16 cm2/m2 (p pannus ingrowth was shown in patients with a small EOAI of the prosthetic aortic valve and combined MVR for rheumatic disease. As reoperation for pannus overgrowth showed good clinical outcomes, an aggressive resection of pannus and repeated AVR should be considered in symptomatic patients to avoid the complications of other cardiac diseases.

Transapical aortic valve implantation without angiography: proof of concept.

Science.gov (United States)

Ferrari, Enrico; Sulzer, Christopher; Marcucci, Carlo; Rizzo, Elena; Tozzi, Piergiorgio; von Segesser, Ludwig K

2010-06-01

Cardiac computed tomographic scans, coronary angiograms, and aortographies are routinely performed in transcatheter heart valve therapies. Consequently, all patients are exposed to multiple contrast injections with a following risk of nephrotoxicity and postoperative renal failure. The transapical aortic valve implantation without angiography can prevent contrast-related complications. Between November 2008 and November 2009, 30 consecutive high-risk patients (16 female, 53.3%) underwent transapical aortic valve implantation without angiography. The landmarks identification, the stent-valve positioning, and the postoperative control were routinely performed under transesophageal echocardiogram and fluoroscopic visualization without contrast injections. Mean age was 80.1 +/- 8.7 years. Mean valve gradient, aortic orifice area, and ejection fraction were 60.3 +/- 20.9 mm Hg, 0.7 +/- 0.16 cm(2), and 0.526 +/- 0.128, respectively. Risk factors were pulmonary hypertension (60%), peripheral vascular disease (70%), chronic pulmonary disease (50%), previous cardiac surgery (13.3%), and chronic renal insufficiency (40%) (mean blood creatinine and urea levels: 96.8 +/- 54 microg/dL and 8.45 +/- 5.15 mmol/L). Average European System for Cardiac Operative Risk Evaluation was 32.2 +/- 13.3%. Valve deployment in the ideal landing zone was 96.7% successful and valve embolization occurred once. Thirty-day mortality was 10% (3 patients). Causes of death were the following: intraoperative ventricular rupture (conversion to sternotomy), right ventricular failure, and bilateral pneumonia. Stroke occurred in one patient at postoperative day 9. Renal failure (postoperative mean blood creatinine and urea levels: 91.1 +/- 66.8 microg/dL and 7.27 +/- 3.45 mmol/L), myocardial infarction, and atrioventricular block were not detected. Transapical aortic valve implantation without angiography requires a short learning curve and can be performed routinely by experienced teams. Our report

Mean-square performance of a convex combination of two adaptive filters

DEFF Research Database (Denmark)

Garcia, Jeronimo; Figueiras-Vidal, A.R.; Sayed, A.H.

2006-01-01

Combination approaches provide an interesting way to improve adaptive filter performance. In this paper, we study the mean-square performance of a convex combination of two transversal filters. The individual filters are independently adapted using their own error signals, while the combination i...

Valve-sparing aortic root replacement†.

Science.gov (United States)

Koolbergen, David R; Manshanden, Johan S J; Bouma, Berto J; Blom, Nico A; Mulder, Barbara J M; de Mol, Bas A J M; Hazekamp, Mark G

2015-02-01

To evaluate our results of valve-sparing aortic root replacement and associated (multiple) valve repair. From September 2003 to September 2013, 97 patients had valve-sparing aortic root replacement procedures. Patient records and preoperative, postoperative and recent echocardiograms were reviewed. Median age was 40.3 (range: 13.4-68.6) years and 67 (69.1%) were male. Seven (7.2%) patients were younger than 18 years, the youngest being 13.4 years. Fifty-four (55.7%) had Marfan syndrome, 2 (2.1%) other fibrous tissue diseases, 15 (15.5%) bicuspid aortic valve and 3 (3.1%) had earlier Fallot repair. The reimplantation technique was used in all, with a straight vascular prosthesis in 11 (26-34 mm) and the Valsalva prosthesis in 86 (26-32 mm). Concomitant aortic valve repair was performed in 43 (44.3%), mitral valve repair in 10 (10.3%), tricuspid valve repair in 5 (5.2%) and aortic arch replacement in 3 (3.1%). Mean follow-up was 4.2 ± 2.4 years. Follow-up was complete in all. One 14-year old patient died 1.3 years post-surgery presumably of ventricular arrhythmia. One patient underwent reoperation for aneurysm of the proximal right coronary artery after 4.9 years and 4 patients required aortic valve replacement, 3 of which because of endocarditis after 0.1, 0.8 and 1.3 years and 1 because of cusp prolapse after 3.8 years. No thrombo-embolic complications occurred. Mortality, root reoperation and aortic regurgitation were absent in 88.0 ± 0.5% at 5-year follow-up. Results of valve-sparing root replacement are good, even in association with a high incidence of concomitant valve repair. Valve-sparing aortic root replacement can be performed at a very young age as long as an adult size prosthesis can be implanted. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Adaptive mean filtering for noise reduction in CT polymer gel dosimetry

International Nuclear Information System (INIS)

Hilts, Michelle; Jirasek, Andrew

2008-01-01

X-ray computed tomography (CT) as a method of extracting 3D dose information from irradiated polymer gel dosimeters is showing potential as a practical means to implement gel dosimetry in a radiation therapy clinic. However, the response of CT contrast to dose is weak and noise reduction is critical in order to achieve adequate dose resolutions with this method. Phantom design and CT imaging technique have both been shown to decrease image noise. In addition, image postprocessing using noise reduction filtering techniques have been proposed. This work evaluates in detail the use of the adaptive mean filter for reducing noise in CT gel dosimetry. Filter performance is systematically tested using both synthetic patterns mimicking a range of clinical dose distribution features as well as actual clinical dose distributions. Both low and high signal-to-noise ratio (SNR) situations are examined. For all cases, the effects of filter kernel size and the number of iterations are investigated. Results indicate that adaptive mean filtering is a highly effective tool for noise reduction CT gel dosimetry. The optimum filtering strategy depends on characteristics of the dose distributions and image noise level. For low noise images (SNR ∼20), the filtered results are excellent and use of adaptive mean filtering is recommended as a standard processing tool. For high noise images (SNR ∼5) adaptive mean filtering can also produce excellent results, but filtering must be approached with more caution as spatial and dose distortions of the original dose distribution can occur

Trabeculectomy With Mitomycin C or Ahmed Valve Implantation in Eyes With Uveitic Glaucoma.

Science.gov (United States)

Bettis, Daniel I; Morshedi, Richard G; Chaya, Craig; Goldsmith, Jason; Crandall, Alan; Zabriskie, Norm

2015-01-01

To report and compare the results of trabeculectomy with mitomycin C (MMC) and Ahmed valve implantation in the management of uveitic glaucoma. The records of 41 eyes of 29 patients who underwent trabeculectomy with MMC or Ahmed valve implantation for uveitic glaucoma were retrospectively reviewed. Seventeen eyes underwent trabeculectomy with MMC, and 24 eyes underwent Ahmed valve implantation. Outcomes included postoperative intraocular pressure (IOP), percent reduction from preoperative IOP, postoperative number of medications, time to failure, and complications. Mean follow-up was 21.2 months in the trabeculectomy group and 23.8 months in the valve group (P=0.06). Mean IOP was reduced from 29.2 to 18.4 mm Hg in the trabeculectomy group (31.3%), compared with a reduction from 33.4 to 15.5 mm Hg in the Ahmed valve group (42.7%, P=0.53). Postoperatively, 1.76 medications were used in the trabeculectomy group, compared with 1.83 medications in the Ahmed valve group (P=0.89). Cumulative success at 1 year was 66.7% in the trabeculectomy group, compared with 100% in the Ahmed valve group (P=0.02). Mean time to failure was 8.36 months with trabeculectomy, and 21.8 months with Ahmed valve (P=0.02). Complications in both groups were typically rare and self-limited, with recurrent inflammation being most common. Although both trabeculectomy with MMC and Ahmed valve implantation are reasonable surgical options in the management of uncontrolled uveitic glaucoma, Ahmed valve implantation was associated with higher cumulative success rate at 1 year and a longer mean time to failure.

The safety relief valve handbook design and use of process safety valves to ASME and International codes and standards

CERN Document Server

Hellemans, Marc

2009-01-01

The Safety Valve Handbook is a professional reference for design, process, instrumentation, plant and maintenance engineers who work with fluid flow and transportation systems in the process industries, which covers the chemical, oil and gas, water, paper and pulp, food and bio products and energy sectors. It meets the need of engineers who have responsibilities for specifying, installing, inspecting or maintaining safety valves and flow control systems. It will also be an important reference for process safety and loss prevention engineers, environmental engineers, and plant and process designers who need to understand the operation of safety valves in a wider equipment or plant design context. . No other publication is dedicated to safety valves or to the extensive codes and standards that govern their installation and use. A single source means users save time in searching for specific information about safety valves. . The Safety Valve Handbook contains all of the vital technical and standards informat...

Early Outcomes of Sutureless Aortic Valves

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Muhammet Onur Hanedan

2016-06-01

Full Text Available Background: In elderly high-risk surgical patients, sutureless aortic valve replacement (AVR should be an alternative to standard AVR. The potential advantages of sutureless aortic prostheses include reducing cross-clamping and cardiopulmonary bypass (CPB time and facilitating minimally invasive surgery and complex cardiac interventions, while maintaining satisfactory hemodynamic outcomes and low rates of paravalvular leakage. The current study reports our single-center experience regarding the early outcomes of sutureless aortic valve implantation. Methods: Between October 2012 and June 2015, 65 patients scheduled for surgical valve replacement with symptomatic aortic valve disease and New York Heart Association function of class II or higher were included to this study. Perceval S (Sorin Biomedica Cardio Srl, Sallugia, Italy and Edwards Intuity (Edwards Lifesciences, Irvine, CA, USA valves were used. Results: The mean age of the patients was 71.15±8.60 years. Forty-four patients (67.7% were female. The average preoperative left ventricular ejection fraction was 56.9±9.93. The CPB time was 96.51±41.27 minutes and the cross-clamping time was 60.85±27.08 minutes. The intubation time was 8.95±4.19 hours, and the intensive care unit and hospital stays were 2.89±1.42 days and 7.86±1.42 days, respectively. The mean quantity of drainage from chest tubes was 407.69±149.28 mL. The hospital mortality rate was 3.1%. A total of five patients (7.69% died during follow-up. The mean follow-up time was 687.24±24.76 days. The one-year survival rate was over 90%. Conclusion: In the last few years, several models of valvular sutureless bioprostheses have been developed. The present study evaluating the single-center early outcomes of sutureless aortic valve implantation presents the results of an innovative surgical technique, finding that it resulted in appropriate hemodynamic conditions with acceptable ischemic time.

Early Outcomes of Sutureless Aortic Valves.

Science.gov (United States)

Hanedan, Muhammet Onur; Mataracı, İlker; Yürük, Mehmet Ali; Özer, Tanıl; Sayar, Ufuk; Arslan, Ali Kemal; Ziyrek, Uğur; Yücel, Murat

2016-06-01

In elderly high-risk surgical patients, sutureless aortic valve replacement (AVR) should be an alternative to standard AVR. The potential advantages of sutureless aortic prostheses include reducing cross-clamping and cardiopulmonary bypass (CPB) time and facilitating minimally invasive surgery and complex cardiac interventions, while maintaining satisfactory hemodynamic outcomes and low rates of paravalvular leakage. The current study reports our single-center experience regarding the early outcomes of sutureless aortic valve implantation. Between October 2012 and June 2015, 65 patients scheduled for surgical valve replacement with symptomatic aortic valve disease and New York Heart Association function of class II or higher were included to this study. Perceval S (Sorin Biomedica Cardio Srl, Sallugia, Italy) and Edwards Intuity (Edwards Lifesciences, Irvine, CA, USA) valves were used. The mean age of the patients was 71.15±8.60 years. Forty-four patients (67.7%) were female. The average preoperative left ventricular ejection fraction was 56.9±9.93. The CPB time was 96.51±41.27 minutes and the cross-clamping time was 60.85±27.08 minutes. The intubation time was 8.95±4.19 hours, and the intensive care unit and hospital stays were 2.89±1.42 days and 7.86±1.42 days, respectively. The mean quantity of drainage from chest tubes was 407.69±149.28 mL. The hospital mortality rate was 3.1%. A total of five patients (7.69%) died during follow-up. The mean follow-up time was 687.24±24.76 days. The one-year survival rate was over 90%. In the last few years, several models of valvular sutureless bioprostheses have been developed. The present study evaluating the single-center early outcomes of sutureless aortic valve implantation presents the results of an innovative surgical technique, finding that it resulted in appropriate hemodynamic conditions with acceptable ischemic time.

Controllable valve in a nuclear reactor system

International Nuclear Information System (INIS)

Schabert, H.P.; Laurer, E.

1980-01-01

The quick-acting gate valve of the PWR is opened and closed by means of two pistons and live steam. One of the pistons is connected to the valve disk by a piston rod which is concentrically lead into another hollow piston rod being connected to the second piston. Stops limit the strokes of the two pistons. (GL) [de

Anesthetic Management and Complications of Percutaneous Aortic Valve Implantation

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Tailur Alberto Grando

2013-05-01

Full Text Available Background and objective: Aortic stenosis is a highly prevalent and life-threatening disease. In elderly patients with comorbidities, percutaneous valve implantation is an option. The aim of the study was to describe the anesthetic management and complications of general anesthesia Method: Case series with 30-day and 24-month follow-ups after implantation of the CoreValve device performed at the Institute of Cardiology/University Foundation of Cardiology between December 2008 and January 2012. The patients underwent general anesthesia monitored with mean arterial pressure (PAM, electrocardiogram (ECG, pulse oximetry, capnography, transesophageal echocardiography, thermometry, and transvenous pacemaker. Results: Twenty-eight patients, mean age 82.46 years, 20.98% mean EuroSCORE, functional class III/IV, successfully underwent valve implantation. Nine patients required permanent pacemaker implantation. During follow-up, two patients died: one during surgery due to LV perforation and the other on the third day of unknown causes. At 24 months, one patient diagnosed with multiple myeloma died. This anesthetic technique proved to be safe. Conclusion: The initial experience with percutaneous aortic valve implantation under general anesthesia has proven to be safe and effective, with no significant anesthetic complications during this procedure. Keywords: Aesthesia, General, Cardiac Surgical Procedures, Aortic Valve Stenosis, Aged.

Preoperative computer tomography evaluation in transcatheter aortic valve replacement (TAVI)

International Nuclear Information System (INIS)

Groudeva, V.; Stoynova, V.; Trendafilova, D.; Dzhorgova, Y.; Nachev, G.

2014-01-01

Transcatheter aortic valve replacement is rapidly emerging technique alternative to surgery in high risk patients. Imaging and especially computer tomography is important in preoperative assessment of the aortic ring and the prosthetic valve choice. The aim of this study is to share authors initial experience in CT assessment of the aortic ring prior to Transcatheter aortic valve replacement. 49 patients (mean age 76,55) underwent 320 rows MDCT (Acquilon One) prior TAVI. Protocol involved scanning from thoracic inlet to common femoral arteries. Aortic root size, aortic diameter at the level of coronary sinuses and the sinotubular junction and distance to coronary ostia were evaluated on a Vitrea work station. MDCT established maximal aortic ring diameter from 18 to 31 mm mean 25,04 mm while the lesser rate was from 16 to 21 mm. Accordingly positioned prostheses were in 34,75% No. 23, in 49% - No. 26 and in16,3% - No. 29. MDCT is crucial in aortic valve assessment prior to TAVI in experienced hands and multidisciplinary team. (authors) Key words: TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVI). MDCT AORTIC VALVE ASSESSMENT

Transfemoral Aortic Valve Implantation with the New Edwards Sapien 3 Valve for Treatment of Severe Aortic Stenosis-Impact of Valve Size in a Single Center Experience.

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Jochen Wöhrle

Full Text Available The third generation Edwards Sapien 3 (Edwards Lifesciences Inc., Irvine, California system was optimized to reduce residual aortic regurgitation and vascular complications.235 patients with severe symptomatic aortic stenosis were prospectively enrolled. Transcatheter aortic valve implantations (TAVI were performed without general anesthesia by transfemoral approach. Patients were followed for 30 days. Patients received 23mm (N = 77, 26mm (N = 91 or 29mm (N = 67 valve based on pre-procedural 256 multislice computer tomography. Mean oversizing did not differ between the 3 valves. There was no residual moderate or severe aortic regurgitation. Rate of mild aortic regurgitation and regurgitation index did not differ between groups. There was no switch to general anesthesia or conversion to surgery. Rate of major vascular complication was 3.0% with no difference between valve and delivery sheath sizes. Within 30 days rates of all cause mortality (2.6% and stroke (2.1% were low.In patients with severe aortic stenosis transfemoral TAVI with the Edwards Sapien 3 valve without general anesthesia was associated with a high rate of device success, no moderate or severe residual aortic regurgitation, low rates of major vascular complication, mortality and stroke within 30 days with no difference between the 3 valve sizes.ClinicalTrials.gov NCT02162069.

Heart valve surgery

Science.gov (United States)

... replacement; Valve repair; Heart valve prosthesis; Mechanical valves; Prosthetic valves ... surgery. Your heart valve has been damaged by infection ( endocarditis ). You have received a new heart valve ...

Patient-specific pediatric silicone heart valve models based on 3D ultrasound

Science.gov (United States)

Ilina, Anna; Lasso, Andras; Jolley, Matthew A.; Wohler, Brittany; Nguyen, Alex; Scanlan, Adam; Baum, Zachary; McGowan, Frank; Fichtinger, Gabor

2017-03-01

PURPOSE: Patient-specific heart and valve models have shown promise as training and planning tools for heart surgery, but physically realistic valve models remain elusive. Available proprietary, simulation-focused heart valve models are generic adult mitral valves and do not allow for patient-specific modeling as may be needed for rare diseases such as congenitally abnormal valves. We propose creating silicone valve models from a 3D-printed plastic mold as a solution that can be adapted to any individual patient and heart valve at a fraction of the cost of direct 3D-printing using soft materials. METHODS: Leaflets of a pediatric mitral valve, a tricuspid valve in a patient with hypoplastic left heart syndrome, and a complete atrioventricular canal valve were segmented from ultrasound images. A custom software was developed to automatically generate molds for each valve based on the segmentation. These molds were 3D-printed and used to make silicone valve models. The models were designed with cylindrical rims of different sizes surrounding the leaflets, to show the outline of the valve and add rigidity. Pediatric cardiac surgeons practiced suturing on the models and evaluated them for use as surgical planning and training tools. RESULTS: Five out of six surgeons reported that the valve models would be very useful as training tools for cardiac surgery. In this first iteration of valve models, leaflets were felt to be unrealistically thick or stiff compared to real pediatric leaflets. A thin tube rim was preferred for valve flexibility. CONCLUSION: The valve models were well received and considered to be valuable and accessible tools for heart valve surgery training. Further improvements will be made based on surgeons' feedback.

Assessment of structural valve deterioration of transcatheter aortic bioprosthetic balloon-expandable valves using the new European consensus definition.

Science.gov (United States)

Eltchaninoff, Hélène; Durand, Eric; Avinée, Guillaume; Tron, Christophe; Litzler, Pierre-Yves; Bauer, Fabrice; Dacher, Jean-Nicolas; Werhlin, Camille; Bouhzam, Najime; Bettinger, Nicolas; Candolfi, Pascal; Cribier, Alain

2018-03-30

Durability of transcatheter aortic bioprosthetic valves remains a major issue. Standardised definitions of deterioration and failure of bioprosthetic valves have recently been proposed. The aim of this study was to assess structural transcatheter valve deterioration (SVD) and bioprosthetic valve failure (BVF) using these new definitions. All TAVI patients implanted up to September 2012 with a minimal theoretical five-year follow-up were included. Systematic clinical and echocardiographic follow-up was performed annually. New standardised definitions were used to assess durability of transcatheter aortic bioprosthetic valves. From 2002 to 2012, 378 patients were included. Mean age and logistic EuroSCORE were 83.3±6.8 years and 22.8±13.1%. Thirty-day mortality was 13.2%. Nine patients had SVD including two severe forms and two patients had definite late BVF. The incidence of SVD and BVF at eight years was 3.2% (95% CI: 1.45-6.11) and 0.58% (95% CI: 0.15-2.75), respectively. Even though limited by the poor survival of the very high-risk/compassionate early population, our data do not demonstrate any alarm concerning transcatheter aortic valve durability. Careful prospective assessment in younger and lower-risk patients and comparison with surgical bioprosthetic valves are required for further assessment of the long-term durability of transcatheter valves.

Recent improvements in check valve monitoring methods

International Nuclear Information System (INIS)

Haynes, H.D.

1991-01-01

In support of the NRC Nuclear Plant Aging Research (NPAR) program, ORNL has carried out an evaluation of three check valve monitoring methods: acoustic emission, ultrasonic inspection, and magnetic flux signature analysis (MFSA). This work has focussed on determining the capabilities of each method to provide diagnostic information useful in determining check valve aging and service wear effects (degradation) and undesirable operating modes. In addition, as part of the ORNL Advanced Diagnostic Engineering Research and Development Center (ADEC), two novel nonintrusive monitoring methods were developed (external ac- and dc-magnetic monitoring) that provide several improvements over the other methods. None of the examined methods could, by themselves, monitor the instantaneous position and motion of check valve internals and valve leakage; however, the combination of acoustic emission monitoring with one of the other methods provides the means to determine vital check valve operational information. This paper describes the benefits and limitations associated with each method and includes recent laboratory and field test data to illustrate the capabilities of these methods to detect simulated check valve degradation. 3 refs., 22 figs., 4 tabs

Recent improvements in check valve monitoring methods

International Nuclear Information System (INIS)

Haynes, H.D.

1990-01-01

In support of the NRC Nuclear Plant Aging Research (NPAR) program, ORNL has carried out an evaluation of three check valve monitoring methods: acoustic emission, ultrasonic inspection, and magnetic flux signature analysis (MFSA). This work has focused on determining the capabilities of each method to provide diagnostic information useful in determining check valve aging and service wear effects (degradation) and undesirable operating modes. In addition, as part of the ORNL Advanced Diagnostic Engineering Research and Development Center (ADEC), two noval nonintrusive monitoring methods were developed (external ac- and dc-magnetic monitoring) that provide several improvements over the other methods. None of the examined methods could, by themselves, monitor the instantaneous position and motion of check valve internals and valve leakage; however, the combination of acoustic emission monitoring with one of the other methods provides the means to determine vital check valve operational information. This paper describes the benefits and limitations associated with each method and includes recent laboratory and field test data to illustrate the capabilities of these methods to detect simulated check valve degradation. 3 refs., 22 figs., 4 tabs

Impact of pannus formation on hemodynamic dysfunction of prosthetic aortic valve: pannus extent and its relationship to prosthetic valve motion and degree of stenosis.

Science.gov (United States)

Koo, Hyun Jung; Ha, Hojin; Kang, Joon-Won; Kim, Jeong A; Song, Jae-Kwan; Kim, Hwa Jung; Lim, Tae-Hwan; Yang, Dong Hyun

2018-02-19

Although pannus is an important cause of prosthetic valve dysfunction, the minimum pannus size that can induce hemodynamic dysfunction has not yet been determined. This study investigated the correlation between the limitation of motion (LOM) of the prosthetic valve and pannus extent and determined the pannus extent that could induce severe aortic stenosis. This study included 49 patients who underwent mechanical aortic valve replacement (AVR) and showed pannus on cardiac computed tomography (CT). Pannus width, ratio of pannus width to valve diameter, pannus area, effective orifice area, encroachment ratio by pannus, pannus involvement angle and percent LOM of mechanical valves were evaluated on CT. Transvalvular peak velocity (TPV) and transvalvular pressure gradient (TPG) were measured by transesophageal echocardiography to determine the degree of aortic stenosis. The relationship between percent LOM of the prosthetic valve and pannus extent and the cut-off of pannus extent required to induce severe aortic stenosis were evaluated. The mean interval between AVR and pannus formation was 11 years and was longer in patients with than without severe aortic stenosis (14.0 vs. 7.3 years). On CT, the percent LOM of the prosthetic valve was significantly associated with the extent of pannus only in patients with pannus involvement angle > 180° (r = 0.55-0.68, P Pannus width, effective orifice area, and encroachment ratio were significantly associated with increased TPV and TPG (r = 0.51-0.62, P Pannus width > 3.5 mm, pannus width/valve inner diameter > 0.15, and encroachment ratio > 0.14 were significantly associated with severe aortic stenosis (TPV > 4 m/s; mean TPG ≥ 35 mmHg), with c-indices of 0.74-079 (P pannus extent parameters are good indicators of significant hemodynamic changes with increased TPV and mean TPG.

Durability Tests of Ball Valve Prototype with Flowmeter Operation

Science.gov (United States)

Rogula, J.; Romanik, G.

2018-02-01

The results of the investigation of the prototypical ball valve are presented in this article. The innovation of the tested valve is a ball with a built-in measuring orifice. The valve has been subjected to durability tests. Leakage under three temperatures: ambient, -30°C and +100°C was analyzed. Sealing elements of the valve were tested for roughness and deviation of shape before and after the cycles of operation. Ball valve operation means cycles of open/close. It was planned to perform 1000 cycles at each temperature condition accordingly. Tests of the valve were performed under gas pressure equal to 10 MPa. The research was carried out under the Operational Program "Intelligent Development" (POIR 01.01.01-00-0013 / 15 "Development of devices for measurement of media flow on industrial trunk-lines".

Shielding analysis of the IEM cell offset adapter plate

International Nuclear Information System (INIS)

Simons, R.L.

1995-01-01

The adapter plate for the Interim Examination and Maintenance (IEM) cell ten foot ceiling valve was modified so that the penetration through the valve is offset to the north side of the steel plate. The modifications required that the shielding effectiveness be evaluated for several operating conditions. The highest gamma ray dose rate (51 mrem/hr) occurs when a Core Component Container (CCC) with six high burn-up driver fuel assemblies is transferred into or out of Solid Waste Cask (SWC). The neutron dose rate at the same source location is 2.5 mrem/hr. The total dose rate during the transfer is less than the 200 mrem/hr limit. If the ten foot ceiling valve is closed, the dose rate with twelve DFA in the cell will be less than 0.1 mrem/hr. However, with the ceiling valve open the dose rate will be as high as 12 mrem/hr. The latter condition will require controlled access to the area around the offset adapter plate when the ceiling valve is open. It was found that gaps in the shield block around the SWC floor valve will allow contact dose rates as high as 350 mrem/hr during the transfer of a fully loaded CCC. Although this situation does not pertain to the offset adapter plate, it will require controlled access around the SWC valve during the transfer of a fully loaded CCC

Anatomic characteristics of bileaflet mitral valve prolapse--Barlow disease--in patients undergoing mitral valve repair.

Science.gov (United States)

Rostagno, Carlo; Droandi, Ginevra; Rossi, Alessandra; Bevilacqua, Sergio; Romagnoli, Stefano; Montesi, Gian Franco; Stefàno, Pier Luigi

2014-01-01

Barlow disease is a still challenging pathology for the surgeon. Aim of the present study is to report anatomic abnormalities of mitral valve in patients undergoing mitral valve repair. Between January 1st, 2007, and December 31st, 2010, 85 consecutive patients (54 men and 31 women, mean age 59 +/- 14 years--range: 28-85 years) with the features of a Barlow mitral valve disease underwent mitral repair Forty seven percent of patients were in New York Heart Association functional class III or IV. Preoperative transesophageal echocardiography was compared with anatomical findings at the moment of surgery. Transthoracic echocardiography diagnosis of Barlow disease according to the criteria described by Carpentier was confirmed at anatomical inspection. Annular calcifications were found in 28 patients while 7 patients presented single or multiple clefts. A flail posterior mitral leaflet was detected in 32 subjects, while a flail anterior leaflet in 8. Elongation of chordae tendineae was demonstrated in 45 patients and chordal rupture in 31. All patients showed at trans esophageal echocardiography the typical features of Barlow disease. Seventy-seven (90.6%) patients had severe mitral valve regurgitation, in the remaining 9.4% it was moderate to severe. Transesophageal echocardiography failed to identify clefts in 2/7 and chordal rupture in 4/31. bileaflet prolapse > 2 mm, billowing valve with excess tissue and thickened leaflets > or = 3 mm, and severe annular dilatation, are characteristics of Barlow disease, however the identification of the associated and complex abnormalities of mitral valve is necessary to obtain optimal valve repair.

Operating Temperatures of a Sodium-Cooled Exhaust Valve as Measured by a Thermocouple

Science.gov (United States)

Sanders, J. C.; Wilsted, H. D.; Mulcahy, B. A.

1943-01-01

A thermocouple was installed in the crown of a sodium-cooled exhaust valve. The valve was then tested in an air-cooled engine cylinder and valve temperatures under various engine operating conditions were determined. A temperature of 1337 F was observed at a fuel-air ratio of 0.064, a brake mean effective pressure of 179 pounds per square inch, and an engine speed of 2000 rpm. Fuel-air ratio was found to have a large influence on valve temperature, but cooling-air pressure and variation in spark advance had little effect. An increase in engine power by change of speed or mean effective pressure increased the valve temperature. It was found that the temperature of the rear spark-plug bushing was not a satisfactory indication of the temperature of the exhaust valve.

Control Valve

Energy Technology Data Exchange (ETDEWEB)

Moore, Wayne R.

2018-03-20

A control valve includes a first conduit having a first inlet and a first outlet and defining a first passage; a second conduit having a second inlet and a second outlet and defining a second passage, the second conduit extending into the first passage such that the second inlet is located within the first passage; and a valve plate disposed pivotably within the first passage, the valve plate defining a valve plate surface. Pivoting of the valve plate within the first passage varies flow from the first inlet to the first outlet and the valve plate is pivotal between a first position and a second position such that in the first position the valve plate substantially prevents fluid communication between the first passage and the second passage and such that in the second position the valve plate permits fluid communication between the first passage and the second passage.

Outcomes of Solo Smart valve in a single-center experience of 270 patients.

Science.gov (United States)

Liu, Hao; Khani-Hanjani, Abbas; Yang, Siyuan; Wang, Wei; Sidhu, Surita; Mullen, John; Modry, Dennis; Wang, Shaohua

2018-04-03

The Solo Smart pericardial aortic valve has been widely used in Europe as an option for aortic valve replacement (AVR). We are reporting early and midterm clinical outcomes of AVR with the Solo Smart valve in a single North America center. This is a retrospective study of 270 consecutive patients who had AVR at Mazankowski Alberta Heart Institute from February 2011 to March 2015. Follow-up and echocardiographic data were collected retrospectively from electronic and paper charts. Univariate and multivariate analysis were performed to evaluate the results. The mean age was 71.2±10.0 years, 67.4% were male, and 79.3% had combined procedures. Mean STS Score was 4.18±3.91. Early mortality was 3.7% for the entire group and 0% for isolated aortic valve replacement group. Mean cross-clamp time for isolated AVR and AVR with concomitant procedure was 70.8±12.7min and 117.0±45.0min, respectively. Permanent pacemaker implantation was necessary in 2.2% of patients. Echocardiography demonstrated a reduction in mean gradients from 40.8±17.4mmHg to 7.6±3.7 mmHg and peak gradient from 72.5 ± 48.8 mmHg to 15.5±7.5 mmHg. The 1-, 3-, and 5- year overall survival was 93.0%, 86.5% and 75.9%, respectively. At 5 years, freedom from valve-related death was 92.4%, freedom from structural valve deterioration and freedom from aortic valve reoperation were 96.4% and 98%, respectively. The Solo Smart valve is safe and has excellent hemodynamic performance. Aortic valve reoperation and rates of valve-related adverse events during midterm follow-up were low.

Ten-year results of the Freedom Solo stentless heart valve: excellent haemodynamics but progressive valve dysfunction in the long term.

Science.gov (United States)

Sponga, Sandro; Barbera, Mila Della; Pavoni, Daisy; Lechiancole, Andrea; Mazzaro, Enzo; Valente, Marialuisa; Nucifora, Gaetano; Thiene, Gaetano; Livi, Ugolino

2017-05-01

Freedom Solo (FS) is a pericardial stentless heart valve showing excellent haemodynamic performance at mid-term. The aim of this study was to evaluate the long-term performance of such bioprostheses. Between December 2004 and November 2009, 109 patients (31 men; mean age 76 ± 6 years) underwent aortic valve replacement with FS. Preoperatively, the mean NYHA class was 2.5 ± 0.7, the mean EuroSCORE II, 2.8 ± 2.5. Mean prosthesis size was 22.7 ± 1.9 mm; concomitant procedures were performed in 65 patients. Structural valve deterioration (SVD) was diagnosed according to the Valve Academic Research Consortium-2 definition. Two patients (1.8%) died within 30 days. Follow-up (72 ± 36 months) was 100% completed. The 1-, 5- and 10-year actuarial survival rates were 89, 73 and 42%, respectively, with 8 valve-related deaths; the actuarial freedom from SVD was 99, 93 and 76%. During 61 ± 39 months of follow-up, echocardiographic findings worsened progressively: At discharge, 3-5 and 7-9 years, the mean gradient was 8 ± 4, 12 ± 11 and 19 ± 19 mmHg ( P  < 0.01); the indexed effective orifice area was 1.0 ± 0.2, 0.9 ± 0.2 and 0.8 ± 0.3 cm 2 /m 2 ( P  < 0.01). Of the 13 patients who developed SVD, it was due to aortic stenosis in 11. SVD was a predictor of cardiovascular mortality at univariate analysis (HR 2.87, 1.12-7.29); 2 explanted prostheses showed massive calcium deposits with mean calcium and phosphorus contents of 234 ± 16 and 116 ± 7 mg/g dry weight, respectively. The FS bioprosthesis shows excellent mid-term clinical and haemodynamic results and offers an alternative to other valves, particularly in the case of a small aortic annulus. Worsening of FS performance was observed at late follow-up because of progressive SVD with stenosis, questioning whether it should be used in patients with a long life expectancy. © The Author 2017. Published by Oxford University Press on behalf of the

Bentall procedure using cryopreserved valved aortic homografts: mid- to long-term results.

Science.gov (United States)

Christenson, Jan T; Sierra, Jorge; Trindade, Pedro T; Dominique, Didier; Kalangos, Afksendiyos

2004-01-01

The Bentall procedure is the standard operation for patients who have lesions of the ascending aorta associated with aortic valve disease. In many cases, however, mechanical prosthetic conduits are not suitable. There are few reports in the English-language medical literature concerning the mid- to long-term outcome of Bentall operations with cryopreserved homografts. Therefore, we reviewed our experience with this procedure and valved homografts. From January 1997 through December 2002, 21 patients underwent a Bentall operation with cryopreserved homografts at our institution. There were 14 males and 7 females; the mean age was 36 +/- 21 years (range, 15-74 years). Eleven patients had undergone previous aortic valve surgery. All patients had aortic dilatation or aneurysms involving the ascending aorta. Indications for surgery included aortic valve stenosis or insufficiency, and aortic valve endocarditis (native valve or prosthetic). One patient had Takayasu's arteritis and 3 had Marfan syndrome. There was 1 hospital death (due to sepsis), but no other major postoperative complications. The mean hospital stay was 14 +/- 7 days. Follow-up echocardiographic and computed tomographic scans were performed yearly. The mean follow-up was 34 months (6-72 months). Follow-up imaging revealed no calcifications or degenerative processes related to the homograft. Four patients had minimal valve regurgitation. Two patients died during follow-up. The 3-year actuarial survival rate was 85.7%. Our data suggest that the Bentall procedure with a valved homograft conduit is a safe procedure with excellent mid- to long-term results, comparable to results reported with aortic valve replacement with a homograft.

Leakage characterization of a piloted power operated relief valve

International Nuclear Information System (INIS)

Ezekoye, L.I.; Hess, M.D.

1995-01-01

In Westinghouse Pressurized Water Reactors (PWRs), power operated relief valves (PORVs) are used to provide overpressure protection of the Pressurizer. The valves are fail closed globe valves which means that power is required to open the valves and, on loss of power, the valves close. There are two ways to operate the PORVs. The more common way is to directly couple the disc to an actuator via a disc-stem assembly. The type of design is not the object of this paper. The other and less common way of operating a PORV is by piloting the main valve such that the opening or closing of a pilot valve opens and closes the main valve. This is the design of interest. In most plants, the PORVs are installed with a water loop seal while in some plants no water loop seals are used. It is generally accepted that loop seal installation minimizes valve seat leakage. In non-loop seal installation, the valve seat is exposed to steam which increases the potential for seat leakage. This paper describes the results of some tests performed with nitrogen and steam to characterize the leakage potential of a pilot operated PORV. The test results were compared with seat leakage tests of check valves to provide insight on the leakage testing of pilot operated valves and check valves. The paper also compares the test data with leakage estimates using the ASME/ANSI OM Code guidance on valve leakage

Risk Factors for Late Aortic Valve Dysfunction After the David V Valve-Sparing Root Replacement.

Science.gov (United States)

Esaki, Jiro; Leshnower, Bradley G; Binongo, Jose N; Lasanajak, Yi; McPherson, LaRonica; Guyton, Robert A; Chen, Edward P

2017-11-01

Valve-sparing root replacement (VSRR) is an established therapy for aortic root pathology. However, late aortic valve dysfunction requiring reoperation remains a primary concern of this procedure. This study examines risk factors for late aortic insufficiency (AI) and aortic stenosis (AS) after David V VSRR. A retrospective review from 2005 to 2015 at a US academic center identified 282 patients who underwent VSRR. Cox proportional hazards regression analysis was used to identify risk factors for late AI and AS after VSRR. The mean age was 46.4 years. Sixty-four patients (22.7%) had bicuspid valves, and 41 patients (14.5%) had Marfan syndrome. The incidence of reoperations was 27 (9.6%), and 42 cases (14.9%) presented with acute type A dissection. Operative mortality was 8 (2.8%). Seven-year survival was 90.9%. Seven-year cumulative incidence of reoperation, greater than 2+ AI and greater than moderate AS were 3.1%, 2.2%, and 0.8%, respectively. Multivariable analysis showed aortic root size 55 mm or larger (hazard ratio 3.44, 95% confidence interval: 1.27 to 9.29, p = 0.01) to be a risk factor for late AI whereas bicuspid valve (hazard ratio 16.07, 95% confidence interval: 3.12 to 82.68, p = 0.001) and cusp repair were found to be risk factors (hazard ratio 5.91, 95% confidence interval: 1.17 to 29.86, p = 0.03) for late AS. Valve-sparing root replacement can be performed with low operative risk and good overall long-term survival even in complex clinical settings. Durable valve function can be expected; however, aortic root size 55 cm or more, bicuspid valve anatomy, and cusp repair represent independent risk factors for late aortic valve dysfunction after these procedures. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Hardfacing and packings for improved valve performance

International Nuclear Information System (INIS)

Aikin, J.A.; Patrick, J.N.F.; Inglis, I.

2003-01-01

The CANDU Owners Group (COG), Chemistry, Materials and Components (CMC) Program has supported an ongoing program on valve maintenance and performance for several years. An overview is presented of recent work on iron-based hardfacing, packing qualification, friction testing of polytetrafluoroethylene (PTFE) packings, and an investigation of re-torquing valve packing. Based on this program, two new valve-packing materials have been qualified for use in CANDU stations. By doing this, CANDU maintenance can avoid having only one packing qualified for station use, as well as assess the potential impact of the industry trend towards using lower gland loads. The results from corrosion tests by AECL and the coefficient of friction studies at Battelle' s tribology testing facilities on Delcrome 910, an iron-based hardfacing alloy, indicate it is an acceptable replacement for Stellite 6 under certain conditions. This information can be used to update in-line valve purchasing specifications. The renewed interest in friction characteristics, and environmental qualification (EQ) of packing containing PTFE has resulted in a new test program in these areas. The COG-funded valve programs have resulted in modifications to design specifications for nuclear station in-line valves and have led to better maintenance practices and valve reliability. In the end, this means lower costs and cheaper electricity. (author)

The influence of the engine load on value and temperature distribution in the valve seats of turbo diesel engine

Directory of Open Access Journals (Sweden)

Aleksander HORNIK

2009-01-01

Full Text Available In this paper was presented the numerical computations of the influence of engine load on value and temperature distribution of characteristic surfaces of the heat transfer of the valve seats in Turbo diesel engine at the beginning phase of its work. The computations were performed by means of a two-zone combustion model, the boundary of III kind conditions and the finite elements method (FEM by adaptation of the COSMOS/M program.

Mitral Valve Disease

Science.gov (United States)

... for mitral valve replacement—mechanical valves (metal) or biological valves (tissue). The principal advantage of mechanical valves ... small risk of stroke due to blood clotting. Biological valves usually are made from animal tissue. Biological ...

Adaptive Shape Kernel-Based Mean Shift Tracker in Robot Vision System

Directory of Open Access Journals (Sweden)

Chunmei Liu

2016-01-01

Full Text Available This paper proposes an adaptive shape kernel-based mean shift tracker using a single static camera for the robot vision system. The question that we address in this paper is how to construct such a kernel shape that is adaptive to the object shape. We perform nonlinear manifold learning technique to obtain the low-dimensional shape space which is trained by training data with the same view as the tracking video. The proposed kernel searches the shape in the low-dimensional shape space obtained by nonlinear manifold learning technique and constructs the adaptive kernel shape in the high-dimensional shape space. It can improve mean shift tracker performance to track object position and object contour and avoid the background clutter. In the experimental part, we take the walking human as example to validate that our method is accurate and robust to track human position and describe human contour.

Adaptive Shape Kernel-Based Mean Shift Tracker in Robot Vision System

Science.gov (United States)

2016-01-01

This paper proposes an adaptive shape kernel-based mean shift tracker using a single static camera for the robot vision system. The question that we address in this paper is how to construct such a kernel shape that is adaptive to the object shape. We perform nonlinear manifold learning technique to obtain the low-dimensional shape space which is trained by training data with the same view as the tracking video. The proposed kernel searches the shape in the low-dimensional shape space obtained by nonlinear manifold learning technique and constructs the adaptive kernel shape in the high-dimensional shape space. It can improve mean shift tracker performance to track object position and object contour and avoid the background clutter. In the experimental part, we take the walking human as example to validate that our method is accurate and robust to track human position and describe human contour. PMID:27379165

Optimising the flow characteristic of a coke-oven flue-gas valve by means of Computational Fluid Dynamics (CFD); Stroemungsoptimierung eines Abgasventils von Koksoefen durch Computational Fluid Dynamics (CFD)

Energy Technology Data Exchange (ETDEWEB)

Hiller, R.; Cremer, I.; Bertling, J. [Fraunhofer-Institut fuer Umwelt-, Sicherheits- und Energietechnik UMSICHT, Oberhausen (Germany); Dittie, J.; Kim, R.; Reinke, M. [Krupp Uhde GmbH, Dortmund (Germany)

1999-06-01

In coke-oven operations flue-gas valves are used to switch the regenerator function from rich gas firing to lean gas firing. Compared with the simple geometry of the other parts of the flow path, which comprise flues and regenerators, the narrow and winding passages of the flue-gas valves give rise to relatively high losses in pressure. Without the construction of high (and therefore expensive) chimneys, this means that operating problems may well arise due the inadequate suction capacity. The project focused on the theoretical and experimental analysis of a coke-oven flue-gas valve. The primary aim was to reduce the pressure drop through the valve without modifying its external geomerty. The internal flow characteristics created by different valve geometries under a variety of operating conditions were simulated using the commercial CFD code Fluent/UNS, which provided velocity and pressure distributions. A half-scale model valve was constructed in order to characterise the internal flow behaviour by pressure measurement. (orig.) [Deutsch] In einem bei Fraunhofer UMSICHT durchgefuehrten Projekt wurde die Stroemung in einem Abgasventil eines Koksofens, das der Umschaltung der Regeneratorfunktion von Starkgasbeheizung auf Schwachgasbeheizung dient, theoretisch und experimentell untersucht, um die relativ hohen Druckverluste zu vermindern. Vorgeschlagen wurde eine Modifikation der Abgasventilkonstruktion, die den Druckverlust um mehr als das Zehnfache vermindert und zu einer baulichen Vereinfachung des Ventils fuehrt. (orig.)

Initial Surgical Experience with Aortic Valve Repair: Clinical and Echocardiographic Results

Directory of Open Access Journals (Sweden)

Francisco Diniz Affonso da Costa

Full Text Available Abstract Introduction: Due to late complications associated with the use of conventional prosthetic heart valves, several centers have advocated aortic valve repair and/or valve sparing aortic root replacement for patients with aortic valve insufficiency, in order to enhance late survival and minimize adverse postoperative events. Methods: From March/2012 thru March 2015, 37 patients consecutively underwent conservative operations of the aortic valve and/or aortic root. Mean age was 48±16 years and 81% were males. The aortic valve was bicuspid in 54% and tricuspid in the remaining. All were operated with the aid of intraoperative transesophageal echocardiography. Surgical techniques consisted of replacing the aortic root with a Dacron graft whenever it was dilated or aneurysmatic, using either the remodeling or the reimplantation technique, besides correcting leaflet prolapse when present. Patients were sequentially evaluated with clinical and echocardiographic studies and mean follow-up time was 16±5 months. Results: Thirty-day mortality was 2.7%. In addition there were two late deaths, with late survival being 85% (CI 95% - 68%-95% at two years. Two patients were reoperated due to primary structural valve failure. Freedom from reoperation or from primary structural valve failure was 90% (CI 95% - 66%-97% and 91% (CI 95% - 69%-97% at 2 years, respectively. During clinical follow-up up to 3 years, there were no cases of thromboembolism, hemorrhage or endocarditis. Conclusions: Although this represents an initial series, these data demonstrates that aortic valve repair and/or valve sparing aortic root surgery can be performed with satisfactory immediate and short-term results.

Tight valve

International Nuclear Information System (INIS)

Guedj, F.

1987-01-01

This sealed valve is made with a valve seat, an axial valve with a rod fixed to its upper end, a thick bell surrounding the rod and welded by a thin join on the valve casing, a threated ring screwed onto the upper end of the rod and a magnet or electromagnet rotating the ring outside the bell [fr

Survival and freedom from aortic valve-related reoperation after valve-sparing aortic root replacement in 1015 patients.

Science.gov (United States)

Kari, Fabian A; Doll, Kai-Nicolas; Hemmer, Wolfgang; Liebrich, Markus; Sievers, Hans-Hinrich; Richardt, Doreen; Reichenspurner, Hermann; Detter, Christian; Siepe, Matthias; Czerny, Martin; Beyersdorf, Friedhelm

2016-04-01

The aim of this study was to characterize mortality and aortic valve replacement after valve-sparing aortic root replacement (V-SARR) in a multicentre cohort. Between 1994 and 2014, 1015 patients had V-SARR with (n = 288, 28%) or without cusp/commissure repair (n = 727, 72%) at the centres of Lübeck (n = 343, 34%), Stuttgart (n = 346, 34%), Hamburg (n = 109, 11%) and Freiburg (n = 217, 21%), Germany. Comparative survival of an age- and gender-matched general population was calculated. Log-rank tests and multiple logistic regression were used to identify risk factors. The mean follow-up was 5.2 ± 3.9 years. Cumulative follow-up comprised 2933 patient-years. Early survival was 98%. NYHA status and aneurysm size were predictive of death during mid-term follow-up (P = 0.025). Freedom from aortic valve replacement was 90% at 8 years, with the type of V-SARR (root remodelling, David II) being a risk factor (P = 0.015). Bicuspid aortic valve (P = 0.26) and initial valve function (P = 0.4) did not impact reoperation. The need of additional valve repair (cusps/commissures) was not linked to reoperation: freedom from aortic valve replacement at 8 years was 84% if cusp repair was performed versus 90% if V-SARR alone was performed (P = 0.218). Marfan syndrome had no impact on survival or on aortic valve replacement. Mid-term survival of patients after V-SARR is comparable with that of a matched general population. The regurgitant bicuspid aortic valve is a favourable substrate for V-SARR. Prophylactic surgery should be performed before symptoms or large aneurysms are present to achieve optimal mid-term outcomes. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Aortic valve bypass

DEFF Research Database (Denmark)

Lund, Jens T; Jensen, Maiken Brit; Arendrup, Henrik

2013-01-01

In aortic valve bypass (AVB) a valve-containing conduit is connecting the apex of the left ventricle to the descending aorta. Candidates are patients with symptomatic aortic valve stenosis rejected for conventional aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI). ...

[Valve-sparing Replacement in Patients with Aortic Root Dilatation].

Science.gov (United States)

Yamazaki, Kazuhiro; Minatoya, Kenji; Ueda, Ryoma; Takehara, Masato; Sakamoto, Kazuhisa; Ide, Yujiro; Kanemitsu, Hideo; Ueyama, Koji; Ikeda, Tadashi

2018-01-01

Valve-sparing root replacement is increasingly used to overcome drawbacks associated with valvular prostheses. In our institution, 7 patients underwent valve-sparing root replacement from August 2016 to July 2017. The mean age was 45 years (range, 14~69 years). Three patients had Marfan syndrome and 1 had Loeys-Dietz syndrome with acute aortic dissection. All patients underwent surgery with reimplantation technique using a Valsalva graft. Two patients required repair of aortic valve leaflet prolapse. All patients had an excellent clinical course, with mild or no aortic regurgitation and a decrease in end-diastolic volume on echocardiography. These results support the continued use of valve-sparing root replacement in selected patients.

Complications and 2-year valve survival following Ahmed valve implantation during the first 2 years of life.

Science.gov (United States)

Almobarak, F; Al-Mobarak, F; Khan, A O

2009-06-01

To report complications and 2-year valve survival following Ahmed valve implantation during the first 2 years of life. Retrospective institutional case series. Forty-two eyes of 36 patients with Ahmed valve implantation (without prior drainage device surgery) during the first 2 years of life and 2 years' postsurgical follow-up were identified. Most eyes had primary congenital glaucoma (28/42, 66.7%), aphakic glaucoma (5/42, 11.9%) or Peters anomaly (5/42, 11.9%). All but three eyes had prior ocular surgery. Surgery was at a mean age of 11.83 months (m) (SD 5.63). The most common significant postoperative complications were tube malpositioning requiring intervention (11/42, 26.2%), endophthalmitis (3/42, 7.1%; one with tube exposure) and retinal detachment (3/42, 7.1%). Thirty-six eyes (85.8%) required resumption of antiglaucoma medications to maintain intraocular pressure (IOP) valve survival (IOPendophthalmitis and retinal detachment are known potential complications following any incisional surgery for advanced buphthalmos; however, tube exposure is a unique potential problem following aqueous shunt implantation that can lead to intraocular infection. Cumulative valve survival 2 years following implantation was 63.3%.

Sutureless implantation of the perceval s aortic valve prosthesis through right anterior minithoracotomy.

Science.gov (United States)

Gilmanov, Daniyar; Miceli, Antonio; Bevilacqua, Stefano; Farneti, Pierandrea; Solinas, Marco; Ferrarini, Matteo; Glauber, Mattia

2013-12-01

Many new, less invasive strategies are proposed for aortic valve operation in elderly patients. Rapid deployment sutureless aortic valve prosthesis has been recently introduced. We analyzed our experience with a sutureless valve implanted through a minimally invasive approach. A retrospective observational study with prospectively registered data was conducted on 137 patients undergoing aortic valve replacement through a right anterior minithoracotomy. Between April 2011 and January 2013, 137 consecutive patients underwent aortic valve replacement with a recently introduced, rapid deployment, sutureless pericardial valve in minithoracotomy access (47 men; mean age, 76.6 ± 7.1 years). There were 35 obese patients with a body mass index of more than 30 kg/m(2). Mean logistic EuroSCORE I was 10.0; 74 (54%) patients were in New York Heart Association functional class III and IV. In all, 19 (13.9%), 45 (32.8%), and 73 (53.3%) patients received 21-, 23-, and 25-mm valve prostheses, respectively. The mean aortic cross-clamp and cardiopulmonary bypass times were 59.3 ± 19 min and 92.3 ± 27 min, respectively. No operative mortality occurred. Median stay in the intensive care unit was 1 day, with assisted ventilation necessary for a median of 6 hours. Three cases of postoperative ischemic stroke were observed (1 patient with a previous history of an ischemic cerebral event). Median hospital length of stay was 6 days. A sutureless valve for minimally invasive aortic valve replacement is a feasible, effective, and safe tool. Ultimately amplifying indications for less invasive aortic valve replacement in a high surgical risk subset of patients, it can become a valid alternative for transcatheter aortic valve implantation. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Transcatheter aortic valve implantation in failed bioprosthetic surgical valves

DEFF Research Database (Denmark)

Dvir, Danny; Webb, John G; Bleiziffer, Sabine

2014-01-01

for patients with structural valve deterioration; however, a comprehensive evaluation of survival after the procedure has not yet been performed. OBJECTIVE: To determine the survival of patients after transcatheter valve-in-valve implantation inside failed surgical bioprosthetic valves. DESIGN, SETTING......, stroke, and New York Heart Association functional class. RESULTS: Modes of bioprosthesis failure were stenosis (n = 181 [39.4%]), regurgitation (n = 139 [30.3%]), and combined (n = 139 [30.3%]). The stenosis group had a higher percentage of small valves (37% vs 20.9% and 26.6% in the regurgitation...... and combined groups, respectively; P = .005). Within 1 month following valve-in-valve implantation, 35 (7.6%) patients died, 8 (1.7%) had major stroke, and 313 (92.6%) of surviving patients had good functional status (New York Heart Association class I/II). The overall 1-year Kaplan-Meier survival rate was 83...

Outcomes of Reoperative Valve Replacement in Patients with Prosthetic Valve Endocarditis: A 20-Year Experience

Directory of Open Access Journals (Sweden)

Young Woong Kim

2018-02-01

Full Text Available Background: Prosthetic valve endocarditis (PVE is a serious complication of cardiac valve replacement, and many p atients with P VE r equire r eoperation. The aim of t his study was to r eview our institutional 2 0 -year experience of surgical reoperative valve replacement in patients with PVE. Methods: A retrospective study was performed on 84 patients (mean age, 54.8±12.7 years; 51 males who were diagnosed with PVE and underwent reoperative valve replacement from January 1995 to December 2016. Results: PVE was found in 1 valve in 61 cases (72.6%, and in 2 or more valves in 23 cases (27.4%. The median follow-up duration was 47.3 months (range, 0 to 250 months. Postoperative complications occurred in 39 patients (46.4%. Reinfection occurred in 6 cases, all within 1 year. The freedom from reinfection rate at 5 years was 91.0%±3.5%. The overall survival rates at 5 and 10 years were 64.4%±5.8% and 54.3%±7.3%, respectively. In stepwise multivariable Cox proportional hazard models, older age (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.05 to 2.10; p=0.027 and cardiopulmonary bypass (CPB time (HR, 1.03; 95% CI, 1.00 to 1.0 1; p =0 . 0 33 e merged a s independent risk f actors f or d eath. Conclusion: Older age and a longer CPB time were associated with an increased risk of overall mortality in PVE patients.

Swing check valve

International Nuclear Information System (INIS)

Eminger, H.E.

1977-01-01

A swing check valve which includes a valve body having an inlet and outlet is described. A recess in the valve body designed to hold a seal ring and a check valve disc swingable between open and closed positions. The disc is supported by a high strength wire secured at one end in a support spacer pinned through bearing blocks fixed to the valve body and at its other end in a groove formed on the outer peripheral surface of the disc. The parts are designed and chosen such to provide a lightweight valve disc which is held open by minimum velocity of fluid flowing through the valve which thus reduces oscillations and accompanying wear of bearings supporting the valve operating parts. (Auth.)

The JUPITER registry: 1-year results of transapical aortic valve implantation using a second-generation transcatheter heart valve in patients with aortic stenosis.

Science.gov (United States)

Silaschi, Miriam; Treede, Hendrik; Rastan, Ardawan J; Baumbach, Hardy; Beyersdorf, Friedhelm; Kappert, Utz; Eichinger, Walter; Rüter, Florian; de Kroon, Thomas L; Lange, Rüdiger; Ensminger, Stephan; Wendler, Olaf

2016-11-01

Transcatheter aortic valve replacement (TAVR) is an established therapy for patients with aortic stenosis (AS) at high surgical risk. The JenaValve™ is a second-generation, self-expanding transcatheter heart valve (THV), implanted through transapical access (TA). During stent deployment, a specific 'clipping-mechanism' engages native aortic valve cusps for fixation. We present 1-year outcomes of the JUPITER registry, a post-market registry of the JenaValve for TA-TAVR. The JUPITER registry is a prospective, multicentre, uncontrolled and observational European study to evaluate the long-term safety and effectiveness of the Conformité Européenne-marked JenaValve THV. A total of 180 patients with AS were enrolled between 2012 and 2014. End-points were adjudicated in accordance with the valve academic research consortium document no. 1 definitions. The mean age was 80.4 ± 5.9 years and the mean logistic European system for cardiac operative risk evaluation I 21.2 ± 14.7%. The procedure was successful in 95.0% (171/180), implantation of a second THV (valve-in-valve) was performed in 2.2% (4/180) and conversion to surgical aortic valve replacement (SAVR) was necessary in 2.8% (5/180). No annular rupture or coronary ostia obstruction occurred. Two patients required SAVR after the day of index procedure (1.1%). All-cause mortality at 30 days was 11.1% (20/180), being cardiovascular in 7.2% (13/180). A major stroke occurred in 1.1% (2/180) at 30 days, no additional major strokes were observed during 1 year. All-cause mortality after 30 days was 13.1% (21/160) and combined efficacy at 1 year was 80.8% (122/151). At 1-year follow-up, no patient presented with more than moderate paravalvular leakage, while 2 patients (3.2%) showed moderate, 12 (19.0%) mild and 49 (82.4%) trace/none paravalvular regurgitation. In a high-risk cohort of patients undergoing TA-TAVR for AS, the use of the JenaValve THV is safe and effective. In patients at higher risk for coronary ostia

Practical use of valve seating machine with remote control system for main steam isolation valve at N.P.S

International Nuclear Information System (INIS)

Ito, Sadao; Noda, Hiroshi; Sadamura, Morito; Utsunomiya, Yasushi.

1975-01-01

The main steam isolation valves in BWR power stations are installed at the boundary of reactor containment vessels, and 2 valves in each main steam system total 8 valves in a plant. They are pneumatically operated Y type globe valves for preventing the release of radioactive substances in the atmosphere in case of the breaking of main steam pipes and also preventing the loss of coolant in case of the breaking of recirculating equipments. Therefore careful leak test, inspection, and seat-fitting are carried out to the valves at each regular maintenance. The manual maintenance work is difficult because of narrow space and the reduction of exposure, and the seat-fitting work requires the skill of high degree, therefore Okano Valve Manufacturing Co. and Tokyo Electric Power Co. jointly started the research and development of an automatic valve seating machine, and successfully put it to practical use in Fukushima No.1 Nuclear Power Station in Nov. 1974. First, the problems in the manual seat-fitting work were investigated, and the means to mechanically solve them were materialized with a prototype machine. After its mock-up test, an actual machine was designed and manufactured. The test result showed remarkable reduction of exposure and labor-saving, and the leak evaluation was sufficiently below the allowable value. (Kako, I.)

Pulmonary valve endocarditis associated to a septal interventricular defect and infundibular and pulmonary valve Stenosis

International Nuclear Information System (INIS)

Echeverri, Juan G; Diaz, Alejandro; Jaramillo, Nicolas; Gonzalez, Sergio

2004-01-01

Ventricular septal defects generate 10% of all adult congenital cardiopathies. 4% to 8% of patients to whom the defect has not been corrected are in risk of developing endocarditis. Pulmonary valve endocarditis is a rare event (1.5% to 2% of all endocarditis cases) and its mean etiology is intravenous drug abuse. The most frequently isolated microorganism in these cases is staphylococcus aurous. We report a case of pulmonary valve endocarditis associated with ventricular septal defect and valvular and infundibular pulmonary stenosis caused by streptococcus sp. in a patient without past medical history of drug abuse, alcoholism or previous invasive procedures

Gas-ion laser with gas pressure maintenance means

International Nuclear Information System (INIS)

Thatcher, J.B.

1975-01-01

A gas-ion laser is described including means to maintain the ionizable gas in the laser cavity at a rather constant pressure over an extended period of time to significantly increase the useful life of the gas-ion laser. The gas laser includes a gas makeup system having a high pressure source or storage container and a regulating valve. The valve has a permeable solid state orifice member through which the gas flows from the high pressure source to the laser cavity to replenish the gas in the laser cavity and maintain the gas pressure in the cavity rather constant. The permeable orifice member is selected from a solid state material having a permeability that is variable in relation to the magnitude of the energy applied to the orifice member. The gas-ion laser has a valve operating means such as a heater for varying the applied energy such as thermal energy to the member to regulate the gas flow. Additionally, the gas-ion laser has a valve control means that is responsive to the gas pressure in the laser cavity for controlling the valve control means to maintain the pressure at a desired level. (U.S.)

Modal-Based Design Improvement of a Butterfly Valve Disc

Directory of Open Access Journals (Sweden)

Marius Draghiciu

2017-11-01

Full Text Available The dynamic behaviour control of a butterfly valve is important because, when one of the valve disc natural frequency is close to the frequency of vortex shedding, which appears when the valve is fully open or partially closed, resonance may appear and vibration with significant amplitudes is generated. This paper presents an example by how the design of a butterfly valve disc can be improved by using a modal analysis performed by means of the finite element method. For this purpose, the research reveals the way in which the natural frequencies of the disc can be modified by applying stiffening ribs or changing the dimensions, respective the position of these ribs.

Experimental investigation of the check valve behaviour when the flow is reversing

Directory of Open Access Journals (Sweden)

Himr D.

2017-01-01

Full Text Available Check valve in a pipeline is supposed to prevent the reverse flow and to allow the flow in the positive direction. The construction of check valves follows these requirements, but the check valve must not cause pressure pulsations in transients. It means when the fluid is accelerating or decelerating. The article describes an experimental investigation of a swing check valve when the flow is changing its direction. The check valve was placed in an experimental circuit, where the pressure on the upstream and downstream side of the valve was measured and the current value of flow rate was determined. The goal was to simulate conditions in the real system, where the check valve slam had been observed.

Magnetostatic Analysis of a Pinch Mode Magnetorheological Valve

Directory of Open Access Journals (Sweden)

Gołdasz Janusz

2017-09-01

Full Text Available The study deals with the pinch mode of magnetorheological (MR fluids’ operation and its application in MR valves. By applying the principle in MR valves a highly non-uniform magnetic field can be generated in flow channels in such a way to solidify the portion of the material that is the nearest to the flow channel’s walls. This is in contrary to well-known MR flow mode valves. The authors investigate a basic pinch mode valve in several fundamental configurations, and then examine their magnetic circuits through magnetostatic finite-element (FE analysis. Flux density contour maps are revealed and basic performance figures calculated and analysed. The FE analysis results yield confidence in that the performance of MR pinch mode devices can be effectively controlled through electromagnetic means.

Impact of patient-prosthesis mismatch after transcatheter aortic valve-in-valve implantation in degenerated bioprostheses.

Science.gov (United States)

Seiffert, Moritz; Conradi, Lenard; Baldus, Stephan; Knap, Malgorzata; Schirmer, Johannes; Franzen, Olaf; Koschyk, Dietmar; Meinertz, Thomas; Reichenspurner, Hermann; Treede, Hendrik

2012-03-01

Transcatheter valve-in-valve implantation is evolving as an alternative to reoperative valve replacement in high-risk patients with degenerated bioprostheses. Nevertheless, hemodynamic performance is limited by the previously implanted xenograft. We report our experience with patient-prosthesis mismatch (PPM) after valve-in-valve implantation in the aortic position. Eleven patients (aged 79.3 ± 6.1 years) received transapical implantation of a balloon-expandable pericardial heart valve into a degenerated bioprosthesis (size, 23.9 ± 1.6 mm; range, 21-27 mm) in the aortic position. All patients were considered high risk for surgical valve replacement (logistic European System for Cardiac Operative Risk Evaluation, 31.8% ± 24.1%). Severe PPM was defined as an indexed effective orifice area less than 0.65 cm(2)/m(2), determined by discharge echocardiography. Severe PPM was evident in 5 patients (group 1) and absent in 6 patients (group 2). Mean transvalvular gradients decreased from 29.2 ± 15.4 mm Hg before implantation to 21.2 ± 9.7 mm Hg at discharge (group 1) and from 28.2 ± 9.0 mm Hg before implantation to 15.2 ± 6.5 mm Hg at discharge (group 2). Indexed effective orifice area increased from 0.5 ± 0.1 cm(2)/m(2) to 0.6 ± 0.1 cm(2)/m(2) and from 0.6 ± 0.3 cm(2)/m(2) to 0.8 ± 0.3 cm(2)/m(2). Aortic regurgitation decreased from grade 2.0 ± 1.1 to 0.4 ± 0.5 overall. No differences in New York Heart Association class improvement or survival during follow-up were observed. One patient required reoperation for symptomatic PPM 426 days after implantation. Valve-in-valve implantation can be performed in high-risk surgical patients to avoid reoperation. However, PPM frequently occurs, making adequate patient selection crucial. Small bioprostheses (body surface area less than 1.8 m(2). Larger prostheses seem to carry a lower risk for PPM. Although no delay in clinical improvement was seen at short-term, 1 PPM-related surgical intervention raises concern regarding

Valve Disease

Science.gov (United States)

... blood. There are 4 valves in the heart: tricuspid, pulmonary, mitral, and aortic. Two types of problems can disrupt blood flow through the valves: regurgitation or stenosis. Regurgitation is also called insufficiency or incompetence. Regurgitation happens when a valve doesn’ ...

Reduction of the suction losses through reed valves in hermetic reciprocating compressors using a magnet coil

Science.gov (United States)

Hopfgartner, J.; Posch, S.; Zuber, B.; Almbauer, R.; Krischan, K.; Stangl, S.

2017-08-01

Reed valves are widely used in hermetic reciprocating compressors and are responsible for a large part of the thermodynamic losses. Especially, the suction valve, which is opened nearly during the whole suction stroke, has a big potential for improvement. Usually, suction valves are opened only by vacuum created by the moving piston and should be closed before the compression stroke starts to avoid a reversed mass-flow through the valve. Therefore, the valves are prestressed, which results on the other hand in a higher flow resistance. In this work, a suction valve is investigated, which is not closed by the preload of the valve but by an electromagnetic coil located in the suction muffler neck. Shortly before the piston reaches its bottom dead centre, voltage is applied to the coil and a magnetic force is generated which pulls the valve shut. Thereby, the flow resistance through the valve can be reduced by changing the preload on the reed valve because it is no longer needed to close the valve. The investigation of this adapted valve and the electromagnetic coil is firstly done by numerical simulations including fluid structure interactions of the reed valves of a reciprocating compressor and secondly by experiments made on a calorimeter test bench.

Aortic valve replacement with the Biocor PSB stentless xenograft.

Science.gov (United States)

Bertolini, P; Luciani, G B; Vecchi, B; Pugliese, P; Mazzucco, A

1998-08-01

The midterm clinical results after aortic valve replacement with the Biocor PSB stentless xenograft on all patients operated between October 1992 and October 1996 were reviewed. One hundred six patients, aged 70+/-6 years, had aortic valve replacement for aortic stenosis (67%), regurgitation (11%), or both (22%). Associated procedures were done in 49 patients (46%), including coronary artery bypass in 30 patients, mitral valve repair/replacement in 16, and ascending aorta replacement in 5 patients. Aortic cross-clamp and cardiopulmonary bypass times were 96+/-24 and 129+/-31 minutes, respectively. There were 3 (3%) early deaths due to low output (2 patients) and cerebrovascular accident (1 patient). Follow-up of survivors ranged from 6 to 66 months (mean, 39+/-14 months). Survival was 94%+/-2% and 90%+/-3% at 1 and 5 years. There were 5 late deaths due to cardiac cause (2), cancer (2), and pulmonary embolism (1 patient). No patient had structural valve deterioration, whereas 100% and 95%+/-3% were free from valve-related events at 1 and 5 years. There were two reoperations due to narrowing of the left coronary ostium and endocarditis, with an actuarial freedom from reoperation of 99%+/-1% and 98+/-1% at 1 and 5 years, respectively. Functional results demonstrated a mean peak transprosthetic gradient of 16+/-12 mm Hg, with only 1 patient (1%) with a 55 mm Hg gradient. No cases of valve regurgitation greater than mild were recorded at follow-up. Assessment of New York Heart Association functional class demonstrated a significant improvement (2.9+/-0.6 versus 1.4+/-0.7; p=0.01). All patients were free from anticoagulation. Aortic valve replacement using the Biocor PSB stentless xenograft offers excellent midterm survival, negligible valve deterioration, and a very low rate of valve-related events, which are comparable to estimates reported with other models of stentless xenografts and currently available stented xenografts. Hemodynamic performance is favorable and

241-AN-A valve pit manifold valves and position indication acceptance test procedure

Energy Technology Data Exchange (ETDEWEB)

VANDYKE, D.W.

1999-08-25

This document describes the method used to test design criteria for gear actuated ball valves installed in 241-AN-A Valve Pit located at 200E Tank Farms. The purpose of this procedure is to demonstrate the following: Equipment is properly installed, labeled, and documented on As-Built drawings; New Manifold Valves in the 241-AN-A Valve Pit are fully operable using the handwheel of the valve operators; New valve position indicators on the valve operators will show correct valve positions; New valve position switches will function properly; and New valve locking devices function properly.

Aortic Valve Stenosis

Science.gov (United States)

... most cases, doctors don't know why a heart valve fails to develop properly, so it isn't something you could have prevented. Calcium buildup on the valve. With age, heart valves may accumulate deposits of calcium (aortic valve ...

Longitudinal Hemodynamics of Transcatheter and Surgical Aortic Valves in the PARTNER Trial.

Science.gov (United States)

Douglas, Pamela S; Leon, Martin B; Mack, Michael J; Svensson, Lars G; Webb, John G; Hahn, Rebecca T; Pibarot, Philippe; Weissman, Neil J; Miller, D Craig; Kapadia, Samir; Herrmann, Howard C; Kodali, Susheel K; Makkar, Raj R; Thourani, Vinod H; Lerakis, Stamatios; Lowry, Ashley M; Rajeswaran, Jeevanantham; Finn, Matthew T; Alu, Maria C; Smith, Craig R; Blackstone, Eugene H

2017-11-01

Use of transcatheter aortic valve replacement (TAVR) for severe aortic stenosis is growing rapidly. However, to our knowledge, the durability of these prostheses is incompletely defined. To determine the midterm hemodynamic performance of balloon-expandable transcatheter heart valves. In this study, we analyzed core laboratory-generated data from echocardiograms of all patients enrolled in the Placement of Aortic Transcatheter Valves (PARTNER) 1 Trial with successful TAVR or surgical AVR (SAVR) obtained preimplantation and at 7 days, 1 and 6 months, and 1, 2, 3, 4, and 5 years postimplantation. Patients from continued access observational studies were included for comparison. Successful implantation after randomization to TAVR vs SAVR (PARTNER 1A; TAVR, n = 321; SAVR, n = 313), TAVR vs medical treatment (PARTNER 1B; TAVR, n = 165), and continued access (TAVR, n = 1996). Five-year echocardiogram data were available for 424 patients after TAVR and 49 after SAVR. Death or reintervention for aortic valve structural indications, measured using aortic valve mean gradient, effective orifice area, Doppler velocity index, and evidence of hemodynamic deterioration by reintervention, adverse hemodynamics, or transvalvular regurgitation. Of 2795 included patients, the mean (SD) age was 84.5 (7.1) years, and 1313 (47.0%) were female. Population hemodynamic trends derived from nonlinear mixed-effects models showed small early favorable changes in the first few months post-TAVR, with a decrease of -2.9 mm Hg in aortic valve mean gradient, an increase of 0.028 in Doppler velocity index, and an increase of 0.09 cm2 in effective orifice area. There was relative stability at a median follow-up of 3.1 (maximum, 5) years. Moderate/severe transvalvular regurgitation was noted in 89 patients (3.7%) after TAVR and increased over time. Patients with SAVR showed no significant changes. In TAVR, death/reintervention was associated with lower ejection fraction, stroke volume

Aortic valve-sparing surgery in Marfan syndrome.

Science.gov (United States)

Nachum, Eyal; Shinfeld, Amichay; Kogan, Alexander; Preisman, Sergey; Levin, Shany; Raanani, Ehud

2013-08-01

Patients with Marfan syndrome are referred for cardiac surgery due to root aneurysm with or without aortic valve regurgitation. Because these patients are young and frequently present with normal-appearing aortic cusps, valve sparing is often recommended. However, due to the genetic nature of the disease, the durability of such surgery remains uncertain. Between February 2004 and June 2012, 100 patients in our department suffering from aortic aneurysm with aortic valve regurgitation underwent elective aortic valve-sparing surgery. Of them, 30 had Marfan syndrome, were significantly younger (30 +/- 13 vs. 53 +/- 16 years), and had a higher percentage of root aneurysm, compared with ascending aorta aneurysm in their non-Marfan counterparts. We evaluated the safety, durability, clinical and echocardiographic mid-term results of these patients. While no early deaths were reported in either group, there were a few major early complications in both groups. At follow-up (reaching 8 years with a mean of 34 +/- 26 months) there were no late deaths, and few major late complications in the Marfan group. Altogether, 96% and 78% of the patients were in New York Heart Association functional class I-II in the Marfan and non-Marfan groups respectively. None of the Marfan patients needed reoperation on the aortic valve. Freedom from recurrent aortic valve regurgitation > 3+ was 94% in the Marfan patients. Aortic valve-sparing surgery in Marfan symdrome patients is safe and yields good mid-term clinical outcomes.

Valve assembly

International Nuclear Information System (INIS)

Sandling, M.

1981-01-01

An improved valve assembly, used for controlling the flow of radioactive slurry, is described. Radioactive contamination of the air during removal or replacement of the valve is prevented by sucking air from the atmosphere through a portion of the structure above the valve housing. (U.K.)

ADAM®/SIPLUG®: An innovative valve monitoring system

International Nuclear Information System (INIS)

Muñoz, L.; Krell, M.

2012-01-01

Optimized maintenance strategies are a key aspect for safe and undisturbed plant operation. Innovative valve service solutions, e.g. valve diagnostics can support this in an efficient way. The ADAM®/SIPLUG® valve monitoring system allows full online monitoring of valves and actuators with automatic evaluation and assessment. Especially for safety-related and operation-related valves this provides valuable information on components condition to ensure proper function and contribute to optimization of maintenance strategies as well as effective maintenance performance. The new SIPLUG®-4 modules are the evolutionary solution for valve diagnosis at the Motor Control Center (MCC). As the SIPLUG®-4 can be installed directly in the MCC outgoing actuator power cable it allows an easy installation in existing switchgear cabinets. Measurement at MCC means also zero effort for performance of diagnostics reducing the number of on-site activities. This results in decrease of maintenance costs and dose rates for deployed personnel. The ADAM® evaluation software and database was developed in parallel with the hardware. It provides automatic analysis of the monitoring results using the limit values specified for the valves. The measured data can be transmitted via the power plant’s local area network to the ADAM® data server, if the SIPLUG® online hardware is installed. With the mobile solution, the data can be transmitted via serial or USB interface to a PC or notebook. With this solution all measurement information will be available immediately in the offices of plant engineers. Also, with SIPLUG® online all operations of valves can be automatically recorded. More than 25 years of experience in various plants worldwide show that the application of ADAM®/SIPLUG® valve diagnostics solution leads to increased plant safety and availability. Some of the references for ADAM®/SIPLUG® are Germany, Switzerland, Brazil, Spain and Eastern Europe. (author)

Mitral Valve Stenosis

Science.gov (United States)

... the left ventricle from flowing backward. A defective heart valve fails to either open or close fully. Risk factors Mitral valve stenosis is less common today than it once was because the most common cause, ... other heart valve problems, mitral valve stenosis can strain your ...

Structural valve deterioration in a starr-edwards mitral caged-disk valve prosthesis.

Science.gov (United States)

Aoyagi, Shigeaki; Tayama, Kei-Ichiro; Okazaki, Teiji; Shintani, Yusuke; Kono, Michitaka; Wada, Kumiko; Kosuga, Ken-Ichi; Mori, Ryusuke; Tanaka, Hiroyuki

2013-01-01

The durability of the Starr-Edwards (SE) mitral caged-disk valve, model 6520, is not clearly known, and structural valve deterioration in the SE disk valve is very rare. Replacement of the SE mitral disk valve was performed in 7 patients 23-40 years after implantation. Macroscopic examination of the removed disk valves showed no structural abnormalities in 3 patients, in whom the disk valves were removed at valves excised >36 years after implantation in 4 patients. Disk fracture, a longitudinal split in the disk along its circumference at the site of incorporation of the titanium ring, was detected in the valves removed 36 and 40 years after implantation, respectively, and many cracks were also observed on the outflow aspect of the disk removed 40 years after implantation. Disk fracture and localized disk wear were found in the SE mitral disk valves implanted >36 years previously. The present results suggest that SE mitral caged-disk valves implanted >20 years previously should be carefully followed up, and that those implanted >30 years previously should be electively replaced with modern prosthetic valves

Aortic valve replacement and the stentless Freedom SOLO valve

NARCIS (Netherlands)

Wollersheim, L.W.L.M.

2016-01-01

Aortic valve stenosis has become the most prevalent valvular heart disease in Europe and North America, and is generally caused by age-related calcification of the aortic valve. For most patients, severe symptomatic aortic stenosis needs effective mechanical relief in the form of valve replacement

Transcatheter Pulmonary Valve Replacement: Current State of Art.

Science.gov (United States)

Alkashkari, Wail; Alsubei, Amani; Hijazi, Ziyad M

2018-03-15

The past couple of decades have brought tremendous advances to the field of pediatric and adult congenital heart disease (CHD). Percutaneous valve interventions are now a cornerstone of not just the congenital cardiologist treating patients with congenital heart disease, but also-and numerically more importantly-for adult interventional cardiologists treating patients with acquired heart valve disease. Transcatheter pulmonary valve replacement (tPVR) is one of the most exciting recent developments in the treatment of CHD and has evolved to become an attractive alternative to surgery in patients with right ventricular outflow tract (RVOT) dysfunction. This review aims to summarize (1) the current state of the art for tPVR, (2) the expanding indications, and (3) the technological obstacles to optimizing tPVR. Since its introduction in 2000, more than ten thousands tPVR procedures have been performed worldwide. Although the indications for tPVR have been adapted earlier from those accepted for surgical intervention, they remain incompletely defined. The new imaging modalities give better assessment of cardiac anatomy and function and determine candidacy for the procedure. The procedure has been shown to be feasible and safe when performed in patients who received pulmonary conduit and or bioprosthetic valves between the right ventricle and the pulmonary artery. Fewer selected patients post trans-annular patch repair for tetralogy of Fallot may also be candidates for this technology. Size restrictions of the currently available valves limit deployment in the majority of patients post trans-annular patch repair. Newer valves and techniques are being developed that may help such patients. Refinements and further developments of this procedure hold promise for the extension of this technology to other patient populations.

Echocardiographic Evaluation of Hemodynamic Changes in Left-Sided Heart Valves in Pregnant Women With Valvular Heart Disease.

Science.gov (United States)

Samiei, Niloufar; Amirsardari, Mandana; Rezaei, Yousef; Parsaee, Mozhgan; Kashfi, Fahimeh; Hantoosh Zadeh, Sedigheh; Beikmohamadi, Somayeh; Fouladi, Masoumeh; Hosseini, Saeid; Peighambari, Mohammad Mehdi; Mohebbi, Ahmad

2016-10-01

Physiologic changes during pregnancy can deteriorate or improve patients' hemodynamic status in the setting of valvular heart disease. There are sparse data regarding the effect of pregnancy on valve hemodynamics in normal pregnant women with known valvular heart disease. In a prospective study from July 2014 to January 2016, a total of 52 normal pregnant women who had mitral stenosis, aortic stenosis, or a history of mitral valve or aortic valve replacements were assessed. All patients underwent echocardiographic examinations and hemodynamic parameters were measured for both the mitral valve and aortic valve at first, second, and third trimesters. The parameters included mean gradient, peak gradient, mean gradient/heart rate, peak gradient/heart rate, pressure halftime, dimensionless velocity index, and valve area. Although most hemodynamic parameters (i.e., mean gradient, peak gradient, mean gradient/heart rate, and peak gradient/heart rate) increased approximately 50% from first to second trimester and first to third trimester (p 0.05). The ratio of changes between trimesters for valve area and dimensionless velocity index were comparable. No clinical decompensations were observed except for 3 and 7 cases of deterioration to functional class II at second and third trimesters, respectively. In conclusion, during a full-term and uncomplicated pregnancy, mitral and aortic valve gradients increase without significant changes in valve area that are more marked between the second and first trimester than between the third and second trimester. Copyright © 2016 Elsevier Inc. All rights reserved.

Microfluidic sieve valves

Science.gov (United States)

Quake, Stephen R; Marcus, Joshua S; Hansen, Carl L

2015-01-13

Sieve valves for use in microfluidic device are provided. The valves are useful for impeding the flow of particles, such as chromatography beads or cells, in a microfluidic channel while allowing liquid solution to pass through the valve. The valves find particular use in making microfluidic chromatography modules.

Reasons for conversion and adverse intraoperative events in Endoscopic Port Access™ atrioventricular valve surgery and minimally invasive aortic valve surgery.

Science.gov (United States)

van der Merwe, Johan; Van Praet, Frank; Stockman, Bernard; Degrieck, Ivan; Vermeulen, Yvette; Casselman, Filip

2018-02-14

This study reports the factors that contribute to sternotomy conversions (SCs) and adverse intraoperative events in minimally invasive aortic valve surgery (MI-AVS) and minimally invasive Endoscopic Port Access™ atrioventricular valve surgery (MI-PAS). In total, 3780 consecutive patients with either aortic valve disease or atrioventricular valve disease underwent minimally invasive valve surgery (MIVS) at our institution between 1 February 1997 and 31 March 2016. MI-AVS was performed in 908 patients (mean age 69.2 ± 11.3 years, 45.2% women, 6.2% redo cardiac surgery) and MI-PAS in 2872 patients (mean age 64.1 ± 13.3 years, 46.7% women, 12.2% redo cardiac surgery). A cumulative total of 4415 MIVS procedures (MI-AVS = 908, MI-PAS = 3507) included 1537 valve replacements (MI-AVS = 896, MI-PAS = 641) and 2878 isolated or combined valve repairs (MI-AVS = 12, MI-PAS = 2866). SC was required in 3.0% (n = 114 of 3780) of MIVS patients, which occurred in 3.1% (n = 28 of 908) of MI-AVS patients and 3.0% (n = 86 of 2872) of MI-PAS patients, respectively. Reasons for SC in MI-AVS included inadequate visualization (n = 4, 0.4%) and arterial cannulation difficulty (n = 7, 0.8%). For MI-PAS, SC was required in 54 (2.5%) isolated mitral valve procedures (n = 2183). Factors that contributed to SC in MI-PAS included lung adhesions (n = 35, 1.2%), inadequate visualization (n = 2, 0.1%), ventricular bleeding (n = 3, 0.1%) and atrioventricular dehiscence (n = 5, 0.2%). Neurological deficit occurred in 1 (0.1%) and 3 (3.5%) MI-AVS and MI-PAS conversions, respectively. No operative or 30-day mortalities were observed in MI-AVS conversions (n = 28). The 30-day mortality associated with SC in MI-PAS (n = 86) was 10.5% (n = 9). MIVS is increasingly being recognized as the 'gold-standard' for surgical valve interventions in the context of rapidly expanding catheter-based technology and increasing

Quantitative assessment of an aortic and pulmonary valve function according to valve fenestration

International Nuclear Information System (INIS)

Mirkhani, S.H.; Golestani, M.G.; Hosini, M.; Kazemian, A.

1999-01-01

There are some reasons for malfunction of aortic and pulmonary valve like fibrosis, calcification, and atheroma. Although, in some papers fenestration were known as a pathologic sign, but it is not generally accepted, while this matter is important in choosing suitable Homograft Heart Valve. In this paper fenestrations and its size, numbers and situation effect was studied. We collected 98 hearts, the donors died because of accident, we excluded valves with atheroma, calcification, fibrosis and unequal cusps, 91 aortic and 93 pulmonary valves were given further consideration. We classified valves according to situation, number and size of fenestration. Each valve was tested with 104 cm of non-nal saline column pressure which is equal to 76 mm Hg. Valve efficacy was detected by fluid flow assay. With study of 184 valves, 95 had no fenestration, 64 had less than 2 fenestration and 25 had more than 2 fenestration. Valve efficacy in condition of less than 2 fenestration was more than others (p <0.01). Malfunction effects of fenestration increased in larger valve and it will be decreased if their situation would be marginal (free margin of cusp). In the comparison of aortic and pulmonary valve we saw that malfunction effect of fenestration in pulmonary valve was more than aortic valve. Our experience in Immam Khomeini Homograft Valve Bank has shown that a great deal of valves is fenestrated. It seems that fenestration must be considered as a quality criterion in homograft valve preparation, especially in pulmonary and large aortic valves; but complementary studies is necessary

Sequential transcatheter aortic valve implantation due to valve dislodgement - a Portico valve implanted over a CoreValve bioprosthesis.

Science.gov (United States)

Campante Teles, Rui; Costa, Cátia; Almeida, Manuel; Brito, João; Sondergaard, Lars; Neves, José P; Abecasis, João; M Gabriel, Henrique

2017-03-01

Transcatheter aortic valve implantation (TAVI) has become an important treatment in high surgical risk patients with severe aortic stenosis (AS), whose complications need to be managed promptly. The authors report the case of an 86-year-old woman presenting with severe symptomatic AS, rejected for surgery due to advanced age and comorbidities. The patient underwent a first TAVI, with implantation of a Medtronic CoreValve ® , which became dislodged and migrated to the ascending aorta. Due to the previous balloon valvuloplasty, the patient's AS became moderate, and her symptoms improved. After several months, she required another intervention, performed with a St. Jude Portico ® repositionable self-expanding transcatheter aortic valve. There was a good clinical response that was maintained at one-year follow-up. The use of a self-expanding transcatheter bioprosthesis with repositioning features is a solution in cases of valve dislocation to avoid suboptimal positioning of a second implant, especially when the two valves have to be positioned overlapping or partially overlapping each other. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

Aerodynamic instabilities in governing valves of steam turbines

International Nuclear Information System (INIS)

Richard, J.M.; Pluviose, M.

1991-01-01

The capacity of a.c. turbogenerators in a Pressurized Water Reactor (PWR) is regulated by means of governing valves located at the inlet of the high-pressure turbine. The conditions created in these valves (due to the throttling of the steam) involve the generation of a jet structure, possibly supersonic. Aerodynamic instabilities could potentially excite the mechanical structure. These aerodynamic phenomena are studied in this paper by means of a two-dimensional numerical model. Viscous effects are taken into account with heuristic criteria on separation and reattachment. Detailed experimental analysis of the flow behaviour is compared with the numerical prediction of stability limits. (Author)

[Periodontal microbiota and microorganisms isolated from heart valves in patients undergoing valve replacement surgery in a clinic in Cali, Colombia].

Science.gov (United States)

Moreno, Sandra; Parra, Beatriz; Botero, Javier E; Moreno, Freddy; Vásquez, Daniel; Fernández, Hugo; Alba, Sandra; Gallego, Sara; Castillo, Gilberto; Contreras, Adolfo

2017-12-01

Periodontitis is an infectious disease that affects the support tissue of the teeth and it is associated with different systemic diseases, including cardiovascular disease. Microbiological studies facilitate the detection of microorganisms from subgingival and cardiovascular samples. To describe the cultivable periodontal microbiota and the presence of microorganisms in heart valves from patients undergoing valve replacement surgery in a clinic in Cali. We analyzed 30 subgingival and valvular tissue samples by means of two-phase culture medium, supplemented blood agar and trypticase soy agar with antibiotics. Conventional PCR was performed on samples of valve tissue. The periodontal pathogens isolated from periodontal pockets were: Fusobacterium nucleatum (50%), Prevotella intermedia/ nigrescens (40%), Campylobacter rectus (40%), Eikenella corrodens (36.7%), Gram negative enteric bacilli (36.7%), Porphyromonas gingivalis (33.3%), and Eubacterium spp. (33.3%). The pathogens isolated from the aortic valve were Propionibacterium acnes (12%), Gram negative enteric bacilli (8%), Bacteroides merdae (4%), and Clostridium bifermentans (4%), and from the mitral valve we isolated P. acnes and Clostridium beijerinckii. Conventional PCR did not return positive results for oral pathogens and bacterial DNA was detected only in two samples. Periodontal microbiota of patients undergoing surgery for heart valve replacement consisted of species of Gram-negative bacteria that have been associated with infections in extraoral tissues. However, there is no evidence of the presence of periodontal pathogens in valve tissue, because even though there were valve and subgingival samples positive for Gram-negative enteric bacilli, it is not possible to maintain they corresponded to the same phylogenetic origin.

Long-Term Outcome of the Sorin Freedom SOLO Stentless Aortic Valve.

Science.gov (United States)

Christ, Torsten; Claus, Benjamin; Zielinski, Christina; Falk, Volkmar; Grubitzsch, Herko

2016-11-01

The Sorin Freedom SOLO valve is a third-generation stentless aortic valve which shows beneficial hemodynamic performance compared to stented bioprostheses. Long-term results regarding hemodynamics, the durability of the valve, and patient outcome are scarce, and their acquisition was the aim of this single-center study. Between 2005 and 2006, a total of 68 consecutive patients (30 males, 38 females; mean age at surgery 76.1 ± 6.3 years) underwent aortic valve replacement with a Sorin Freedom SOLO prosthesis. Indications were aortic stenosis (n = 50), aortic regurgitation (n = 1) and mixed lesions (n = 17). Associated procedures were performed in 31 patients (45.6%), most of which were coronary artery bypass grafting (68.8 %). The follow up was performed by telephone interviews, and clinical and echocardiographic examinations. Morbidity, mortality and echocardiographic data were analyzed. The total follow up was 501.1 patient-years, with a mean follow up of 7.4 ± 3.4 years (maximum 11.2 years). The follow up was 100% complete. Hospital mortality was 4.4% (n = 3). Actuarial survival at five and 10 years was 76.5 ± 5.1% and 41.5 ± 6.5%, respectively. Reinterventions were performed in eight patients; these included three reoperations due to endocarditis, four transcatheter aortic valve implantations, and one reoperation due to structural valve deterioration (SVD). The overall freedom from valve reintervention due to SVD at five and 10 years was 97.8 ± 2.2% and 82.9 ± 7.5%, respectively. After eight years, echocardiography demonstrated peak and mean transvalvular gradients of 18 ± 11 and 10 ± 7 mmHg, respectively. The overall effective and indexed aortic valve orifice areas were 1.73 ± 0.58 cm2 and 0.92 ± 0.33 cm2/m2, respectively. At long-term follow up the Sorin Freedom SOLO bioprosthesis was associated with favourable hemodynamic results and survival. Freedom from SVD was not superior to that occurring with stented bioprostheses.

Flow mapping for assessment of native and repaired valves

International Nuclear Information System (INIS)

Felner, J.; Pollack, S.; McMillan, S.; Yoganathan, A.; Knopf, W.; Craver, J.

1986-01-01

Color Doppler flow mapping (CDFM) was performed in 47 normal women ages 18-41 mean (m) 28 to determine the normal flow phenomena across each of the 4 heart valves. The group included: 15 elite marathon runners average run (ave.) 70 miles/week, heart rate (HR) 35-54 (m 45); 14 joggers ave. 40 mi/wkm HR 40-69 (m 53); and 17 controls 0 mi/wk, HR 49-93 (m 77). 2-D echo and CDFM defined the motion of each valve, including the presence of mitral valve prolapse (MVP), the ventricular inflow and outflow patterns and the presence of regurgitation

Factors influencing mortality after bioprosthetic valve replacement; a midterm outcome.

Science.gov (United States)

Javadzadegan, Hassan; Javadzadegan, Amir; Mehdizadeh Baghbani, Jafar

2013-01-01

Although valve repair is applied routinely nowadays, particularly for mitral regurgitation (MR) or tricuspid regurgitation (TR), valve replacement using prosthetic valves is also common especially in adults. Unfortunately the valve with ideal hemodynamic performance and long-term durability without increasing the risk of bleeding due to long-term anticoagulant therapy has not been introduced. Therefore, patients and physicians must choose either bioprosthetic or mechanical valves. Currently, there is an increasing clinical trend of using bioprosthetic valves instead of mechanical valves even in young patients apparently because of their advantages. Seventy patients undergone valvular replacement using bioprosthetic valves were evaluated by ECG and Echocardiography to assess the rhythm and ejection fracture. Mean follow-up time was 33 months (min 9, max 92). Mortality rate was 25.9% (n=18) within 8 years of follow-up. Statistical analysis showed a significant relation between atrial fibrillation rhythm and mortality (P=0.02). Morbidities occurred in 30 patients (42.8%). Significant statistical relation was found between the morbidities and age over 65 years old (P=0.005). In follow-up period, 4 cases (5.7%) underwent re-operation due to global valve dysfunction. Our study shows that using biprosthetic valve could reduce the risk of morbidity occurrence in patient who needs valve replacement. However, if medical treatments fail, patients should be referred for surgery. This would reduce the risk of mortality because of lower incident of complications such as atrial fibrillation and morbidities due to younger patients' population.

Rotary pneumatic valve

Science.gov (United States)

Hardee, Harry C.

1991-01-01

A rotary pneumatic valve which is thrust balanced and the pneumatic pressure developed produces only radial loads on the valve cylinder producing negligible resistance and thus minimal torque on the bearings of the valve. The valve is multiplexed such that at least two complete switching cycles occur for each revolution of the cylinder spindle.

Heavy gas valves

Energy Technology Data Exchange (ETDEWEB)

Steier, L [Vereinigte Armaturen Gesellschaft m.b.H., Mannheim (Germany, F.R.)

1979-01-01

Heavy gas valves must comply with special requirements. Apart from absolute safety in operation there are stringent requirements for material, sealing and ease of operation even in the most difficult conditions. Ball valves and single plate pipe gate valves lateral sealing rings have a dual, double sided sealing effect according to the GROVE sealing system. Single plate gate valves with lateral protective plates are suitable preferably for highly contaminated media. Soft sealing gate valves made of cast iron are used for low pressure applications.

Anterior urethral valves: not such a benign condition…

Directory of Open Access Journals (Sweden)

Omar eCruz-Diaz

2013-11-01

Full Text Available Purpose: Anterior urethral valves (AUV is an unusual cause of congenital obstruction of the male urethra, being 15 to 30 times less common than posterior urethral valves (PUV. It has been suggested that patients with congenital anterior urethral obstruction have a better prognosis than those with PUV.The long term prognosis of anterior urethral valves is not clear in the literature. In this report we describe our experience and long-term follow up of patients with AUV.Materials and methods: We retrospectively identified 13 patients who presented with the diagnosis of AUV in our institutions between 1994 and 2012. From the 11 patients included, we evaluated the gestational age, ultrasound and voiding cystourethrogram findings, age upon valve ablation, micturition pattern, creatinine and clinical follow up.Results: Between 1994 and 2012 we evaluated 150 patients with the diagnosis of urethral valves, where 11 patients (7.3% had AUV and an adequate follow up. Mean follow up is 6.3 years. 5 patients (45.4% had pre-natal diagnosis of AUV. The most common prenatal ultrasonographic finding was bilateral hydronephrosis and distended bladder.The mean gestational age was 37.6 weeks. Postnatally, 90% had trabeculated bladder, 80% hydronephrosis and 40% renal dysplasia. The most common clinical presentation was urinary tract infection in 5 patients (45.4%.7 patients (63.6% had primary transurethral valve resection or laser ablation and 3 patients (27.2% had primary vesicostomies. One boy (9.1% had urethrostomy with urethral diverticulum excision. 2 patients (18.2% developed end-stage renal disease (ESRD.Conclusions: Early urinary tract obstruction resulted in ESRD in 18% of our patient population. In our series, the complication rate and the evolution to renal failure are high and similar to patients with PUV. In patients with AUV we recommend long-term follow up and close evaluation of patient’s bladder and renal function.

Impact of Chronic Rheumatic Valve Diseases on Large Vessels.

Science.gov (United States)

Altunbas, Gokhan; Yuce, Murat; Ozer, Hasan O; Davutoglu, Vedat; Ercan, Suleyman; Kizilkan, Nese; Bilici, Muhammet

2016-01-01

BACKGROUND AND AIM OF STUDY: Rheumatic valvular heart disease, which remains a common health problem in developing countries, has numerous consequences on the heart chambers and circulation. The study aim was to investigate the effects of chronic rheumatic valve disease on the diameters of the descending aorta (DA) and inferior vena cava (IVC). METHODS: A total of 88 patients with echocardiographically documented rheumatic valvular heart disease and 112 healthy controls were enrolled into the study. All patients underwent detailed echocardiographic examinations, while their height and body weight were recorded and adjusted to their body surface area. RESULTS: The most common involvement was mitral valve disease, followed by aortic valve disease and tricuspid valve disease. The mean diameter of the DA (indexed to BSA) was 1.79 ± 0.49 cm for patients and 1.53 ± 0.41 for controls (p Rheumatic valve disease, especially mitral stenosis, was closely related to remodeling of the great vessels.

Hemodynamics in the Valsalva sinuses after transcatheter aortic valve implantation (TAVI).

Science.gov (United States)

Ducci, Andrea; Tzamtzis, Spyridon; Mullen, Michael J; Burriesci, Gaetano

2013-09-01

The study aim was to assess, in vitro, the hemodynamic modifications produced by transcatheter valves in the Valsalva sinuses, by mean of phase-resolved particle image velocimetry (PIV) measurements. Flow measurements were performed on a glass mock aortic root that included three polymeric valve leaflets, before and after the implantation of a Medtronic CoreValve device and of an Edwards SAPIEN valve. All experiments were carried out in a hydro-mechanical cardiovascular pulse duplicator system (Vivitro Superpump System SP3891) that reproduced physiologically equivalent pressures and flow rates conforming to the requirements of the standard ISO 5840:2005. The flow dynamics, before and after implantation of the two prosthetic devices, was characterized on the basis of phase-resolved velocity field and viscous shear rate measurements. Direct comparison indicated that both transcatheter valves determined a significant variation of flow during the early stages of valve opening and during valve closure. In general, the presence of the two valve implants significantly reduced the flow activity in the Valsalva sinuses, promoting regions of stagnation at their base. The reduction in flow in the Valsalva sinuses could be associated with the higher incidence of ischemic events reported after transcatheter heart valve implantation.

Midterm Results of Aortic Valve Replacement with Cryopreserved Homografts

Directory of Open Access Journals (Sweden)

Emre Özker

2012-06-01

Full Text Available Objective: The aim of this study was to analyze the midterm clinical results of aortic valve replacement with cryopreserved homografts.Materials and Methods: Aortic valve replacement was performed in 40 patients with cryopreserved homograft. The indications were aortic valve endocarditis in 20 patients (50%, truncus arteriosus in 6 patients (15%, and re-stenosis or regurtitation after aortic valve reconstruction in 14 (35% patients. The valve sizes ranged from 10 to 27mm. A full root replacement technique was used for homograft replacement in all patients.Results: The 30-day postoperative mortality rate was 12.5% (5 patients. There were four late deaths. Only one of them was related to cardiac events. Overall mortality was 22.5%. Thirty-three patients were followed up for 67±26 months. Two patients needed reoperation due to aortic aneurysm caused by endocarditis. The mean transvalvular gradient significantly decreased after valve replacement (p<0.003. The last follow up showed that the 27 (82% patients had a normal left ventricular function.Conclusion: Cryopreserved homografts are safe alternatives to mechanical valves that can be used when there are proper indications. Although it has a high perioperative mortality rate, cryopreserved homograft implantation is an alternative for valve replacement, particularly in younger patients and for complex surgical problems such as endocarditis that must be minimalized.

THE RESULTS OF SURGICAL TREATMENT OF TRICUSPID VALVE INFECTIVE ENDOCARDITIS USING VALVE REPAIR AND VALVE REPLACEMENT OPERATIONS

Directory of Open Access Journals (Sweden)

S. A. Kovalev

2015-01-01

Full Text Available Aim. To evaluate in-hospital and long-term results of surgical treatment of patients with infective endocarditis of the tricuspid valve, to compare the effectiveness of valve repair and valve replacement techniques, and to identify risk factors of mortality and reoperations. Materials and methods. 31 surgical patients with tricuspid valve infective endocarditis were evaluated. Patients were divided into 2 groups. In Group 1 (n = 14 repairs of the tricuspid valve were performed, in Group 2 (n = 17 patients had undergone tricuspid valve replacements. Epidemiological, clinical, microbiological and echocardiographic data were studied. Methods of comparative analysis, the Kaplan–Meier method, and Cox risk models were applied. Results. The most common complication of in-hospital stay was atrioventricular block (17.7% of cases in Group 2. In Group 1, this type of complication was not found. Hospital mortality was 7.14% in Group 1, and 0% in Group 2. Long-term results have shown the significant reduction of heart failure in general cohort and in both groups. In Group 1 the severity of heart failure in the long term was less than in Group 2. No significant differences in the severity of tricuspid regurgitation were found between the groups. In 7-year follow up no cases of death were registered in Group 1. Cumulative survival rate in Group 2 within 60 months was 67.3 ± 16.2%. No reoperations were performed in patients from Group 1. In Group 2, the freedom from reoperation within 60 months was 70.9 ± 15.3%. Combined intervention was found as predictor of postoperative mortality. Prosthetic valve endocarditis was identified as risk factor for reoperation. Conclusion. Valve repair and valve replacement techniques of surgical treatment of tricuspid valve endocarditis can provide satisfactory hospital and long-term results. Tricuspid valve repair techniques allowed reducing the incidence of postoperative atrioventricular block. In the long-term, patients

Cobalt reduction of NSSS valve hardfacings for ALARA

Energy Technology Data Exchange (ETDEWEB)

Kim, Joo Hak; Lee, Sang Sub [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

1994-07-01

This report informs NSSS designer that replacement of materials is one of the major means of ALARA implementation, and describes that NSSS valves with high-cobalt hardfacing are significant contributors to post-shutdown radiation fields caused by activation of cobalt-59 to cobalt-60. Generic procedures for implementing cobalt reduction programs for valves are presented. Discussions are presented of the general and specific design requirements for valve hardfacing in nuclear service. The nuclear safety issues involved with changing valve hardfacing materials are discussed. The common methods used to deposit hardfacing materials are described together with an explanation of the wear measurements. Wear resistance, corrosion resistance, friction coefficient, and mechanical properties of candidate hardfacing alloys are given. World-wide nuclear utility experience with cobalt-free hardfacing alloys is described. The use of low-cobalt or cobalt-free alloys in other nuclear plant components is described. 17 figs., 38 tabs., 18 refs. (Author).

Cobalt reduction of NSSS valve hardfacings for ALARA

International Nuclear Information System (INIS)

Kim, Joo Hak; Lee, Sang Sub

1994-07-01

This report informs NSSS designer that replacement of materials is one of the major means of ALARA implementation, and describes that NSSS valves with high-cobalt hardfacing are significant contributors to post-shutdown radiation fields caused by activation of cobalt-59 to cobalt-60. Generic procedures for implementing cobalt reduction programs for valves are presented. Discussions are presented of the general and specific design requirements for valve hardfacing in nuclear service. The nuclear safety issues involved with changing valve hardfacing materials are discussed. The common methods used to deposit hardfacing materials are described together with an explanation of the wear measurements. Wear resistance, corrosion resistance, friction coefficient, and mechanical properties of candidate hardfacing alloys are given. World-wide nuclear utility experience with cobalt-free hardfacing alloys is described. The use of low-cobalt or cobalt-free alloys in other nuclear plant components is described. 17 figs., 38 tabs., 18 refs. (Author)

Personal Meaning Orientations and Psychosocial Adaptation in Older Adults

Directory of Open Access Journals (Sweden)

Gary T. Reker

2011-04-01

Full Text Available This study examined how different patterns of sources of meaning in life impact the psychosocial adaptation of older adults. A total of 120 (62 women and 58 men community-residing older adults completed self-report measures of sources of meaning in life, physical health, life satisfaction, depression, personality, existential regrets, attitudes toward aging, and attitudes toward life. Cluster analysis of sources of meaning revealed four distinct meaning orientations: self-transcendent (n = 32, collectivistic (n = 24, individualistic (n = 34, and self-preoccupied (n = 30. MANCOVA analysis of the four groups, controlling for age, marital status, education, and financial satisfaction, revealed a strong multivariate main effect for meaning orientation. No statistically significant gender and Gender × Meaning orientation interaction effects were found. Older adults, who derive meaning from self-transcendent sources, are more extraverted, open to experience, agreeable, and conscientious; perceive greater purpose and coherence in life; feel more in control in directing their lives; express a stronger desire to get more out of life; and are less depressed compared with those who derive meaning through pursuing self-serving interests without any real commitment to personal, interpersonal, or societal development. The implications of the findings for positive aging are discussed.

Proving test on the reliability for nuclear valves

International Nuclear Information System (INIS)

Kajiyama, Yasuo; Tashiro, Hisao; Uga, Takeo; Maeda, Shunichi.

1986-01-01

Since valves are the most common components, they could be the most frequent causes of troubles in nuclear power plants. This proving test, therefore, has an important meaning to examine and verify the reliability of various valves under simulating conditions of abnormal and transient operations of the nuclear power plant. The test was performed mainly for the various types and pressure ratings of valves which were used in the primary and secondary systems in BWR and PWR nuclear power plants and which had major operating or safety related functions in those nuclear power plants. The results of the proving test, confirmed for more than four years, showed relatively favourable performance of the tested valves. It is concluded that performances of valves including operability, seat sealing and structural integrity were proved under the thermal cycling, vibration and pipe reaction load conditions. Operating functions during and after accident such as loss of coolant accident were satisfactory. From these results, it was considered that the purpose of this proving test was satisfactorily fulfilled. Several data accumulated by the test would be useful to get better reliability if it was evaluated with the actually experienced data of valves in the nuclear power plants. (Nogami, K.)

Development and Characterization a Single-Active-Chamber Piezoelectric Membrane Pump with Multiple Passive Check Valves.

Science.gov (United States)

Zhang, Ronghui; You, Feng; Lv, Zhihan; He, Zhaocheng; Wang, Haiwei; Huang, Ling

2016-12-12

In order to prevent the backward flow of piezoelectric pumps, this paper presents a single-active-chamber piezoelectric membrane pump with multiple passive check valves. Under the condition of a fixed total number of passive check valves, by means of changing the inlet valves and outlet valves' configuration, the pumping characteristics in terms of flow rate and backpressure are experimentally investigated. Like the maximum flow rate and backpressure, the testing results show that the optimal frequencies are significantly affected by changes in the number inlet valves and outlet valves. The variation ratios of the maximum flow rate and the maximum backpressure are up to 66% and less than 20%, respectively. Furthermore, the piezoelectric pump generally demonstrates very similar flow rate and backpressure characteristics when the number of inlet valves in one kind of configuration is the same as that of outlet valves in another configuration. The comparison indicates that the backflow from the pumping chamber to inlet is basically the same as the backflow from the outlet to the pumping chamber. No matter whether the number of inlet valves or the number of outlet valves is increased, the backflow can be effectively reduced. In addition, the backpressure fluctuation can be significantly suppressed with an increase of either inlet valves or outlet valves. It also means that the pump can prevent the backflow more effectively at the cost of power consumption. The pump is very suitable for conditions where more accurate flow rates are needed and wear and fatigue of check valves often occur.

Analysis of Mitral Valve Replacement Outcomes is Enhanced by Meaningful Clinical Use of Electronic Health Records

Science.gov (United States)

Chen, John C; Pfeffer, Thomas; Johnstone, Shelley; Chen, Yuexin; Kiley, Mary-Lou; Richter, Richard; Lee, Hon

2013-01-01

Objective: Cardiac surgical mortality has improved during the last decade despite the aging of the population. An integrated US health plan developed a heart valve registry to track outcomes and complications of heart valve operations. This database was used for longitudinal evaluation of mitral valve (MV) outcomes from 1999 to 2008 at four affiliated hospitals. Methods: We identified 3130 patients in the Apollo database who underwent 3180 initial MV procedures. Internal administrative and Social Security Administration databases were merged to determine survival rates. Electronic health records were searched to ascertain demographics, comorbidities, and postoperative complications. Cox regression was used to evaluate mean survival and identify risk factors. Results: The procedures included 1160 mechanical valve replacements, 1159 tissue valve replacements, and 861 annuloplasties. The mean age of patients undergoing these procedures was 58 ± 11 years, 69 ± 12 years, and 62 ± 12 years, respectively. Mean survival was 8.9 ± 0.1 years for mechanical valve replacement, 7.0 ± 0.1 years for tissue valve replacement, and 7.7 ± 0.1 years for annuloplasty. Early in the study, there was a preference for implanting mechanical MVs. Beginning in 2003, more patients received tissue valve replacements rather than mechanical valves. Over time, there was an increasing trend of annuloplasty. Cox regression analysis identified the following risk factors for increased ten-year mortality: tissue valve implantation; advanced age; female sex; nonelective, nonisolated procedure; diabetes; postoperative use of banked blood products; previous cardiovascular intervention; dialysis; and longer perfusion time. Hospital location, reoperation, preoperative anticoagulation, and cardiogenic shock were not statistically significant risk factors. Conclusions: When controlling for other risk factors, we observed a lower long-term survival rate for tissue valve replacement compared with

Valve-sparing root replacement in children with aortic root aneurysm: mid-term results.

Science.gov (United States)

Lange, Rüdiger; Badiu, Catalin C; Vogt, Manfred; Voss, Bernhard; Hörer, Jürgen; Prodan, Zsolt; Schreiber, Christian; Mazzitelli, Domenico

2013-05-01

We aimed at evaluating the results of aortic valve-sparing root replacement (AVSRR) in children with aortic root aneurysm (ARA) due to genetic disorders in terms of mortality, reoperation and recurrent aortic valve regurgitation (AVR). Thirteen patients (mean age 9.7 ± 6.5 years, 10 months-18 years) underwent AVSRR for ARA between 2002 and 2011. Six of the 13 patients had Marfan syndrome, 3 Loeys-Dietz syndrome (LDS), 2 bicuspid aortic valve syndrome and 2 an unspecified connective tissue disorder. AVR was graded as none/trace, mild and severe in 5, 7 and 1 patient, respectively. The mean pre-operative root diameter was 45 ± 10 mm (mean Z-score 10.3 ± 2.0). Remodelling of the aortic root was performed in 4 patients, reimplantation of the aortic valve in 9 and a concomitant cusp repair in 4. The diameter of the prostheses used for root replacement varied from 22 to 30 mm (mean Z-score = 2.3 ± 3). The follow-up was 100% complete with a mean follow-up time of 3.7 years. There was no operative mortality. One patient with LDS died 2.5 years after the operation due to spontaneous rupture of the descending aorta. Root re-replacement with mechanical conduit was necessary in 1 patient for severe recurrent AVR 8 days after remodelling of the aortic root. At final follow-up, AVR was graded as none/trace and mild in all patients. Eleven patients presented in New York Heart Association functional Class I and 1 in Class II. In paediatric patients with ARA, valve-sparing root replacement can be performed with low operative risk and excellent mid-term valve durability. Hence, prosthetic valve-related morbidity may be avoided. Due to the large diameters of the aortic root and the ascending aorta, the size of the implanted root prostheses will not limit later growth of the native aorta.

Clinical Implication of Transaortic Mitral Pannus Removal During Repeat Cardiac Surgery for Patients With Mechanical Mitral Valve.

Science.gov (United States)

Park, Byungjoon; Sung, Kiick; Park, Pyo Won

2018-01-25

This study aimed to evaluate the safety and feasibility of transaortic mitral pannus removal (TMPR).Methods and Results:Between 2004 and 2016, 34 patients (median age, 57 years; 30 women) with rheumatic disease underwent pannus removal on the ventricular side of a mechanical mitral valve through the aortic valve during reoperation. The median time interval from the previous surgery was 14 years. TMPR was performed after removal of the mechanical aortic valve (n=21) or diseased native aortic valve (n=11). TMPR was performed in 2 patients through a normal aortic valve. The mitral transprosthetic mean pressure gradient (TMPG) was ≥5 mmHg in 11 patients, including 3 with prosthetic valve malfunction. Prophylactic TMPR was performed in 23 patients. There were no early deaths. Concomitant operations included 22 tricuspid valve surgeries (13 replacements, 15 repairs) and 32 aortic valve replacements (24 repeats, 8 primary). The mean gradient in patients who had mitral TMPG ≥5 mmHg was significantly decreased from 6.46±1.1 to 4.37±1.17 mmHg at discharge (Ppannus overgrowth in such valves.

Force measuring valve assemblies, systems including such valve assemblies and related methods

Science.gov (United States)

DeWall, Kevin George [Pocatello, ID; Garcia, Humberto Enrique [Idaho Falls, ID; McKellar, Michael George [Idaho Falls, ID

2012-04-17

Methods of evaluating a fluid condition may include stroking a valve member and measuring a force acting on the valve member during the stroke. Methods of evaluating a fluid condition may include measuring a force acting on a valve member in the presence of fluid flow over a period of time and evaluating at least one of the frequency of changes in the measured force over the period of time and the magnitude of the changes in the measured force over the period of time to identify the presence of an anomaly in a fluid flow and, optionally, its estimated location. Methods of evaluating a valve condition may include directing a fluid flow through a valve while stroking a valve member, measuring a force acting on the valve member during the stroke, and comparing the measured force to a reference force. Valve assemblies and related systems are also disclosed.

Magnetically operated check valve

Science.gov (United States)

Morris, Brian G.; Bozeman, Richard J., Jr.

1994-06-01

A magnetically operated check valve is disclosed. The valve is comprised of a valve body and a movable poppet disposed therein. A magnet attracts the poppet to hold the valve shut until the force of fluid flow through the valve overcomes the magnetic attraction and moves the poppet to an unseated, open position. The poppet and magnet are configured and disposed to trap a magnetically attracted particulate and prevent it from flowing to a valve seating region.

Low intake valve lift in a port fuel-injected engine

Energy Technology Data Exchange (ETDEWEB)

Begg, S.M.; Hindle, M.P.; Cowell, T.; Heikal, M.R. [The Sir Harry Ricardo Laboratories, Centre for Automotive Engineering, Cockcroft Building, University of Brighton, Lewes Road, Brighton, East Sussex, BN2 4GJ (United Kingdom)

2009-12-15

A phenomenological study of the airflow and fuel spray interaction in a variable valve gasoline engine is presented. Experiments were performed in a steady-state flow rig fitted with a modified production cylinder head. The intake valve lift was varied manually. The mass flow rates of air and fuel through the test rig were adjusted to match typical engine operating conditions. Particle Image Velocimetry (PIV) and Laser Doppler Anemometry (LDA) measurements of the airflow showed the breakdown of a single, forward tumbling vortex-like structure into a pair of high-speed, turbulent jets at low valve lifts. Two transitional phases in the flow at the valve gap were identified for valve lifts less than 1.5 mm and greater than 3 mm. At the lower limit, a jet flapping instability was recorded. A port fuel injector (PFI) spray was characterised in a quiescent, chamber and within the test rig. High Speed Photography (HSP) and Phase Doppler Anemometry (PDA) were used to measure the effects of varying valve lift upon the fuel droplet characteristics. The in-cylinder measurements showed a reduction in mean droplet diameter of up to 50%, close to the valve gap, for peak valve lifts of less than 3 mm. (author)

A remote control valve

International Nuclear Information System (INIS)

Cachard, Maurice de; Dumont, Maurice.

1976-01-01

This invention concerns a remote control valve for shutting off or distributing a fluid flowing at a high rate and low pressure. Among the different valves at present in use, electric valves are the most recommended for remote control but their reliability is uncertain and they soon become costly when large diameter valves are used. The valve described in this invention does away with this drawback owing to its simplicity and the small number of moving parts, this makes it particularly reliable. It mainly includes: a tubular body fitted with at least one side opening; at least one valve wedge for this opening, coaxial with the body, and mobile; a mobile piston integral with this wedge. Several valves to the specifications of this invention can be fitted in series (a shut-off valve can be used in conjunction with one or more distribution valves). The fitting and maintenance of the valve is very simple owing to its design. It can be fabricated in any material such as metals, alloys, plastics and concrete. The structure of the valve prevents the flowing fluid from coming into contact with the outside environment, thereby making it particularly suitable in the handling of dangerous or corrosive fluids. Finally, the opening and shutting of the valve occurs slowly, thereby doing away with the water hammer effect so frequent in large bore pipes [fr

Infective Endocarditis of the Aortic Valve with Anterior Mitral Valve Leaflet Aneurysm

NARCIS (Netherlands)

Tomsic, Anton; Li, Wilson W. L.; van Paridon, Marieke; Bindraban, Navin R.; de Mol, Bas A. J. M.

2016-01-01

Mitral valve leaflet aneurysm is a rare and potentially devastating complication of aortic valve endocarditis. We report the case of a 48-year-old man who had endocarditis of the native aortic valve and a concomitant aneurysm of the anterior mitral valve leaflet. Severe mitral regurgitation occurred

Aortic valve insufficiency in the teenager and young adult: the role of prosthetic valve replacement.

Science.gov (United States)

Bradley, Scott M

2013-10-01

The contents of this article were presented in the session "Aortic insufficiency in the teenager" at the congenital parallel symposium of the 2013 Society of Thoracic Surgeons (STS) annual meeting. The accompanying articles detail the approaches of aortic valve repair and the Ross procedure.(1,2) The current article focuses on prosthetic valve replacement. For many young patients requiring aortic valve surgery, either aortic valve repair or a Ross procedure provides a good option. The advantages include avoidance of anticoagulation and potential for growth. In other patients, a prosthetic valve is an appropriate alternative. This article discusses the current state of knowledge regarding mechanical and bioprosthetic valve prostheses and their specific advantages relative to valve repair or a Ross procedure. In current practice, young patients requiring aortic valve surgery frequently undergo valve replacement with a prosthetic valve. In STS adult cardiac database, among patients ≤30 years of age undergoing aortic valve surgery, 34% had placement of a mechanical valve, 51% had placement of a bioprosthetic valve, 9% had aortic valve repair, and 2% had a Ross procedure. In the STS congenital database, among patients 12 to 30 years of age undergoing aortic valve surgery, 21% had placement of a mechanical valve, 18% had placement of a bioprosthetic valve, 30% had aortic valve repair, and 24% had a Ross procedure. In the future, the balance among these options may be altered by design improvements in prosthetic valves, alternatives to warfarin, the development of new patch materials for valve repair, and techniques to avoid Ross autograft failure.

Development and Characterization a Single-Active-Chamber Piezoelectric Membrane Pump with Multiple Passive Check Valves

Directory of Open Access Journals (Sweden)

Ronghui Zhang

2016-12-01

Full Text Available In order to prevent the backward flow of piezoelectric pumps, this paper presents a single-active-chamber piezoelectric membrane pump with multiple passive check valves. Under the condition of a fixed total number of passive check valves, by means of changing the inlet valves and outlet valves’ configuration, the pumping characteristics in terms of flow rate and backpressure are experimentally investigated. Like the maximum flow rate and backpressure, the testing results show that the optimal frequencies are significantly affected by changes in the number inlet valves and outlet valves. The variation ratios of the maximum flow rate and the maximum backpressure are up to 66% and less than 20%, respectively. Furthermore, the piezoelectric pump generally demonstrates very similar flow rate and backpressure characteristics when the number of inlet valves in one kind of configuration is the same as that of outlet valves in another configuration. The comparison indicates that the backflow from the pumping chamber to inlet is basically the same as the backflow from the outlet to the pumping chamber. No matter whether the number of inlet valves or the number of outlet valves is increased, the backflow can be effectively reduced. In addition, the backpressure fluctuation can be significantly suppressed with an increase of either inlet valves or outlet valves. It also means that the pump can prevent the backflow more effectively at the cost of power consumption. The pump is very suitable for conditions where more accurate flow rates are needed and wear and fatigue of check valves often occur.

Meaning of visualizing retinal cone mosaic on adaptive optics images.

Science.gov (United States)

Jacob, Julie; Paques, Michel; Krivosic, Valérie; Dupas, Bénédicte; Couturier, Aude; Kulcsar, Caroline; Tadayoni, Ramin; Massin, Pascale; Gaudric, Alain

2015-01-01

To explore the anatomic correlation of the retinal cone mosaic on adaptive optics images. Retrospective nonconsecutive observational case series. A retrospective review of the multimodal imaging charts of 6 patients with focal alteration of the cone mosaic on adaptive optics was performed. Retinal diseases included acute posterior multifocal placoid pigment epitheliopathy (n = 1), hydroxychloroquine retinopathy (n = 1), and macular telangiectasia type 2 (n = 4). High-resolution retinal images were obtained using a flood-illumination adaptive optics camera. Images were recorded using standard imaging modalities: color and red-free fundus camera photography; infrared reflectance scanning laser ophthalmoscopy, fluorescein angiography, indocyanine green angiography, and spectral-domain optical coherence tomography (OCT) images. On OCT, in the marginal zone of the lesions, a disappearance of the interdigitation zone was observed, while the ellipsoid zone was preserved. Image recording demonstrated that such attenuation of the interdigitation zone co-localized with the disappearance of the cone mosaic on adaptive optics images. In 1 case, the restoration of the interdigitation zone paralleled that of the cone mosaic after a 2-month follow-up. Our results suggest that the interdigitation zone could contribute substantially to the reflectance of the cone photoreceptor mosaic. The absence of cones on adaptive optics images does not necessarily mean photoreceptor cell death. Copyright © 2015 Elsevier Inc. All rights reserved.

Thrombocytopenia following implantation of the stentless biological sorin freedom SOLO valve.

Science.gov (United States)

Gersak, Borut; Gartner, Urska; Antonic, Miha

2011-07-01

Stentless biological valves have proven advantages in hemodynamic performance and left ventricular function compared to stented biological valves. Following a marked postoperative fall in the platelet count of patients after implantation of the Freedom SOLO valve, the study aim was to confirm clinical observations that this effect was more severe in patients receiving Freedom SOLO valves than in those receiving St. Jude Medical (SJM) mechanical aortic valves. Preoperative and postoperative platelet counts were compared in two groups of patients who underwent aortic valve replacement (AVR) without any concomitant procedures between January and December 2007. Patients received either a Freedom SOLO valve (n = 28) or a SJM mechanical valve (n = 41). Mean values of platelet counts were compared using three multiple linear regression models. Platelet counts were significantly lower in the Freedom SOLO group than in the SJM group from the first postoperative day (POD 1) up to POD 6 (p SOLO group the platelet count fell below 30x10(9)/l, while the lowest level in the SJM group was 75x10(9)/l. Based on multiple linear regression models, the type of valve implanted had a statistically significant influence on postoperative platelet counts on POD 1, POD 3, and POD 5 (p SOLO group.

A comparison of conventional surgery, transcatheter aortic valve replacement, and sutureless valves in "real-world" patients with aortic stenosis and intermediate- to high-risk profile.

Science.gov (United States)

Muneretto, Claudio; Alfieri, Ottavio; Cesana, Bruno Mario; Bisleri, Gianluigi; De Bonis, Michele; Di Bartolomeo, Roberto; Savini, Carlo; Folesani, Gianluca; Di Bacco, Lorenzo; Rambaldini, Manfredo; Maureira, Juan Pablo; Laborde, Francois; Tespili, Maurizio; Repossini, Alberto; Folliguet, Thierry

2015-12-01

We sought to investigate the clinical outcomes of patients with isolated severe aortic stenosis and an intermediate- to high-risk profile treated by means of conventional surgery (surgical aortic valve replacement), sutureless valve implantation, or transcatheter aortic valve replacement in a multicenter evaluation. Among 991 consecutive patients with isolated severe aortic stenosis and an intermediate- to high-risk profile (Society of Thoracic Surgeons score >4 and logistic European System for Cardiac Operative Risk Evaluation I >10), a propensity score analysis was performed on the basis of the therapeutic strategy: surgical aortic valve replacement (n = 204), sutureless valve implantation (n = 204), and transcatheter aortic valve replacement (n = 204). Primary end points were 30-day mortality and overall survival at 24-month follow-up; the secondary end point was survival free from a composite end point of major adverse cardiac events (defined as cardiac-related mortality, myocardial infarction, cerebrovascular accidents, and major hemorrhagic events) and periprosthetic regurgitation greater than 2. Thirty-day mortality was significantly higher in the transcatheter aortic valve replacement group (surgical aortic valve replacement = 3.4% vs sutureless = 5.8% vs transcatheter aortic valve replacement = 9.8%; P = .005). The incidence of postprocedural was 3.9% in asurgical aortic valve replacement vs 9.8% in sutureless vs 14.7% in transcatheter aortic valve replacement (Prisk factor for overall mortality hazard ratio (hazard ratio, 2.5; confidence interval, 1.1-4.2; P = .018). The use of transcatheter aortic valve replacement in patients with an intermediate- to high-risk profile was associated with a significantly higher incidence of perioperative complications and decreased survival at short- and mid-term when compared with conventional surgery and sutureless valve implantation. Copyright © 2015 The American Association for Thoracic Surgery. Published by

THE PROGNOSIS IN TRANSCATHETER AORTIC VALVE IMPLANTATION

Directory of Open Access Journals (Sweden)

T. E. Imaev

2016-01-01

Full Text Available Aim. To study the effect of transcatheter aortic valve implantation (TAVI, performed by different types of prostheses and various surgical access, on the prognosis of patients with critical aortic stenosis and comorbidities.Material and methods. Patients (n=130 that had consistently performed 80 TAVI by Edwards valve transfemoral (n=50 and transapical (n=30 access, as well as 50 transcatheter aortic valve replacement by CoreValve system were included into the study. Complications including perioperative mortality, total 30-day mortality, as well as post-hospital mortality were registered during aortic valve replacement, immediately after surgery, before the expiry of 30 days. Mean follow-up was 2.2 years (range 0.2 to 5.2 years.Results. Hospital mortality was on average 6.9%. 121 patients had been discharged from the department after the surgery. The number of deaths in the post-hospital period was 14.8%. Valve type and the type of access had no effect on post-hospital mortality. Men died more than 2.5 times often than women, regardless of age. Atrioventricular block, pacemaker implantation, and history of chronic obstructive pulmonary disease were the most significant prognostic factors. An important role of minor stroke and renal failure should be noted. Mortality did not depend on the surgical access or valve type. All parameters characterizing the intervention were significantly associated with mortality, both during and after surgery. The proportion of survivors at the end of the first year of observation using Corvalve system was 86.9%, Edwards valve by transfemoral access - 88% and Edwards valve by transapical access – 85.4% (insignificant differences for all groups, p>0.05. Two-year survival was 77.5%, 82.5% and 82.7%, respectively (also insignificant differences for all groups, p>0.05.Conclusion. TAVI is the method of choice, reasonable alternative approach for surgical valve replacement in patients with high surgical risk, although

A 3D velocimetry study of the flow through prosthetic heart valves

Science.gov (United States)

Ledesma, R.; Zenit, R.; Pulos, G.; Sanchez, E.; Juarez, A.

2006-11-01

Blood damage commonly appears in medical valve prothesis. It is a mayor concern for the designers and surgeons. It is well known that this damage and other complications result from the modified fluid dynamics through the replacement valve. To evaluate the performance of prosthetic heart valves, it is necessary to study the flow through them. To conduct this study , we have built a flow channel that emulates cardiac conditions and allows optical access such that a 3D-PIV velocimetry system could be used. The experiments are aimed to reconstruct the downstream structure of the flow through a mechanical and a bio-material tricuspid heart valve prothesis. Preliminary results show that the observed coherent structures can be related with haemolysis and trombosis, illnesses commonly found in valve prothesis recipients. The mean flow, the levels of strain rate and the turbulence intensity generated by the valves can also be directly related to blood damage. In general, bio-material made valves tend to reduce these complications.

Characteristics of transonic moist air flows around butterfly valves with spontaneous condensation

Directory of Open Access Journals (Sweden)

A.B.M. Toufique Hasan

2015-06-01

Full Text Available Effects of spontaneous condensation of moist air on the shock wave dynamics around butterfly valves in transonic flows are investigated by experimental and numerical simulations. Two symmetric valve disk shapes namely- a flat rectangular plate and a mid-plane cross-section of a prototype butterfly valve have been studied in the present research. Results showed that in case with spontaneous condensation, the root mean square of pressure oscillation (induced by shock dynamics is reduced significantly with those without condensation for both shapes of the valves. Moreover, local aerodynamic moments were reduced in case with condensation which is considered to be beneficial in torque requirement in case of on/off applications of valves as flow control devices. However, total pressure loss was increased with spontaneous condensation in both the valves. Furthermore, the disk shape of a prototype butterfly valve showed better aerodynamic performances compared to flat rectangular plate profile in respect of total pressure loss and vortex shedding frequency in the wake region.

Design and performance characteristic analysis of servo valve-type water hydraulic poppet valve

International Nuclear Information System (INIS)

Park, Sung Hwan

2009-01-01

For water hydraulic system control, the flow or pressure control using high-speed solenoid valve controlled by PWM control method could be a good solution for prevention of internal leakage. However, since the PWM control of on-off valves cause extensive flow and pressure fluctuation, it is difficult to control the water hydraulic actuators precisely. In this study, the servo valve-type water hydraulic valve using proportional poppet as the main valve is designed and the performance characteristics of the servo valve-type water hydraulic valve are analyzed. Furthermore, it is demonstrated through experiments that a decline in control chamber pressure that follows the change of pilot flow is caused by the occurrence of cavitation around the proportional poppet, and that fundamental characteristics of the developed valve remain unaffected by the occurrence of cavitation

Surgical treatment of aortic valve endocarditis: a 26-year experience

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Taylan Adademir

2014-03-01

Full Text Available Objective: We have retrospectively analyzed the results of the operations made for aortic valve endocarditis in a single center in 26 years. Methods: From June 1985 to January 2011, 174 patients were operated for aortic valve endocarditis. One hundred and thirty-eight (79.3% patients were male and the mean age was 39.3±14.4 (9-77 years. Twenty-seven (15.5% patients had prosthetic valve endocarditis. The mean duration of follow-up was 7.3±4.2 years (0.1-18.2 adding up to a total of 1030.8 patient/years. Results: Two hundred and eighty-two procedures were performed. The most frequently performed procedure was aortic valve replacement with mechanical prosthesis (81.6%. In-hospital mortality occurred in 27 (15.5% cases. Postoperatively, 25 (14.4% patients had low cardiac output and 17 (9.8% heart block. The actuarial survival rates for 10 and 15 years were 74.6±3.7% and 61.1±10.3%, respectively. In-hospital mortality was found to be associated with female gender, emergency operation, postoperative renal failure and low cardiac output. The long term mortality was significantly associated with mitral valve involvement. Male gender was found to be a significant risk factor for recurrence in the follow-up. Conclusion: Surgery for aortic valve endocarditis has significant mortality. Emergency operation, female gender, postoperative renal failure and low cardiac output are significant risk factors. Risk for recurrence and need for reoperation is low.

Which valve is which?

Directory of Open Access Journals (Sweden)

Pravin Saxena

2015-01-01

Full Text Available A 25-year-old man presented with a history of breathlessness for the past 2 years. He had a history of operation for Tetralogy of Fallot at the age of 5 years and history suggestive of Rheumatic fever at the age of 7 years. On echocardiographic examination, all his heart valves were severely regurgitating. Morphologically, all the valves were irreparable. The ejection fraction was 35%. He underwent quadruple valve replacement. The aortic and mitral valves were replaced by metallic valve and the tricuspid and pulmonary by tissue valve.

Mitral Valve Prolapse

Science.gov (United States)

Mitral valve prolapse (MVP) occurs when one of your heart's valves doesn't work properly. The flaps of the valve are "floppy" and ... to run in families. Most of the time, MVP doesn't cause any problems. Rarely, blood can ...

Adaptive Mean and Trend Removal of Heart Rate Variability Using Kalman Filtering

National Research Council Canada - National Science Library

Schloegl, A

2001-01-01

Analysis of heart rate van ability requires the calculation of the mean heart rate, Adaptive methods are important for online and real-time parameter estimation, In this paper we demonstrate the use...

Transaortic edge-to-edge mitral valve repair for moderate secondary/functional mitral regurgitation in patients undergoing aortic root/valve intervention.

Science.gov (United States)

Choudhary, Shiv Kumar; Abraham, Atul; Bhoje, Amol; Gharde, Parag; Sahu, Manoj; Talwar, Sachin; Airan, Balram

2017-11-01

The present study evaluates the feasibility, safety, and efficacy of edge-to-edge repair for moderate secondary/functional mitral regurgitation in patients undergoing aortic valve/root interventions. Sixteen patients underwent transaortic edge-to-edge mitral valve repair. Mitral regurgitation was 2+ in 8 patients and 3+ in 6 patients. Two patients in whom cardiac arrest developed preoperatively had severe (4+) mitral regurgitation. Patients underwent operation for severe aortic regurgitation ± aortic root lesions. The mean left ventricular systolic and diastolic diameters were 51.5 ± 12.8 mm and 70.7 ± 10.7 mm, respectively. Left ventricular ejection fraction ranged from 20% to 60%. Primary surgical procedure included Bentall's ± hemiarch replacement in 10 patients, aortic valve replacement in 5 patients, and noncoronary sinus replacement with aortic valve repair in 1 patient. Severity of mitral regurgitation decreased to trivial or zero in 13 patients, 1+ in 2 patients, and 2+ in 1 patient. There were no gradients across the mitral valve in 9 patients, less than 5 mm Hg in 6 patients, and 9 mm Hg in 1 patient. There was no operative mortality. Follow-up ranged from 2 weeks to 54 months. Echocardiography showed trivial or no mitral regurgitation in 12 patients, 1+ in 2 patients, and 2+ in 2 patients. None of the patients had significant mitral stenosis. The mean left ventricular systolic and diastolic diameters decreased to 40.5 ± 10.3 mm and 58.7 ± 11.6 mm, respectively. Ejection fraction also improved slightly (22%-65%). Transaortic edge-to-edge mitral valve repair is a safe and effective technique to abolish secondary/functional mitral regurgitation. However, its impact on overall survival needs to be studied. Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Aortic valve-sparing operation in Marfan syndrome: what do we know after a decade?

Science.gov (United States)

Kallenbach, Klaus; Baraki, Hassina; Khaladj, Nawid; Kamiya, Hiroyuki; Hagl, Christian; Haverich, Axel; Karck, Matthias

2007-02-01

We assessed the outcome in patients with Marfan syndrome operated on exclusively with the aortic valve-sparing reimplantation technique for aortic root aneurysms during more than a decade. Between July 1993 and April 2005, the aortic valve-sparing reimplantation technique (David I) was used in 325 patients. In 59 patients with clinical evidence of Marfan syndrome, procedures were done for aortic root aneurysm (n = 55) or aortic dissection type A (n = 4). Their mean age was 30 +/- 12 years (range, 9 to 62 years), and 37 (63%) were male. Additional procedures were arch replacement in 4 patients, coronary artery bypass grafting in 1, mitral valve surgery in 9, and closure of atrial septal defect in 3. Mean follow-up was 54 +/- 37 months (range, 0 to 139 months). No patient died during the first 30 days postoperatively. Mean bypass time was 163 +/- 34 minutes (range, 99 to 248 minutes), and mean aortic cross clamp time was 126 +/- 28 minutes (range, 78 to 202 minutes). Four patients (6.8%) required rethoracotomy for postoperative bleeding. Five late deaths (8.5%) occurred during follow-up. Reoperation of the reconstructed valve was required in 7 patients. Freedom from reoperation was 88% +/- 5% at 5 years and 80% +/- 9% at 10 years. Mean grade of aortic insufficiency was 1.81 preoperatively compared with 0.20 early postoperatively (p valve should encourage use of this technique in patients with Marfan syndrome.

Maximizing prosthetic valve size with the Top Hat supra-annular aortic valve

DEFF Research Database (Denmark)

Aagaard, Jan; Geha, Alexander S.

2007-01-01

BACKGROUND AND AIM OF THE STUDY: The CarboMedics Top Hat supra-annular aortic valve allows a one-size (and often two-size) increase over the standard intra-annular valve. This advantage should minimize the risk of patient-prosthesis mismatch, where the effective prosthetic valve orifice area....... This study evaluates the authors' clinical experience with Top Hat supra-annular aortic valve size selection, and the technical aspects of implantation. METHODS: Between January 1999 and October 2005, a total of 251 consecutive patients underwent 252 aortic valve replacements with Top Hat supra...... required unplanned coronary bypass, and 30-day mortality was 2.0% (5/251), indicating a good safety profile for the valves implanted in this series. CONCLUSION: The general distribution of implant sizes in the US indicates that cardiac surgeons may be under-sizing the Top Hat supra-annular aortic valve...

Very long-term results (more than 20 years) of valve repair with carpentier's techniques in nonrheumatic mitral valve insufficiency.

Science.gov (United States)

Braunberger, E; Deloche, A; Berrebi, A; Abdallah, F; Celestin, J A; Meimoun, P; Chatellier, G; Chauvaud, S; Fabiani, J N; Carpentier, A

2001-09-18

Mitral valve repair is considered the gold standard in surgery of degenerative mitral valve insufficiency (MVI), but the long-term results (>20 years) are unknown. We reviewed the first 162 consecutive patients who underwent mitral valve repair between 1970 and 1984 for MVI due to nonrheumatic disease. The cause of MVI was degenerative in 146 patients (90%) and bacterial endocarditis in 16 patients (10%). MVI was isolated or, in 18 cases, associated with tricuspid insufficiency. The mean age of the 162 patients (104 men and 58 women) was 56+/-10 years (age range 22 to 77 years). New York Heart Association functional class was I, II, III, and IV in 2%, 39%, 52%, and 7% of patients, respectively. The mean cardiothoracic ratio was 0.58+/-0.07 (0.4 to 0.8), and 72 (45%) patients had atrial fibrillation. Valve analysis showed that the main mechanism of MVI was type II Carpentier's functional classification in 152 patients. The leaflet prolapse involved the posterior leaflet in 93 patients, the anterior leaflet in 28 patients, and both leaflets in 31 patients. Surgical technique included a Carpentier's ring annuloplasty in all cases, a valve resection in 126 patients, and shortening or transposition of chordae in 49 patients. During the first postoperative month, there were 3 deaths (1.9%) and 3 reoperations (2 valve replacements and 1 repeat repair [1.9%]). Six patients were lost to follow-up. The remaining 151 patients with mitral valve repair were followed during a median of 17 years (range 1 to 29 years; 2273 patient-years). The 20-year Kaplan-Meier survival rate was 48% (95% CI 40% to 57%), which is similar to the survival rate for a normal population with the same age structure. The 20-year rates were 19.3% (95% CI 11% to 27%) for cardiac death and 26% (95% CI 17% to 35%) for cardiac morbidity/mortality (including death from a cardiac cause, stroke, and reoperation). During the 20 years of follow-up, 7 patients were underwent surgery at 3, 7, 7, 8, 8, 10, or 12

Numerical simulation and analysis of ball valve three-dimensional flow based on CFD

International Nuclear Information System (INIS)

Zhang, S C; Zhang, Y L; Fang, Z M

2012-01-01

The new rotor oil-gas mixture pump that added ball valves in its export is a kind of innovative products, which can better adapt to the oil and gas mixed condition. In order to explore the rule of flow field in the export ball valve of new rotor oil-gas mixture pump, established the 3 d model of ball valve flow field was established. Using the FLUENT software, combining the standard k-ε turbulent model with multiphase flow technology and adopting the SIMPLE algorithm to simulate the 3 d gas-liquid two phase flow field in export ball valve of new rotor oil-gas mixture pump. In the different conditions that the volume of gas rate was 25%, 50%, 75%, through analyzing the velocity field, stress field and the distribution of the liquid and gas with the ball valve open height respectively at 3mm, 5mm, 7mm. Discussed how open height and different volume of gas rate to influence the field in export ball valve in the process of gas-liquid mixing was discussed. The simulation results showed that the greater the open height, the smaller the difference pressure of ball valve; the gap velocity decreasing with the open height increasing. The gas is mainly distributed in the vicinity of the valve ball in the process of gas-liquid mixing. The gas liquid ratio has a little effect on the gap velocity in the same open height. The results showed the flow field forms in the ball valve directly, to a certain degree, it had released the rules of gas-liquid flow in the valve and provided the theoretical guidance for design and optimization of the new rotor oil-gas mixture pump export ball valve.

Left ventricular mass regression after porcine versus bovine aortic valve replacement: a randomized comparison.

Science.gov (United States)

Suri, Rakesh M; Zehr, Kenton J; Sundt, Thoralf M; Dearani, Joseph A; Daly, Richard C; Oh, Jae K; Schaff, Hartzell V

2009-10-01

It is unclear whether small differences in transprosthetic gradient between porcine and bovine biologic aortic valves translate into improved regression of left ventricular (LV) hypertrophy after aortic valve replacement. We investigated transprosthetic gradient, aortic valve orifice area, and LV mass in patients randomized to aortic valve replacement with either the Medtronic Mosaic (MM) porcine or an Edwards Perimount (EP) bovine pericardial bioprosthesis. One hundred fifty-two patients with aortic valve disease were randomly assigned to receive either the MM (n = 76) or an EP prosthesis. There were 89 men (59%), and the mean age was 76 years. Echocardiograms from preoperative, postoperative, predismissal, and 1-year time points were analyzed. Baseline characteristics and preoperative echocardiograms were similar between the two groups. The median implant size was 23 mm for both. There were no early deaths, and 10 patients (7%) died after dismissal. One hundred seven of 137 patients (78%) had a 1-year echocardiogram, and none required aortic valve reoperation. The mean aortic valve gradient at dismissal was 19.4 mm Hg (MM) versus13.5 mm Hg (EP; p regression of LV mass index (MM, -32.4 g/m(2) versus EP, -27.0 g/m(2); p = 0.40). Greater preoperative LV mass index was the sole independent predictor of greater LV mass regression after surgery (p regression of LV mass during the first year after aortic valve replacement.

Prior oral conditions in patients undergoing heart valve surgery.

Science.gov (United States)

Silvestre, Francisco-Javier; Gil-Raga, Irene; Martinez-Herrera, Mayte; Lauritano, Dorina; Silvestre-Rangil, Javier

2017-11-01

Patients scheduled for heart valve surgery should be free of any oral infectious disorders that might pose a risk in the postoperative period. Few studies have been made on the dental conditions of such patients prior to surgery. The present study describes the most frequent prior oral diseases in this population group. A prospective, observational case-control study was designed involving 60 patients (30 with heart valve disease and 30 controls, with a mean age of 71 years in both groups). A dental exploration was carried out, with calculation of the DMFT (decayed, missing and filled teeth) index and recording of the periodontal parameters (plaque index, gingival bleeding index, periodontal pocket depth, and attachment loss). The oral mucosa was also examined, and panoramic X-rays were used to identify possible intrabony lesions. Significant differences in bacterial plaque index were observed between the two groups ( p <0.05), with higher scores in the patients with valve disease. Probing depth and the presence of moderate pockets were also greater in the patients with valve disease than among the controls ( p <0.01). Sixty percent of the patients with valve disease presented periodontitis. Patients scheduled for heart valve surgery should be examined for possible active periodontitis before the operation. Those individuals found to have periodontal disease should receive adequate periodontal treatment before heart surgery. Key words: Valve disease, aortic, mitral, heart surgery, periodontitis.

AREVA's innovative solutions for valve diagnostics and in-situ valve repair

International Nuclear Information System (INIS)

Damies, H.; Breitenberger, U.; Munoz, L.; Kostroun, F.

2012-01-01

Optimized maintenance strategies are a key aspect for safe and undisturbed plant operation. Innovative valve service solutions can support that in an efficient way. The ADAM®/SIPLUG® valve monitoring system allows full online monitoring of valves and actuators with automatic evaluation and assessment. Especially for safety-related and operation-related valves this provides valuable information on components condition to ensure proper function and contribute to optimization of maintenance strategies as well as effective maintenance performance. More than 25 years of experience in various plants worldwide show that application of ADAM®/SIPLUG® valve diagnostics solution leads to increased plant safety and availability. With the innovative AVARIS technology an in-situ valve repair is possible. It has the unique ability to conduct several steps in-situ, to maintain the sealing seat of gate or check valves. By applying AVARIS, the valve is restored in its original state, the system remains unchanged. Thus, all original documents remain valid and applicable. In comparison to previous procedures like cutting valves out of the pipeline and repairing hard facings or damaged seal seats in a separate workshop or alternatively replacement by a new valve body the new AVARIS technology avoids costs, risk and effort. (author)

Effects of valve characteristics and pipe diameter on water hammer phenomena

International Nuclear Information System (INIS)

Hur, J.; Kim, T. H.; Mun, B. H.; Choi, H. Y.; Lee, K. W.; Noh, T. S.

2001-01-01

The water hammer phenomena mean that the dynamic loads are induced on the pipe, the pipe support and the equipments in the system due to the sudden change of the flow velocity inside the pipe. The sudden changes are mainly caused by the valve sudden on/off and pump sudden start/trip. To develop a selection criterion of the parts to be analyzed for the water hammer, the effects of the valve characteristics and pipe diameter on the water hammer are analyzed. The analyses using Method of Characteristics (MOC) show that the effects of the valve pressure difference and the valve opening time are very significant, but the effects of the pipe diameter are not dominant

Inter-ethnic differences in valve morphology, valvular dysfunction, and aortopathy between Asian and European patients with bicuspid aortic valve.

Science.gov (United States)

Kong, William K F; Regeer, Madelien V; Poh, Kian K; Yip, James W; van Rosendael, Philippe J; Yeo, Tiong C; Tay, Edgar; Kamperidis, Vasileios; van der Velde, Enno T; Mertens, Bart; Ajmone Marsan, Nina; Delgado, Victoria; Bax, Jeroen J

2018-04-14

, and valve function, the dimensions of the aortic annulus [mean difference 1.17 mm/m2, 95% confidence interval (CI) 0.96-1.39], SOV (mean difference 1.86 mm/m2, 95% CI 1.47-2.24), STJ (mean difference 0.52 mm/m2, 95% CI 0.14-0.90) and AA (mean difference 1.05 mm/m2, 95% CI 0.57-1.52) were significantly larger among Asians compared with Europeans. This large multicentre registry reports for the first time that Asians with BAV showed more frequently type 1 BAV (with fusion between right and non-coronary cusp) and have larger aortic dimensions than Europeans. These findings have important implications for prosthesis type and size selection for TAVR.

Leaflet escape in a new bileaflet mechanical valve: TRI technologies.

Science.gov (United States)

Bottio, Tomaso; Casarotto, Dino; Thiene, Gaetano; Caprili, Luca; Angelini, Annalisa; Gerosa, Gino

2003-05-13

Leaflet escape is a mode of structural valve failure for mechanical prostheses. This complication previously has been reported for both monoleaflet and bileaflet valve models. We report 2 leaflet escape occurrences observed in 2 patients who underwent valve replacement with a TRI Technologies valve prosthesis. At the University of Padua, between November 2000 and February 2002, 36 TRI Technologies valve prostheses (26 aortic and 10 mitral) were implanted in 34 patients (12 women and 22 men) with a mean age of 59.9+/-10.3 years (range, 30 to 75 years). There were 5 deaths: 3 in hospital, 1 early after discharge, and 1 late. Two patients experienced a catastrophic prosthetic leaflet escape; the first patient was a 52-year-old man who died 10 days after aortic valve and ascending aorta replacement, and the second was a 58-year-old man who underwent a successful emergency reoperation 20 months after mitral valve replacement. Examination of the explanted prostheses showed in both cases a leaflet escape caused by a leaflet's pivoting system fracture. Prophylactic replacement was then successfully accomplished so far in 12 patients, without evidence of structural valve failure in any of them. Among other significant postoperative complications, we observed 3 major thromboembolisms, 1 hemorrhage, and 1 paravalvular leak. These catastrophes prompted us to interrupt the implantation program, and they cast a shadow on the durability of the TRI Technologies valve prosthesis because of its high risk of structural failure.

Valve Concepts for Microfluidic Cell Handling

Directory of Open Access Journals (Sweden)

M. Grabowski

2010-01-01

Full Text Available In this paper we present various pneumatically actuated microfluidic valves to enable user-defined fluid management within a microfluidic chip. To identify a feasible valve design, certain valve concepts are simulated in ANSYS to investigate the pressure dependent opening and closing characteristics of each design. The results are verified in a series of tests. Both the microfluidic layer and the pneumatic layer are realized by means of soft-lithographic techniques. In this way, a network of channels is fabricated in photoresist as a molding master. By casting these masters with PDMS (polydimethylsiloxane we get polymeric replicas containing the channel network. After a plasma-enhanced bonding process, the two layers are irreversibly bonded to each other. The bonding is tight for pressures up to 2 bar. The valves are integrated into a microfluidic cell handling system that is designed to manipulate cells in the presence of a liquid reagent (e.g. PEG – polyethylene glycol, for cell fusion. For this purpose a user-defined fluid management system is developed. The first test series with human cell lines show that the microfluidic chip is suitable for accumulating cells within a reaction chamber, where they can be flushed by a liquid medium.

Evaluation of the flow forces on a direct (single stage) proportional valve by means of a computational fluid dynamic analysis

International Nuclear Information System (INIS)

Amirante, R.; Moscatelli, P.G.; Catalano, L.A.

2007-01-01

The aim of this paper is to investigate the fluid dynamic behaviour of a commercial hydraulic proportional valve in order to evaluate and justify its global performances and, in particular, to analyze the effects of some additional design features on the reduction of the force required to maintain the valve open. The proposed analysis has been performed by applying the commercial computational fluid dynamics (CFD) code, Fluent, to the solution of the three dimensional turbulent flow field through a circumferential sector of the entire valve for different spool strokes. The reliability of the employed modelization is demonstrated by the comparison between the computed flow rate curve and the corresponding experimental data provided by the manufacturer. With regard to the metering edge design, it is shown that the cylindrical hole provided on the top of the hemi-spherical notch to improve metering at small valve openings has no influence on the flow force balance. The presented results also demonstrate that compensation techniques based on an adequate spool profiling are effective in balancing the flow forces mainly at medium and large valve openings, thanks to the pressure difference on the compensation profile; which also results in an increased axial momentum at the inlet of the high pressure chamber. The benefits of its presence are amplified by the adoption of two grooves machined on the valve body, which modify the flow field so as both to increase the axial momentum at the inlet of the high pressure chamber and to reduce it at the outlet

Heart Valve Diseases

Science.gov (United States)

Your heart has four valves. Normally, these valves open to let blood flow through or out of your heart, and then shut to keep it from flowing ... close tightly. It's one of the most common heart valve conditions. Sometimes it causes regurgitation. Stenosis - when ...

[Discordance between mitral valve area (MVA) and pressure gradient in patients with mitral valve stenosis: mean transmitral valve gradient is a severity index or a tolerance index of severity of mitralss valve stenosis?

Science.gov (United States)

Najih, Hayat; Arous, Salim; Laarje, Aziza; Baghdadi, Dalila; Benouna, Mohamed Ghali; Azzouzi, Leila; Habbal, Rachida

2016-01-01

Rheumatic mitral valve stenosis (MVS) is a frequent valvulopathy in developing countries. However, industrialized countries have seen the emergence of new etiologies of MVS in recent years, in particular drug-induced and/or toxic valvular regurgitation and stenosis. For this reason, the echocardiographic assessment of MVS and especially the definition of objective diagnostic criteria for severe MVS remains relevant. The objectives are: to determine whether there is a direct causal link between mean transmitral gradient (MTG) and severity of MVS in patients with severe MVS or true severe MVS (primary criterion); to analyze different parameters determining mean transmitral gradient (MTG) (secondary criterion). We conducted a single-center cross-sectional study including all patients with severe or true severe MVS admitted to the Department of Cardiology, University Hospital Ibn Rushd, Casablanca over a period of one year (January 2014-December 2014). We analyzed data from two groups of patients separately: those with a mean transmitral gradientgradient>10mmHg (group 2). 50 patients with severe or true severe MVS have been included in the study. The average age of our patients was 41.7 years with a female predominance (sex ratio 0,25). 64% of patients had severe MVS and 36% of patients had true severe MVS. 52% (26 patients) had MTG gradient> 10mmHg, suggesting no direct correlation between the severity of MVS and MTG (Pearson's correlation coefficient R: -0,137). With regards to dyspnea, 80% of patients of group 1 had stage II NYHA dyspnea (classification system) and 70% of patients of group 2 had stage III NYHA dyspnea (41%) or IV NYHA dyspnea (29%), which means that there was a significant correlation between MTG and the severity of dyspnea (R: 0,586 and p: 0,001). The analytical study of heart rate and the presence of cardiac decompensation compared with mean gradient transmitral showed a significant correlation. Indeed, among patients in group 1, 96% had HR

Prosthetic valve endocarditis after transcatheter aortic valve implantation

DEFF Research Database (Denmark)

Olsen, Niels Thue; De Backer, Ole; Thyregod, Hans G H

2015-01-01

BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an advancing mode of treatment for inoperable or high-risk patients with aortic stenosis. Prosthetic valve endocarditis (PVE) after TAVI is a serious complication, but only limited data exist on its incidence, outcome, and procedural......%) were treated conservatively and 1 with surgery. Four patients (22%) died from endocarditis or complications to treatment, 2 of those (11%) during initial hospitalization for PVE. An increased risk of TAVI-PVE was seen in patients with low implanted valve position (hazard ratio, 2.8 [1.1-7.2]), moderate...

Questionnaire Adapting: Little Changes Mean a Lot.

Science.gov (United States)

Sousa, Vanessa E C; Matson, Jeffrey; Dunn Lopez, Karen

2017-09-01

Questionnaire development involves rigorous testing to ensure reliability and validity. Due to time and cost constraints of developing new questionnaires, researchers often adapt existing questionnaires to better fit the purpose of their study. However, the effect of such adaptations is unclear. We conducted cognitive interviews as a method to evaluate the understanding of original and adapted questionnaire items to be applied in a future study. The findings revealed that all subjects (a) comprehended the original and adapted items differently, (b) changed their scores after comparing the original to the adapted items, and (c) were unanimous in stating that the adapted items were easier to understand. Cognitive interviewing allowed us to assess the interpretation of adapted items in a useful and efficient manner before use in data collection.

Minimising life cycle costs of automated valves in offshore platforms

Energy Technology Data Exchange (ETDEWEB)

Yli-Petays, Juha [Metso Automation do Brasil Ltda., Rio de Janeiro, RJ (Brazil); Niemela, Ismo [Metso Automation, Imatra (Finland)

2012-07-01

Automated process valves play an essential role in offshore platforms operation. If you are able to optimize their operation and maintenance activities you can receive extensive operational savings with minimal investment. Valves used in offshore platforms doesn't differentiate that much from the valves used in downstream but there are certain specialties, which makes the operations more challenging in offshore: Process valves are more difficult to access and maintain because of space limitations. Also spare part inventories and deliveries are challenging because of offshore platform's remote location. To overcome these challenges usage of digital positioners with diagnostic features has become more common because predictive maintenance capabilities enable possibilities to plan the maintenance activities and this way optimise the spare part orders regarding to valves. There are intelligent controllers available for control valves, automated on/off valves as well as ESD-valves and whole network of automated valves on platforms can be controlled by intelligent valve controllers. This creates many new opportunities in regards of optimized process performance or predictive maintenance point-of-view. By means of intelligent valve controllers and predictive diagnostics, condition monitoring and maintenance planning can also be performed remotely from an onshore location. Thus, intelligent valve controllers provide good way to minimize spending related to total cost of ownership of automated process valves. When purchase value of control valve represent 20% of TCO, intelligent positioner and predictive maintenance methods can enable as high as 30% savings over the life cycle of asset so basically it benefit savings higher than whole investment of monitored asset over its life cycle. This is mainly achieved through the optimized maintenance activities since real life examples has shown that with time based maintenance (preventive maintenance) approach 70% of

Valve monitoring ITI-MOVATS

International Nuclear Information System (INIS)

Moureau, S.

1993-01-01

ITI-MOVATS provides a wide range of test devices to monitor the performance of valves: motor operated gate or globe valve, butterfly valve, air operated valve, and check valve. The ITI-MOVATS testing equipment is used in the following three areas: actuator setup/baseline testing, periodic/post-maintenance testing, and differential pressure testing. The parameters typically measured with the MOVATS diagnostic system as well as the devices used to measure them are described. (Z.S.)

The nordic aortic valve intervention (NOTION) trial comparing transcatheter versus surgical valve implantation

DEFF Research Database (Denmark)

Thyregod, Hans Gustav; Søndergaard, Lars; Ihlemann, Nikolaj

2013-01-01

Degenerative aortic valve (AV) stenosis is the most prevalent heart valve disease in the western world. Surgical aortic valve replacement (SAVR) has until recently been the standard of treatment for patients with severe AV stenosis. Whether transcatheter aortic valve implantation (TAVI) can...

Gasoline New Timing and Flux Adjustable Rotary Valve Design (Hereinafter: Rotary Valve

Directory of Open Access Journals (Sweden)

Du huiqi

2016-01-01

Full Text Available Conventional gasoline engine with an umbrella valve control cylinder intake and exhaust, in order to achieve sealing effect, the valve is driven by the spring force; at the same time, when the cam opens the valve to overcome the spring force acting. Sealing the better, the more power consumed in the engine mechanical losses, the valve mechanism consumes about 30%, which is not a small loss! This article describes a new type of rotary valve is to significantly reduce mechanical losses, so as to achieve energy saving purposes.

Fluid control valves

International Nuclear Information System (INIS)

Rankin, J.

1980-01-01

A fluid control valve is described in which it is not necessary to insert a hand or a tool into the housing to remove the valve seat. Such a valve is particularly suitable for the control of radioactive fluids since maintenance by remote control is possible. (UK)

What Is Heart Valve Surgery?

Science.gov (United States)

... working correctly. Most valve replacements involve the aortic Tricuspid valve and mitral valves. The aortic valve separates ... where it shouldn’t. This is called incompetence, insufficiency or regurgitation. • Prolapse — mitral valve flaps don’t ...

What Is Heart Valve Disease?

Science.gov (United States)

... and replacing it with a man-made or biological valve. Biological valves are made from pig, cow, or human ... the valve. Man-made valves last longer than biological valves and usually don’t have to be ...

Relief valve testing study

International Nuclear Information System (INIS)

BROMM, R.D.

2001-01-01

Reclosing pressure-actuated valves, commonly called relief valves, are designed to relieve system pressure once it reaches the set point of the valve. They generally operate either proportional to the differential between their set pressure and the system pressure (gradual lift) or by rapidly opening fully when the set pressure is reached (pop action). A pop action valve allows the maximum fluid flow through the valve when the set pressure is reached. A gradual lift valve allows fluid flow in proportion to how much the system pressure has exceeded the set pressure of the valve (in the case of pressure relief) or has decreased below the set pressure (vacuum relief). These valves are used to protect systems from over and under pressurization. They are used on boilers, pressure vessels, piping systems and vacuum systems to prevent catastrophic failures of these systems, which can happen if they are under or over pressurized beyond the material tolerances. The construction of these valves ranges from extreme precision of less than a psi tolerance and a very short lifetime to extremely robust construction such as those used on historic railroad steam engines that are designed operate many times a day without changing their set pressure when the engines are operating. Relief valves can be designed to be immune to the effects of back pressure or to be vulnerable to it. Which type of valve to use depends upon the design requirements of the system

Comparative study between CardiaMed valves (freely floating valve leaflets versus St. Jude Medical (fixed valve leaflets in mitral valve replacement surgery

Directory of Open Access Journals (Sweden)

Mostafa Ahmed

2017-09-01

Conclusions: CardiaMed freely floating leaflet prostheses showed good hemodynamic characteristics. The prosthesis adequately corrects hemodynamics and is safe and no worse than the St. Jude Medical valve in the mitral valve position.

Late thrombosis of a mitral bioprosthetic valve with associated massive left atrial thrombus

Directory of Open Access Journals (Sweden)

Preetham R Muskula

2017-04-01

Full Text Available An 84-year-old man presented 5 years after bioprosthetic mitral valve replacement with three months of worsening dyspnea on exertion. A new mitral stenosis murmur was noted on physical examination, and an electrocardiogram revealed newly recognized atrial fibrillation. Severe mitral stenosis (mean gradient = 13 mmHg was confirmed by transthoracic echocardiography. Transesophageal echocardiography revealed markedly thickened mitral bioprosthetic leaflets with limited mobility, and a massive left atrial thrombus (>4 cm in diameter (Fig. 1A, B, C, D and Videos 1, 2, 3 and 4. Intravenous heparin was initiated, and 5 days later, he was taken to the operating room for planned redo mitral valve replacement and left atrial thrombus extraction. Intraoperative transesophageal echocardiography revealed near-complete resolution of the bioprosthetic leaflet thickening, and a mean mitral gradient of only 3 mmHg (Fig. 2A, B, C and Videos 5, 6 and 7. The patient underwent resection of the massive left atrial thrombus (Fig. 2D but did not require redo mitral valve replacement. He was initiated on heparin (and transitioned to warfarin early in the post-operative period, with complete resolution of dyspnea on exertion at 3-month follow-up. Bioprosthetic valve thrombosis is increasingly recognized as a cause of early prosthetic valve dysfunction (1, 2. This case illustrates that bioprosthetic valve thrombosis may occur years after valve replacement; therefore, any deterioration in a patient’s clinical status (new-onset dyspnea, heart failure or atrial fibrillation warrants a thorough evaluation of the bioprosthetic valve with transesophageal echocardiography. In this case, initiation of anticoagulation obviated the need for redo mitral valve replacement.

Long-Term Results of Mitral Valve Repair

Directory of Open Access Journals (Sweden)

Francisco Diniz Affonso da Costa

Full Text Available Abstract Introduction: Current guidelines state that patients with severe mitral regurgitation should be treated in reference centers with a high reparability rate, low mortality rate, and durable results. Objective: To analyze our global experience with the treatment of organic mitral regurgitation from various etiologies operated in a single center. Methods: We evaluated all surgically treated patients with organic mitral regurgitation from 2004-2017. Patients were evaluated clinically and by echocardiography every year. We determined early and late survival rates, valve related events and freedom from recurrent mitral regurgitation and tricuspid regurgitation. Valve failure was defined as any mitral regurgitation ≥ moderate degree or the need for reoperation for any reason. Results: Out of 133 patients with organic mitral regurgitation, 125 (93.9% were submitted to valve repair. Mean age was 57±15 years and 52 patients were males. The most common etiologies were degenerative disease (73 patients and rheumatic disease (34 patients. Early mortality was 2.4% and late survival was 84.3% at 10 years, which are similar to the age- and gender-matched general population. Only two patients developed severe mitral regurgitation, and both were reoperated (95.6% at 10 years. Freedom from mitral valve failure was 84.5% at 10 years, with no difference between degenerative and rheumatic valves. Overall, late ≥ moderate tricuspid regurgitation was present in 34% of the patients, being more common in the rheumatic ones. The use of tricuspid annuloplasty abolished this complication. Conclusion: We have demonstrated that mitral regurgitation due to organic mitral valve disease from various etiologies can be surgically treated with a high repair rate, low early mortality and long-term survival that are comparable to the matched general population. Concomitant treatment of atrial fibrillation and tricuspid valve may be important adjuncts to optimize long

Face-Sealing Butterfly Valve

Science.gov (United States)

Tervo, John N.

1992-01-01

Valve plate made to translate as well as rotate. Valve opened and closed by turning shaft and lever. Interactions among lever, spring, valve plate, and face seal cause plate to undergo combination of translation and rotation so valve plate clears seal during parts of opening and closing motions.

Transapical JenaValve in a patient with mechanical mitral valve prosthesis.

LENUS (Irish Health Repository)

O' Sullivan, Katie E

2014-01-29

We report the first case of transcatheter aortic valve replacement implantation using JenaValve™ in a patient with mechanical mitral valve prosthesis. We believe that the design features of this valve may be particularly suited for use in this setting. © 2014 Wiley Periodicals, Inc.

Butterfly valves for seawater

International Nuclear Information System (INIS)

Yamanaka, Katsuto

1991-01-01

Recently in thermal and nuclear power stations and chemical plants which have become large capacity, large quantity of cooling water is required, and mostly seawater is utilized. In these cooling water systems, considering thermal efficiency and economy, the pipings become complex, and various control functions are demanded. For the purpose, the installation of shut-off valves and control valves for pipings is necessary. The various types of valves have been employed, and in particular, butterfly valves have many merits in their function, size, structure, operation, maintenance, usable period, price and so on. The corrosion behavior of seawater is complicated due to the pollution of seawater, therefore, the environment of the valves used for seawater became severe. The structure and the features of the butterfly valves for seawater, the change of the structure of the butterfly valves for seawater and the checkup of the butterfly valves for seawater are reported. The corrosion of metallic materials is complicatedly different due to the locating condition of plants, the state of pipings and the condition of use. The corrosion countermeasures for butterfly valves must be examined from the synthetic viewpoints. (K.I.)

Minimally invasive redo mitral valve surgery without aortic crossclamp.

Science.gov (United States)

Milani, Rodrigo; Brofman, Paulo Roberto Slud; Oliveira, Sergio; Patrial Neto, Luiz; Rosa, Matheus; Lima, Victor Hugo; Binder, Luis Fernando; Sanches, Aline

2013-01-01

Reoperations of the mitral valve have a higher rate of complications when compared with the first surgery. With the field of video-assisted techniques for the first surgery of mitral valve became routine, reoperation cases began to arouse interest for this less invasive procedures. To assess the results and the technical difficulties in 10 patients undergoing minimally invasive redo mitral valve surgery. Cardiopulmonary bypass was installed through a cannula placed in the femoral vessels and right internal jugular vein, conducted in 28 degrees of temperature in ventricular fibrillation. A right lateral thoracotomy with 5 to 6 cm in the third or fourth intercostal space was done, pericardium was displaced only at the point of atriotomy. The aorta was not clamped. Ten patients with mean age of 56.9 ± 10.5 years, four were in atrial fibrilation rhythm and six in sinusal. Average time between first operation and reoperations was 11 ± 3.43 years. The mean EuroSCORE group was 8.3 ± 1.82. The mean ventricular fibrillation and cardiopulmonary bypass was respectively 70.9 ± 17.66 min and 109.4 ± 25.37 min. The average length of stay was 7.6 ± 1.5 days. There were no deaths in this series. Mitral valve reoperation can be performed through less invasive techniques with good immediate results, low morbidity and mortality. However, this type of surgery requires a longer duration of cardiopulmonary bypass, especially in cases where the patient already has prosthesis. The presence of a minimal aortic insufficiency also makes this procedure technically more challenging.

Supra-annular valve strategy for an early degenerated transcatheter balloon-expandable heart valve.

Science.gov (United States)

Kamioka, Norihiko; Caughron, Hope; Corrigan, Frank; Block, Peter; Babaliaros, Vasilis

2018-01-23

Currently, there are no recommendations regarding the selection of valve type for a transcatheter heart valve (THV)-in-THV procedure. A supra-annular valve design may be superior in that it results in a larger effective orifice area and may have a lower chance of valve thrombosis after THV-in-THV. In this report, we describe the use of a supra-annular valve strategy for an early degenerated THV. © 2018 Wiley Periodicals, Inc.

Performance and morphology of decellularized pulmonary valves implanted in juvenile sheep.

Science.gov (United States)

Quinn, Rachael W; Hilbert, Stephen L; Bert, Arthur A; Drake, Bill W; Bustamante, Julie A; Fenton, Jason E; Moriarty, Sara J; Neighbors, Stacy L; Lofland, Gary K; Hopkins, Richard A

2011-07-01

Because of cryopreserved heart valve-mediated immune responses, decellularized allograft valves are an attractive option in children and young adults. The objective of this study was to investigate the performance and morphologic features of decellularized pulmonary valves implanted in the right ventricular outflow tract of juvenile sheep. Right ventricular outflow tract reconstructions in juvenile sheep (160±9 days) using cryopreserved pulmonary allografts (n=6), porcine aortic root bioprostheses (n=4), or detergent/enzyme-decellularized pulmonary allografts (n=8) were performed. Valve performance (echocardiography) and morphologic features (gross, radiographic, and histologic examination) were evaluated 20 weeks after implantation. Decellularization reduced DNA in valve cusps by 99.3%. Bioprosthetic valves had the largest peak and mean gradients versus decellularized valves (p=0.03; p<0.001) and cryopreserved valves (p=0.01; p=0.001), which were similar (p=0.45; p=0.40). Regurgitation was minimal and similar for all groups (p=0.16). No cusp calcification was observed in any valve type. Arterial wall calcification was present in cryopreserved and bioprosthetic grafts but not in decellularized valves. No autologous recellularization or inflammation occurred in bioprostheses, whereas cellularity progressively decreased in cryopreserved grafts. Autologous recellularization was present in decellularized arterial walls and variably extending into the cusps. Cryopreserved and decellularized graft hemodynamic performance was comparable. Autologous recellularization of the decellularized pulmonary arterial wall was consistently observed, with variable cusp recellularization. As demonstrated in this study, decellularized allograft valves have the potential for autologous recellularization. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Remote actuated valve implant

Science.gov (United States)

McKnight, Timothy E; Johnson, Anthony; Moise, Jr., Kenneth J; Ericson, Milton Nance; Baba, Justin S; Wilgen, John B; Evans, III, Boyd McCutchen

2014-02-25

Valve implant systems positionable within a flow passage, the systems having an inlet, an outlet, and a remotely activatable valve between the inlet and outlet, with the valves being operable to provide intermittent occlusion of the flow path. A remote field is applied to provide thermal or magnetic activation of the valves.

One-year multicentre outcomes of transapical aortic valve implantation using the SAPIEN XT™ valve: the PREVAIL transapical study.

Science.gov (United States)

Walther, Thomas; Thielmann, Matthias; Kempfert, Joerg; Schroefel, Holger; Wimmer-Greinecker, Gerhard; Treede, Hendrik; Wahlers, Thorsten; Wendler, Olaf

2013-05-01

The study aimed to evaluate 1-year outcomes of the multicentre PREVAIL transapical (TA) study of TA-aortic valve implantation (AVI) in high-risk patients. From September 2009 to August 2010, a total of 150 patients, aged 81.6 ± 5.8 years, 40.7% female, were included at 12 European TA-AVI experienced sites. Patients received 23 (n = 36), 26 (n = 57) and 29 mm (n = 57) second-generation SAPIEN XT™ (Edwards Lifesciences, Irvine, CA, USA) valves. The mean logistic EuroSCORE was 24.3 ± 7.0, and mean Society Thoracic Surgeons score was 7.5 ± 4.4%. Survival was 91.3% at 30 days and 77.9% at 1 year. Subgroup analysis revealed survivals of 91.7/88.9, 86.0/70.2, 96.55/91.2% for patients receiving 23-, 26- and 29-mm valves at 30 days and at 1 year, respectively. Transthoracic echocardiography revealed preserved left ventricular ejection fraction and low gradients. Aortic incompetence was none in 41/48, trace 30/36, mild 22/12 and moderate in 7/4% at discharge and 1 year. Walking distance increased from 221 (postimplant) to 284 m (at 1 year, P = 0.0004). Three patients required reoperation due to increasing aortic incompetence during follow-up. Causes of mortality at 1 year were cardiac (n = 7), stroke (n = 1) and others (n = 5). The European PREVAIL multicentre trial demonstrates good functionality and good outcomes for TA-AVI using the second-generation SAPIEN XT prosthesis and the ASCENDRA-II delivery system. The 29-mm SAPIEN XT valve was successfully introduced and showed excellent results.

Growth and remodeling play opposing roles during postnatal human heart valve development.

Science.gov (United States)

Oomen, Pim J A; Holland, Maria A; Bouten, Carlijn V C; Kuhl, Ellen; Loerakker, Sandra

2018-01-19

Tissue growth and remodeling are known to govern mechanical homeostasis in biological tissue, but their relative contributions to homeostasis remain unclear. Here, we use mechanical models, fueled by experimental findings, to demonstrate that growth and remodeling have different effects on heart valve stretch homeostasis during physiological postnatal development. Two developmental stages were considered: early-stage (from infant to adolescent) and late-stage (from adolescent to adult) development. Our models indicated that growth and remodeling play opposing roles in preserving tissue stretch and with time. During early-stage development, excessive tissue stretch was decreased by tissue growth and increased by remodeling. In contrast, during late-stage development tissue stretch was decreased by remodeling and increased by growth. Our findings contribute to an improved understanding of native heart valve adaptation throughout life, and are highly relevant for the development of tissue-engineered heart valves.

3D printed mitral valve models: affordable simulation for robotic mitral valve repair.

Science.gov (United States)

Premyodhin, Ned; Mandair, Divneet; Ferng, Alice S; Leach, Timothy S; Palsma, Ryan P; Albanna, Mohammad Z; Khalpey, Zain I

2018-01-01

3D printed mitral valve (MV) models that capture the suture response of real tissue may be utilized as surgical training tools. Leveraging clinical imaging modalities, 3D computerized modelling and 3D printing technology to produce affordable models complements currently available virtual simulators and paves the way for patient- and pathology-specific preoperative rehearsal. We used polyvinyl alcohol, a dissolvable thermoplastic, to 3D print moulds that were casted with liquid platinum-cure silicone yielding flexible, low-cost MV models capable of simulating valvular tissue. Silicone-moulded MV models were fabricated for 2 morphologies: the normal MV and the P2 flail. The moulded valves were plication and suture tested in a laparoscopic trainer box with a da Vinci Si robotic surgical system. One cardiothoracic surgery fellow and 1 attending surgeon qualitatively evaluated the ability of the valves to recapitulate tissue feel through surveys utilizing the 5-point Likert-type scale to grade impressions of the valves. Valves produced with the moulding and casting method maintained anatomical dimensions within 3% of directly 3D printed acrylonitrile butadiene styrene controls for both morphologies. Likert-type scale mean scores corresponded with a realistic material response to sutures (5.0/5), tensile strength that is similar to real MV tissue (5.0/5) and anatomical appearance resembling real MVs (5.0/5), indicating that evaluators 'agreed' that these aspects of the model were appropriate for training. Evaluators 'somewhat agreed' that the overall model durability was appropriate for training (4.0/5) due to the mounting design. Qualitative differences in repair quality were notable between fellow and attending surgeon. 3D computer-aided design, 3D printing and fabrication techniques can be applied to fabricate affordable, high-quality educational models for technical training that are capable of differentiating proficiency levels among users. © The Author 2017

Modeling valve leakage

International Nuclear Information System (INIS)

Bell, S.R.; Rohrscheib, R.

1994-01-01

The American Society of Mechanical Engineers (ASME) Code requires individual valve leakage testing for Category A valves. Although the U.S. Nuclear Regulatory Commission (USNRC) has recognized that it is more appropriate to test containment isolation valves in groups, as allowed by 10 CFR 50, Appendix J, a utility seeking relief from these Code requirements must provide technical justification for the relief and establish a conservative alternate acceptance criteria. In order to provide technical justification for group testing of containment isolation valves, Illinois Power developed a calculation (model) for determining the size of a leakage pathway in a valve disc or seat for a given leakage rate. The model was verified experimentally by machining leakage pathways of known size and then measuring the leakage and comparing this value to the calculated value. For the range of values typical of leakage rate testing, the correlation between the experimental values and calculated values was quote good. Based upon these results, Illinois Power established a conservative acceptance criteria for all valves in the inservice testing (IST) program and was granted relief by the USNRC from the individual leakage testing requirements of the ASME Code. This paper presents the results of Illinois Power's work in the area of valve leakage rate testing

Use of a valve operation test and evaluation system to enhance valve reliability

International Nuclear Information System (INIS)

Lowry, D.A.

1990-01-01

Power plant owners have emphasized the need for assuring safe, reliable operation of valves. While most valves must simply open or close, the mechanisms involved can be quite complex. Motor operated valves (MOVs) must be properly adjusted to assure operability. Individual operator components determine the performance of the entire MOV. Failure in MOVs could cripple or shut down a unit. Thus, a complete valve program consisting of design reviews, operational testing, and preventive and predictive maintenance activities will enhance an owner's confidence level that his valves win operate as expected. Liberty's Valve Operation Test and Evaluation System (VOTES) accurately measures stein thrust without intruding on valve operation. Since mounting a strain gage to a valve stem is a desirable but impractical way of obtaining precise stem thrust, Liberty developed a method to obtain identical data by placing a strain gage sensor on the valve yoke. VOTES provides information which effectively eliminates costly, unscheduled downtime. This paper presents the results of infield VOTES testing. The system's proven ability to identify and characterize actuator and valve performance is demonstrated. Specific topics of discussion include the ability of VOTES to ease a utility's IE Bulletin 8543 concerns and conclusively diagnose MOV components. Data from static and differential pressure testing are presented. Technical, operational, and financial advantages resulting from VOTES technology are explored in detail

Multiple-port valve

International Nuclear Information System (INIS)

Doody, T.J.

1978-01-01

A multiple-port valve assembly is designed to direct flow from a primary conduit into any one of a plurality of secondary conduits as well as to direct a reverse flow. The valve includes two mating hemispherical sockets that rotatably receive a spherical valve plug. The valve plug is attached to the primary conduit and includes diverging passageways from that conduit to a plurality of ports. Each of the ports is alignable with one or more of a plurality of secondary conduits fitting into one of the hemispherical sockets. The other hemispherical socket includes a slot for the primary conduit such that the conduit's motion along that slot with rotation of the spherical plug about various axes will position the valve-plug ports in respect to the secondary conduits

Topology Selection and Analysis of Actuator for Seat Valves suitable for use in Digital Displacement Pumps/Motors

DEFF Research Database (Denmark)

Rømer, Daniel; Johansen, Per; Pedersen, Henrik C.

2013-01-01

seat valves is developed, and the resulting dynamic response of the seat valve is presented. Requirements for the valve actuator is established based on the DD application, and three feasible actuator topologies are analyzed by means of transient electro-magnetic FEA simulation. From this analysis...

Nuclear reactor steam depressurization valve

International Nuclear Information System (INIS)

Moore, G.L.

1991-01-01

This patent describes improvement in a nuclear reactor plant, an improved steam depressurization valve positioned intermediate along a steam discharge pipe for controlling the venting of steam pressure from the reactor through the pipe. The improvement comprises: a housing including a domed cover forming a chamber and having a partition plate dividing the chamber into a fluid pressure activation compartment and a steam flow control compartment, the valve housing being provided with an inlet connection and an outlet connection in the steam flow control compartment, and a fluid duct in communication with a source of fluid pressure for operating the valve; a valve set mounted within the fluid flow control compartment comprising a cylindrical section surrounding the inlet connection with one end adjoining the connection and having a radially projecting flange at the other end with a contoured extended valve sealing flange provided with an annular valve sealing member, and a valve cylinder traversing the partition plate and reciprocally movable within an opening in the partition plate with one terminal and extending into the fluid pressure activation compartment and the other terminal end extending into the steam flow control compartment coaxially aligned with the valve seat surrounding the inlet connection, the valve cylinder being surrounded by two bellow fluid seals and provided with guides to inhibit lateral movement, an end of the valve cylinder extending into the fluid flow control compartment having a radially projecting flange substantially conterminous with the valve seat flange and having a contoured surface facing and complimentary to the contoured valve seating surface whereby the two contoured valve surfaces can meet in matching relationship, thus providing a pressure actuated reciprocatable valve member for making closing contact with the valve seat and withdrawing therefrom for opening fluid flow through the valve

Comparison of polypropylene and silicone Ahmed Glaucoma Valves.

Science.gov (United States)

Ishida, Kyoko; Netland, Peter A; Costa, Vital P; Shiroma, Lineu; Khan, Baseer; Ahmed, Iqbal Ike K

2006-08-01

To evaluate and compare the clinical outcomes after implantation of the silicone plate and the polypropylene plate Ahmed Glaucoma Valves. Prospective, multicenter, comparative series. A total of 132 patients with uncontrolled glaucoma were treated with either the silicone or polypropylene Ahmed Glaucoma Valve implant. Success was defined according to 2 criteria: (1) intraocular pressure (IOP) of 6 mmHg or more or 21 mmHg or less, and (2) IOP reduction of at least 30% relative to preoperative values. Eyes requiring further glaucoma surgery, including cyclophotocoagulation, or showing loss of light perception were classified as failures. Average follow-up was 12.8 months (range, 6-30 months) for the silicone plate group and 14.5 months (range, 6-30 months) for the polypropylene plate group (P = 0.063). At the last follow-up examination, the mean IOP was 13.8+/-3.9 mmHg and 17.3+/-6.5 mmHg (PAhmed Glaucoma Valve (model FP7) showed improved IOP reduction compared with the polypropylene (model S2) implant. Differences observed in mean IOP, success rate, and complications suggest that plate material may influence clinical outcome.

Redo mitral valve surgery

Directory of Open Access Journals (Sweden)

Redoy Ranjan

2018-03-01

Full Text Available This study is based on the findings of a single surgeon’s practice of mitral valve replacement of 167 patients from April 2005 to June 2017 who developed symptomatic mitral restenosis after closed or open mitral commisurotomy. Both clinical and color doppler echocardiographic data of peri-operative and six months follow-up period were evaluated and compared to assess the early outcome of the redo mitral valve surgery. With male-female ratio of 1: 2.2 and after a duration of 6 to 22 years symptom free interval between the redo procedures, the selected patients with mitral valve restenosis undergone valve replacement with either mechanical valve in 62% cases and also tissue valve in 38% cases. Particular emphasis was given to separate the adhered pericardium from the heart completely to ameliorate base to apex and global contraction of the heart. Besides favorable post-operative clinical outcome, the echocardiographic findings were also encouraging as there was statistically significant increase in the mitral valve area and ejection fraction with significant decrease in the left atrial diameter, pressure gradient across the mitral valve and pulmonary artery systolic pressure. Therefore, in case of inevitable mitral restenosis after closed or open commisurotomy, mitral valve replacement is a promising treatment modality.

Intro to Valve Guide Reconditioning. Automotive Mechanics. Valves. Instructor's Guide [and] Student Guide.

Science.gov (United States)

Horner, W.

This instructional package, one in a series of individualized instructional units on tools and techniques for repairing worn valve guides in motor vehicles, provides practical experience for students in working on cylinder heads. Covered in the module are reaming valve guides that are oversized to match a new oversized valve, reaming valve guides…

Factors associated with the development of aortic valve regurgitation over time after two different techniques of valve-sparing aortic root surgery.

Science.gov (United States)

Hanke, Thorsten; Charitos, Efstratios I; Stierle, Ulrich; Robinson, Derek; Gorski, Armin; Sievers, Hans-H; Misfeld, Martin

2009-02-01

Early results after aortic valve-sparing root reconstruction are excellent. Longer-term follow-up, especially with regard to aortic valve function, is required for further judgment of these techniques. Between July of 1993 and September of 2006, 108 consecutive patients (mean age 53.0 +/- 15.8 years) underwent the Yacoub operation (group Y) and 83 patients underwent the David operation (group D). Innovative multilevel hierarchic modeling methods were used to analyze aortic regurgitation over time. In general, aortic regurgitation increased with time in both groups. Factors associated with the development of a significant increase in aortic regurgitation were Marfan syndrome, concomitant cusp intervention, and preoperative aortic anulus dimension. In Marfan syndrome, the initial aortic regurgitation was higher in group Y versus group D (0.56 aortic regurgitation vs 0.29 aortic regurgitation, P = .049), whereas the mean annual progression rate of aortic regurgitation was marginally higher in group Y (0.132 aortic regurgitation vs 0.075 aortic regurgitation, P = .1). Concomitant cusp intervention was associated with a significant aortic regurgitation increase in both groups (P Marfan syndrome and a large preoperative aortic annulus diameter were better treated with the reimplantation technique, whereas those with a smaller diameter were better treated with the remodeling technique. Concomitant free-edge plication of prolapsing cusps was disadvantageous in both groups. Considering these factors may serve to improve the aortic valve longevity after valve-sparing aortic root surgery.

Guide to prosthetic cardiac valves

International Nuclear Information System (INIS)

Morse, D.; Steiner, R.M.; Fernandez, J.

1985-01-01

This book contains 10 chapters. Some of the chapter titles are: The development of artificial heart valves: Introduction and historical perspective; The radiology of prosthetic heart valves; The evaluation of patients for prosthetic valve implantation; Pathology of cardiac valve replacement; and Bioengineering of mechanical and biological heart valve substitutes

[Plastic repair of tricuspid valve: Carpentier's ring annuloplasty versus De VEGA technique].

Science.gov (United States)

Charfeddine, Salma; Hammami, Rania; Triki, Faten; Abid, Leila; Hentati, Mourad; Frikha, Imed; Kammoun, Samir

2017-01-01

Tricuspid valve disease has been neglected for a long time by cardiologists and surgeons, but for some years now leakage of tricuspid valve has been demonstrated as a prognostic factor in the evolution of patients with left heart valve disease undergoing surgery. Several techniques for plastic repair of tricuspid valve have been developed and the published studies differ on the results of these techniques; we conducted this study to assess the results of plastic repair of tricuspid valve in a population of patients with a high prevalence of rheumatic disease and to compare Carpentier's ring annuloplasty techniques with DEVEGA plasty. We conducted a retrospective study of patients undergoing plastic repair of tricuspid valve in the Department of Cardiology at the Medicine University of Sfax over a period of 25 years. We compared the results from the Group 1 (Carpentier's ring annuloplasty) with Group 2 (DeVEGA plasty). 91 patients were included in our study, 45 patients in the Group 1 and 46 patients in the Group 2. Most patients had mean or severe TI (83%) before surgery, ring dilation was observed in 90% of patients with no significant difference between the two groups. Immediate results were comparable between the two techniques but during monitoring recurrent, at least mean, insufficiency was significantly more frequent in the DeVEGA plasty Group. The predictive factors for significant recurring long term TI were DeVEGA technique (OR=3.26[1.12-9.28]) in multivariate study and preoperative pulmonary artery systolic pressure (OR=1.06 (1.01-1.12)). Plastic repair of tricuspid valve using Carpentier's ring seems to guarantee better results than DeVEGA plasty. On the other hand, preoperative high PASP is predictive of recurrent leakage of tricuspid valve even after plasty; hence the importance of surgery in the treatment of patients at an early stage of the disease.

Aortic Valve Predilatation with a Small Balloon, without Rapid Pacing, prior to Transfemoral Transcatheter Aortic Valve Replacement

Directory of Open Access Journals (Sweden)

Anupama Shivaraju

2018-01-01

Full Text Available Objectives. The aim of this study is to assess the feasibility and clinical outcome of transcatheter aortic valve replacement (TAVR using aortic valve predilatation (AVPD with a small, nonocclusive balloon. Background. Balloon aortic valvuloplasty (BAV under rapid pacing is generally performed in TAVR to ensure the passage and sufficient deployment of the prosthesis in the stenotic AV. BAV may cause serious complications, such as left ventricular stunning or cerebrovascular embolism. Methods. A cohort of 50 consecutive patients with severe aortic stenosis underwent transfemoral TAVR with the Edwards Sapien 3-heart valve. All patients underwent AVPD with a small, nonocclusive balloon (12 × 60 or 14 × 60 mm without rapid pacing. Procedural data and clinical outcomes were analyzed. Results. The mean age of the cohort was 81±6 years and the mean logistic EuroSCORE (European System for Cardiac Operative Risk Evaluation was 13±9. Crossing the AV and prosthesis implantation was successful in all cases. The postprocedural mean AV gradient was 12±5 mmHg. There were no cases of aortic regurgitation ≥ grade 2. No periprocedural stroke occurred. One patient (2% with chronic atrial fibrillation displayed a transient Wernicke aphasia occurring more than 24 hours after TAVR. Mortality was 0% at 30 days after procedure. Conclusion. In TAVR, AVPD with a small, nonocclusive balloon can be safely performed. By avoiding rapid pacing, this technique may be a valid alternative to traditional BAV. Whether or not the use of APVD without rapid pacing translates into less periprocedural complications needs to be assessed in future studies.

Trans-apical aortic valve implantation in a patient with stentless valve degeneration.

Science.gov (United States)

Kapetanakis, Emmanouil I; MacCarthy, Philip; Monaghan, Mark; Wendler, Olaf

2011-06-01

Trans-apical valve-in-valve trans-catheter aortic valve implantation (TAVI) has successfully been performed in selected, high-risk patients, who suffered prosthetic degeneration after aortic valve replacement using stented xenografts. We report the case of a 79-year-old male patient who underwent one of the first successful TAVIs in a failing stentless bioprosthesis. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Early clinical outcome of aortic transcatheter valve-in-valve implantation in the Nordic countries

DEFF Research Database (Denmark)

Ihlberg, Leo; Nissen, Henrik Hoffmann; Nielsen, Niels Erik

2013-01-01

Transcatheter valve-in-valve implantation has emerged as an option, in addition to reoperative surgical aortic valve replacement, to treat failed biologic heart valve substitutes. However, the clinical experience with this approach is still limited. We report the comprehensive experience...

Outcomes in nonagenarians after heart valve replacement operation.

Science.gov (United States)

Edwards, Maria-Benedicta; Taylor, Kenneth M

2003-03-01

Changes in the age profile of the United Kingdom population and improvements in preoperative and postoperative care have resulted in increasing numbers of very elderly patients undergoing heart valve replacement (HVR) operations. Although HVR operations in nonagenarians are relatively uncommon, the demand for cardiac operations in this age group may increase over time. Outcomes after HVR operations in nonagenarians have not been well described yet. Therefore, the aim of this study was to determine outcomes in terms of early mortality and long-term survival in 35 nonagenarians after HVR operation. Data from the United Kingdom Heart Valve Registry were analyzed and nonagenarian patients were identified. Additional analyzed data include gender, valve position, valve type, valve size, operative priority, follow-up time, and date and cause of death. Kaplan-Meier actuarial curves were calculated to determine accurate 30-day mortality and long-term survival. On average five HVR operations are performed annually in the United Kingdom in nonagenarians with equal numbers of males and females. Aortic valve replacement with a bioprosthetic valve was the most common operation and 86% were elective admissions. Fourteen patients died within the review period; mean time to death was 402 days. Overall 30-day mortality was 17%, which was higher for males compared with females; females also displayed better long-term survival. HVR operations in nonagenarians carry a significantly higher risk of early mortality and reduced long-term survival. Despite increases in the age profile of the population, elective HVR operation with patients aged 90 years or older is likely to remain an infrequent surgical procedure reserved for very carefully selected patients.

Nuclear valves latest development

International Nuclear Information System (INIS)

Isaac, F.; Monier, M.

1993-01-01

In the frame of Nuclear Power Plant upgrade (Emergency Power Supply and Emergency Core Cooling), Westinghouse had to face a new valve design philosophy specially for motor operated valves. The valves have to been designed to resist any operating conditions, postulated accident or loss of control. The requirements for motor operated valves are listed and the selected model and related upgrading explained. As part of plant upgrade and valves replacement, Westinghouse has sponsored alternative hardfacing research programme. Two types of materials have been investigated: nickel base alloys and iron base alloys. Programme requirements and test results are given. A new globe valve model (On-Off or regulating) is described developed by Alsthom Velan permitting the seat replacement in less than 10 min. (Z.S.) 2 figs

Low Transvalvular Flow Rate Predicts Mortality in Patients With Low-Gradient Aortic Stenosis Following Aortic Valve Intervention.

Science.gov (United States)

Vamvakidou, Anastasia; Jin, Wenying; Danylenko, Oleksandr; Chahal, Navtej; Khattar, Rajdeep; Senior, Roxy

2018-03-09

This study aimed to assess the value of low transvalvular flow rate (FR) for the prediction of mortality compared with low stroke volume index (SVi) in patients with low-gradient (mean gradient: gradient AS who had undergone valve intervention. We retrospectively followed prospectively assessed consecutive patients with low-gradient, low aortic valve area AS who underwent aortic valve intervention between 2010 and 2014 for all-cause mortality. Of the 218 patients with mean age 75 ± 12 years, 102 (46.8%) had low stroke volume index (SVi) (gradient, low valve area aortic stenosis undergoing aortic valve intervention, low FR, not low SVi, was an independent predictor of medium-term mortality. Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Magnetic Check Valve

Science.gov (United States)

Morris, Brian G.; Bozeman, Richard J., Jr.

1994-01-01

Poppet in proposed check valve restored to closed condition by magnetic attraction instead of spring force. Oscillations suppressed, with consequent reduction of wear. Stationary magnetic disk mounted just upstream of poppet, also containing magnet. Valve body nonmagnetic. Forward pressure or flow would push poppet away from stationary magnetic disk so fluid flows easily around poppet. Stop in valve body prevents poppet from being swept away. When flow stopped or started to reverse, magnetic attraction draws poppet back to disk. Poppet then engages floating O-ring, thereby closing valve and preventing reverse flow. Floating O-ring facilitates sealing at low loads.

Valve-sparing operation for aortic root aneurysm in patients with Marfan syndrome.

Science.gov (United States)

Wang, R; Ma, W G; Tian, L X; Sun, L Z; Chang, Q

2010-03-01

We report our experience with aortic valve-sparing procedures in patients with Marfan syndrome and aortic root aneurysm. Between August 2003 and July 2007, we performed aortic valve-sparing procedures in 20 patients with aortic root aneurysm resulting from Marfan syndrome. Mean age was 28 +/- 10 years (range, 10 to 57 years), and there were 9 females and 11 males. A reimplantation technique was used in 9 cases, a remodeling technique in 8 and a patch technique in 3 cases. Additional procedures included total aorta replacement in 1 patient, and aortic arch replacement plus stented elephant trunk in 2 patients. The mean follow-up time was 46 +/- 16 months (range, 17 to 64 months). No in-hospital or late death occurred. Reexploration for bleeding was required in one case on postoperative day 1. No valve-related complications occurred during the follow-up period. At the end of follow-up, trivial or no aortic regurgitation was demonstrated in 14 patients, mild in 4 patients, moderate in 1 and severe in 1. Two patients with moderate and severe aortic regurgitation required reoperation. The early and mid-term results of the valve-sparing operations were favorable, and the durability of the preserved valve should encourage use of this technique in patients with Marfan syndrome.

Anterior mitral valve aneurysm: a rare sequelae of aortic valve endocarditis

Directory of Open Access Journals (Sweden)

Rajesh Janardhanan

2016-05-01

Full Text Available In intravenous drug abusers, infective endocarditis usually involves right-sided valves, with Staphylococcus aureus being the most common etiologic agent. We present a patient who is an intravenous drug abuser with left-sided (aortic valve endocarditis caused by Enterococcus faecalis who subsequently developed an anterior mitral valve aneurysm, which is an exceedingly rare complication. A systematic literature search was conducted which identified only five reported cases in the literature of mitral valve aneurysmal rupture in the setting of E. faecalis endocarditis. Real-time 3D-transesophageal echocardiography was critical in making an accurate diagnosis leading to timely intervention. Learning objectives: • Early recognition of a mitral valve aneurysm (MVA is important because it may rupture and produce catastrophic mitral regurgitation (MR in an already seriously ill patient requiring emergency surgery, or it may be overlooked at the time of aortic valve replacement (AVR. • Real-time 3D-transesophageal echocardiography (RT-3DTEE is much more advanced and accurate than transthoracic echocardiography for the diagnosis and management of MVA.

Anterior mitral valve aneurysm: a rare sequelae of aortic valve endocarditis.

Science.gov (United States)

Janardhanan, Rajesh; Kamal, Muhammad Umar; Riaz, Irbaz Bin; Smith, M Cristy

2016-03-01

SummaryIn intravenous drug abusers, infective endocarditis usually involves right-sided valves, with Staphylococcus aureus being the most common etiologic agent. We present a patient who is an intravenous drug abuser with left-sided (aortic valve) endocarditis caused by Enterococcus faecalis who subsequently developed an anterior mitral valve aneurysm, which is an exceedingly rare complication. A systematic literature search was conducted which identified only five reported cases in the literature of mitral valve aneurysmal rupture in the setting of E. faecalis endocarditis. Real-time 3D-transesophageal echocardiography was critical in making an accurate diagnosis leading to timely intervention. Early recognition of a mitral valve aneurysm (MVA) is important because it may rupture and produce catastrophic mitral regurgitation (MR) in an already seriously ill patient requiring emergency surgery, or it may be overlooked at the time of aortic valve replacement (AVR).Real-time 3D-transesophageal echocardiography (RT-3DTEE) is much more advanced and accurate than transthoracic echocardiography for the diagnosis and management of MVA. © 2016 The authors.

Inducement of Design Parameters for Reliability Improvement of Servo Actuator for Hydraulic Valve Operation

Energy Technology Data Exchange (ETDEWEB)

Sung, Baek Ju; Kim, Do Sik [Korea Institute of Machinery and Materials, Daejeon (Korea, Republic of)

2014-05-15

The precision hydraulic valve is widely used in various industrial field like aircraft, automobile, and general machinery. Servo actuator is the most important device for driving the precise hydraulic valve. The reliable operation of servo actuator effects on the overall hydraulic system. The performance of servo actuator relies on frequency response and step response according to arbitrary input signal. In this paper, we performed the analysis for the components of servo actuator to satisfy the reliable operation and response characteristics through the reliability analysis, and also induced the design parameters to realize the reliable operation and fast response characteristics of servo actuator for hydraulic valve operation through the empirical knowledge of experts and electromagnetic theories. We suggested the design equations to determine the values of design parameters of servo actuator as like bobbin size, length of yoke and plunger and turn number of coil, and verified the achieved design values through FEM analysis and performance tests using some prototypes of servo actuators adapted in hydraulic valve.

Transcatheter Aortic Valve Replacement for Degenerative Bioprosthetic Surgical Valves

DEFF Research Database (Denmark)

Dvir, Danny; Webb, John; Brecker, Stephen

2012-01-01

Transcatheter aortic valve-in-valve implantation is an emerging therapeutic alternative for patients with a failed surgical bioprosthesis and may obviate the need for reoperation. We evaluated the clinical results of this technique using a large, worldwide registry....

Mechanisms of valve competency after mitral valve annuloplasty for ischaemic mitral regurgitation using the Geoform ring: insights from three-dimensional echocardiography.

Science.gov (United States)

Armen, Todd A; Vandse, Rashmi; Crestanello, Juan A; Raman, Subha V; Bickle, Katherine M; Nathan, Nadia S

2009-01-01

Left ventricular remodelling leads to functional mitral regurgitation resulting from annular dilatation, leaflet tethering, tenting, and decreased leaflet coaptation. Mitral valve annuloplasty restores valve competency, improving the patient's functional status and ventricular function. This study was designed to evaluate the mechanisms underlying mitral valve competency after the implantation of a Geoform annuloplasty ring using three-dimensional (3D) echocardiography. Seven patients (mean age of 65 years) with ischaemic mitral regurgitation underwent mitral valve annuloplasty with the Geoform ring and coronary artery bypass surgery. Pre- and post-operative 3D echocardiograms were performed. Following mitral annuloplasty, mitral regurgitation decreased from 3.4+/-0.2 to 0.9+/-0.3 (P-value<0.0001), mitral valve tenting volume from 13+/-1.7 to 3.2+/-0.3 mL (P-value<0.001), annulus area from 12.6+/-1.0 to 3.3+/-0.2 cm2 (P-value<0.0001), valve circumference from 13+/-0.5 to 7.3+/-0.3 cm (P-value<0.0001), septolateral distance from 2.1+/-0.1 to 1.4+/-0.06 cm (P-value<0.01) and intercommissural distance from 3.4+/-0.1 to 2.7+/-0.03 cm (P-value<0.03). There was significant decrease in the septolateral distance at the level of A2-P2 with respect to other regions. These geometric changes were associated with the improvement in the NYHA class from 3.1+/-0.3 to 1.3+/-0.3 (P-value<0.002). The mitral valve annuloplasty with the Geoform ring restores leaflet coaptation and eliminates mitral regurgitation by effectively modifying the mitral annular geometry.

The JUPITER registry: One-year outcomes of transapical aortic valve implantation using a second generation transcatheter heart valve for aortic regurgitation.

Science.gov (United States)

Silaschi, Miriam; Conradi, Lenard; Wendler, Olaf; Schlingloff, Friederike; Kappert, Utz; Rastan, Ardawan J; Baumbach, Hardy; Holzhey, David; Eichinger, Walter; Bader, Ralf; Treede, Hendrik

2018-06-01

We present 1-year outcomes of the post-market registry of a next-generation transcatheter heart valve used for aortic regurgitation (AR). Transcatheter aortic valve replacement (TAVR) is routine in high-risk patients with aortic stenosis but is not recommended for AR. The JenaValve™ (JenaValve Technology GmbH, Munich, Germany) overcomes technical challenges in AR patients through a leaflet clipping mechanism. The JenaValve EvalUation of Long Term Performance and Safety In PaTients with SEvere Aortic Stenosis oR Aortic Insufficiency (JUPITER) Registry is a European study to evaluate safety and effectiveness of this THV. From 2012-2015, 30 patients with AR were enrolled. Mean age was 74.4 ± 9.3 years. Procedural success was 96.7% (29/30). One patient was converted to open surgery. No annular rupture or coronary ostia obstruction occurred. Mortality at 30 days was 10.0% (3/30). Combined safety endpoint was met in 13.3% (4/30). Paravalvular regurgitation was not present/trivial in 84.6% (22/26) and mild in 15.4% (4/26). Rate of permanent pacemaker implantation was 3.8% (1/26). One-year Kaplan-Meier survival was 79.9%, one-year combined efficacy was 73.1% (19/30). No further strokes were observed during 1 year of follow-up. The JenaValve overcomes technical challenges of TAVR in AR through a clipping mechanism. We report satisfactory outcomes of a multicenter registry using the JenaValve for predominant AR, as rate of THV embolization, residual AR and permanent pacemaker implantation was low. One-year results using the JenaValve for AR encourage its use for this indication. © 2017 Wiley Periodicals, Inc.

Transcatheter aortic valve replacement

Science.gov (United States)

... gov/ency/article/007684.htm Transcatheter aortic valve replacement To use the sharing features on this page, please enable JavaScript. Transcatheter aortic valve replacement (TAVR) is surgery to replace the aortic valve. ...

Repeat transcatheter aortic valve implantation using a latest generation balloon-expandable device for treatment of failing transcatheter heart valves.

Science.gov (United States)

Schaefer, Andreas; Treede, Hendrik; Seiffert, Moritz; Deuschl, Florian; Schofer, Niklas; Schneeberger, Yvonne; Blankenberg, Stefan; Reichenspurner, Hermann; Schaefer, Ulrich; Conradi, Lenard

2016-01-15

Paravalvular leakage (PVL) is a known complication of transcatheter aortic valve implantation (TAVI) and is associated with poor outcome. Besides balloon-post-dilatation, valve-in-valve (ViV) procedures can be taken into consideration to control this complication. Herein we present initial experience with use of the latest generation balloon-expandable Edwards Sapien 3® (S3) transcatheter heart valve (THV) for treatment of failing THVs. Between 01/2014 and 12/2014 three patients (two male, age: 71-80 y, log EUROScore I: 11.89 - 32.63) with failing THVs were refered to our institution for further treatment. THV approach with secondary implantation of an S3 was chosen after mutual agreement of the local interdisciplinary heart team at an interval of 533-1119 days from the index procedure. The performed procedures consisted of: S3 in Sapien XT, JenaValve and CoreValve. Successful transfemoral implantation with significant reduction of PVL was achieved in all cases. No intraprocedural complications occurred regarding placement of the S3 with a postprocedural effective orifice area (EOA) of 1.5-2.5 cm(2) and pressure gradients of max/mean 14/6-36/16 mmHg. 30-day mortality was 0%. At the latest follow-up of 90-530 days, all patients are alive and well with satisfactory THV function. Regarding VARC-2 criteria one major bleeding and one TIA was reported. In the instance of moderate or severe aortic regurgitation after TAVI, S3 ViV deployment is an excellent option to reduce residual regurgitation to none or mild. For further assertions concerning functional outcomes long-term results have to be awaited.

The prognosis of infective endocarditis treated with biological valves versus mechanical valves: A meta-analysis.

Science.gov (United States)

Tao, Ende; Wan, Li; Wang, WenJun; Luo, YunLong; Zeng, JinFu; Wu, Xia

2017-01-01

Surgery remains the primary form of treatment for infective endocarditis (IE). However, it is not clear what type of prosthetic valve provides a better prognosis. We conducted a meta-analysis to compare the prognosis of infective endocarditis treated with biological valves to cases treated with mechanical valves. Pubmed, Embase and Cochrane databases were searched from January 1960 to November 2016.Randomized controlled trials, retrospective cohorts and prospective studies comparing outcomes between biological valve and mechanical valve management for infective endocarditis were analyzed. The Newcastle-Ottawa Scale(NOS) was used to evaluate the quality of the literature and extracted data, and Stata 12.0 software was used for the meta-analysis. A total of 11 publications were included; 10,754 cases were selected, involving 6776 cases of biological valves and 3,978 cases of mechanical valves. The all-cause mortality risk of the biological valve group was higher than that of the mechanical valve group (HR = 1.22, 95% CI 1.03 to 1.44, P = 0.023), as was early mortality (RR = 1.21, 95% CI 1.02 to 1.43, P = 0.033). The recurrence of endocarditis (HR = 1.75, 95% CI 1.26 to 2.42, P = 0.001), as well as the risk of reoperation (HR = 1.79, 95% CI 1.15 to 2.80, P = 0.010) were more likely to occur in the biological valve group. The incidence of postoperative embolism was less in the biological valve group than in the mechanical valve group, but this difference was not statistically significant (RR = 0.90, 95% CI 0.76 to 1.07, P = 0.245). For patients with prosthetic valve endocarditis (PVE), there was no significant difference in survival rates between the biological valve group and the mechanical valve group (HR = 0.91, 95% CI 0.68 to 1.21, P = 0.520). The results of our meta-analysis suggest that mechanical valves can provide a significantly better prognosis in patients with infective endocarditis. There were significant differences in the clinical features of patients

Comparative study of Butterfly valves

International Nuclear Information System (INIS)

Galmes Belmonte, F.B.

1998-01-01

This work tries to justify the hydrodynamic butterfly valves performance, using the EPRI tests, results carried out in laboratory and in situ. This justification will be possible if: - The valves to study are similar - Their performance is calculated using EPRI's methodology Looking for this objective, the elements of the present work are: 1. Brief EPRI butterfly valve description it wild provide the factors which are necessary to define the butterfly valves similarity. 2. EPRI tests description and range of validation against test data definition. 3. Description of the spanish butterfly analyzed valves, and comparison with the EPRI performance results, to prove that this valves are similar to the EPRI test valves. In this way, it will not be necessary to carry out particular dynamic tests on the spanish valves to describe their hydrodynamic performance. (Author)

Fluid mechanics of heart valves.

Science.gov (United States)

Yoganathan, Ajit P; He, Zhaoming; Casey Jones, S

2004-01-01

Valvular heart disease is a life-threatening disease that afflicts millions of people worldwide and leads to approximately 250,000 valve repairs and/or replacements each year. Malfunction of a native valve impairs its efficient fluid mechanic/hemodynamic performance. Artificial heart valves have been used since 1960 to replace diseased native valves and have saved millions of lives. Unfortunately, despite four decades of use, these devices are less than ideal and lead to many complications. Many of these complications/problems are directly related to the fluid mechanics associated with the various mechanical and bioprosthetic valve designs. This review focuses on the state-of-the-art experimental and computational fluid mechanics of native and prosthetic heart valves in current clinical use. The fluid dynamic performance characteristics of caged-ball, tilting-disc, bileaflet mechanical valves and porcine and pericardial stented and nonstented bioprostheic valves are reviewed. Other issues related to heart valve performance, such as biomaterials, solid mechanics, tissue mechanics, and durability, are not addressed in this review.

Intelligent Flow Control Valve

Science.gov (United States)

Kelley, Anthony R (Inventor)

2015-01-01

The present invention is an intelligent flow control valve which may be inserted into the flow coming out of a pipe and activated to provide a method to stop, measure, and meter flow coming from the open or possibly broken pipe. The intelligent flow control valve may be used to stop the flow while repairs are made. Once repairs have been made, the valve may be removed or used as a control valve to meter the amount of flow from inside the pipe. With the addition of instrumentation, the valve may also be used as a variable area flow meter and flow controller programmed based upon flowing conditions. With robotic additions, the valve may be configured to crawl into a desired pipe location, anchor itself, and activate flow control or metering remotely.

Experience with valves for PHWR reactors

International Nuclear Information System (INIS)

Narayan, K.; Mhetre, S.G.

1977-01-01

Material specifications and inspection and testing requirements of the valves meant for use in nuclear reactors are mentioned. In the heavy water systems (both primary and moderator) of a PHWR type reactor, the valves used are gate valves, globe valves, diaphragm valves, butterfly valves, check valves and relief valves. Their locations and functions they perform in the Rajasthan Atomic Power Station Unit-1 are described. Experience with them is given. The major problems encountered with them have been : (1) leakage from the stem seals and body bonnet joint, (2) leakage due to failure of diaphragm and/or washout of the packing and (3) malfunctioning. Measures taken to solve these are discussed. Finally a mention has been made of improved versions of valves, namely, metal diaphragm valve and inverted relief valve. (M.G.B.)

Heart valve replacement with the Sorin tilting-disc prosthesis. A 10-year experience.

Science.gov (United States)

Milano, A; Bortolotti, U; Mazzucco, A; Mossuto, E; Testolin, L; Thiene, G; Gallucci, V

1992-02-01

From 1978 to 1988, 697 patients with a mean age of 48 +/- 11 years (range 5 to 75 years) received a Sorin tilting-disc prosthesis; 358 had had aortic valve replacement, 247 mitral valve replacement, and 92 mitral and aortic valve replacement. Operative mortality rates were 7.8%, 11.3%, and 10.8%, respectively, in the three groups. Cumulative duration of follow-up is 1650 patient-years for aortic valve replacement (maximum follow-up 11.4 years), 963 patient-years for mitral valve replacement (maximum follow-up 9.9 years) and 328 patient-years for mitral and aortic valve replacement (maximum follow-up 9.4 years). Actuarial survival at 9 years is 72% +/- 4% after mitral valve replacement, 70% +/- 3% after aortic valve replacement, and 50% +/- 12% after mitral and aortic valve replacement, and actuarial freedom from valve-related deaths is 97% +/- 2% after mitral valve replacement, 92% +/- 2% after aortic valve replacement, and 62% +/- 15% after mitral and aortic valve replacement. Thromboembolic events occurred in 21 patients with aortic valve replacement (1.3% +/- 0.2%/pt-yr), in 12 with mitral valve replacement (1.2% +/- 0.3% pt-yr), and in seven with mitral and aortic valve replacement (2.1% +/- 0.8%), with one case of prosthetic thrombosis in each group; actuarial freedom from thromboembolism at 9 years is 92% +/- 3% after mitral valve replacement, 91% +/- 3% after aortic valve replacement, and 74% +/- 16% after mitral and aortic valve replacement. Anticoagulant-related hemorrhage was observed in 15 patients after aortic valve replacement (0.9% +/- 0.2%/pt-yr), in 9 after mitral valve replacement (0.9% +/- 0.3%/pt-yr), and in 6 with mitral and aortic valve replacement (0.9% +/- 0.5%/pt-yr); actuarial freedom from this complication at 9 years is 94% +/- 2% after aortic valve replacement, 91% +/- 4% after mitral valve replacement, and 68% +/- 16% after mitral and aortic valve replacement. Actuarial freedom from reoperation at 9 years is 97% +/- 2% after mitral and

Mitral Valve Stenosis in Pregnancy and Its Effects on Maternal and Fetal Outcomes

Directory of Open Access Journals (Sweden)

İlker Gül

2012-12-01

Full Text Available Objective: Our aim is to determine the effect of mitral valvular disease on pregnancy follow up parameters and newborns. Material and Methods: We retrospectively reviewed the pregnant patients those were hospitalized because of mild-moderate mitral valve stenosis (n=16 between January 1998 and January 2011 in our center. Echocardiography was performed with regular intervals and the datas were recorded. Gestational age of delivery, type of delivery, general condition of newborn due to APGAR system were assessed. Values were compared with those of controls without any cardiac disease (n=16. Results: Mean mitral valve area, average mitral gradient and systemic pulmonary artery pressure were established 1.44+0.45 cm2, 5.2+1.5 mmHg ve 23+4.8 mmHg respectively in patients with mitral stenosis. Mean gestational age of delivery was 36.2±1.4 weeks (p=0.001 and mean fetal weight was 2646±431.1 g (p=0.016 in patients with mitral valve stenosis. These values were 38.7±2.12 weeks and 3056±212.13 gram respectively in control group. No significant difference was observed in terms of 1. and 5. APGAR scoring system among two groups. Conclusion: To optimize pregnancy outcomes, accurate diagnosis of the etiology, severity of valve disease and preconception evaluation are the main factors. Obstetrician should be careful in terms of intrauterine growth retardation and preterm delivery during pregnancy in patients with mitral valve stenosis.

Percutaneous aortic valve implantation of the Medtronic CoreValve self-expanding valve prosthesis via left subclavian artery access: the first case report in Greece.

Science.gov (United States)

Karavolias, George K; Georgiadou, Panagiota; Houri, Mazen; Sbarouni, Eftihia; Thomopoulou, Sofia; Tsiapras, Dimitrios; Smirli, Anna; Balanika, Marina; Voudris, Vassilis

2010-01-01

This case report describes a percutaneous aortic valve implantation with the Medtronic CoreValve selfexpanding valve prosthesis in a patient with severe aortic stenosis. The approach was made via the left subclavian artery because of the lack of femoral vessel access. The patient was a 78-year-old female with breathlessness on minimal effort, a recent hospitalisation due to pulmonary oedema, and frequent episodes of pre-syncope; surgical valve replacement had been ruled out. The prosthetic valve was successfully implanted with mild paravalvular aortic regurgitation. At 30 days, the patient's clinical condition had significantly improved, with excellent functioning of the aortic valve prosthesis.

Climate change adaptation: What does it mean for me?; Klimatilpasning: hva betyr det for meg?

Energy Technology Data Exchange (ETDEWEB)

O' Brien, Karen; Mittet, Siri; Bakkeslett, Eva; Eriksen, Siri; Hansen-Bauer, Inger; Hovelsrud, Grete; Inderberg, Tor Haakon; Ruud, Cathrine; Saglie, Inger-Lise; Sygna, Inger Lise

2012-11-01

The book 'Climate Change Adaptation: What Does it Mean for Me?' is written as a collective endeavor in the PLAN project (link this to the webpage), an interdisciplinary research project that focuses on climate change adaptation in Norway. With contributions from multiple disciplines, including arts, the book introduces a variety of perspectives and interpretations on adaptation. Focusing on climate change adaptation as a social, cultural and human process, this book recognizes that adaptation is more than a technical problem that can be addressed through technology, management and expertise. It is also an adaptive challenge that calls for attention to the values, beliefs, habits, loyalties and interests that sustain behaviors, systems, structures, and institutions in a changing climate. Confronted with complex and non-linear risks associates with climate change, and the interactions by other processes of change, this book call for a more comprehensive interpretation of adaptation, where both subjective and objective aspects are considered. This book thus goes beyond most contemporary understandings of adaptation, by focusing on the personal dimensions of adaptation. Arguing that the greatest adaptation of all may be the realization that humanity is in fact changing the climate and that we as individuals can do something about it, that we can {sup c}hange the change{sup ,} the book discusses the role of the arts, engaged individuals and different forms of leadership in levering change towards a more sustainable future. Full reference to the book: Karen O'Brien, Siri Mittet, Eva Bakkeslett, Siri Eriksen, Inger Hansen-Bauer, Grete Hovelsrud, Tor-Haakon Inderberg, Cathrine Ruud, Inger-Lise Saglie, and Linda Sygna (2012) Klimatilpasning: Hva betyr det for meg/ Climate Change Adaptation: What Does it Mean for Me?, Unipub forlag, 108 pages (in Norwegian). Online. Available HTTP: < http://www.sv.uio.no/iss/forskning/prosjekter/plan/klimatilpasning--hva-betyr-det-for-meg.pdf>.(auth)

Flow oscillations on the steam control valve in the middle opening condition. Clarification of the effects of valve body and valve seat by steam experiments

International Nuclear Information System (INIS)

Morita, Ryo; Inada, Fumio

2007-01-01

A steam control valve might cause vibrations of piping when the valve opening is in a middle condition. For rationalization of maintenance and management of the plant, the valve should be improved, but it is difficult to understand flow characteristics in detail by experiment because flow around the valve is complex 3D structure and becomes supersonic (M>1). Therefore, it is necessary to clarify the cause of the vibrations and to develop the countermeasures by CFD (Computational Fluid Dynamics) technology. In previous researches, we clarified a mechanism of the pressure fluctuations in the middle opening condition and suggested the new valve shape (named 'Extended Valve') that can suppress the pressure fluctuations by air experiments and CFD calculations. Then, we also conducted steam experiments and CFD calculations to understand the differences between air and the steam, and found that the pressure fluctuations in the middle opening condition also occurred in the steam tests and the differences between the air and steam were not remarkable. In this report, to clarify the effects of valve and valve seat shape in steam flow condition, we conduct the steam experiments with various valve and seat shape. As a result, we find the change of the valve seat can decrease the amplitude of pressure fluctuations, but can not quite suppress the pressure fluctuations in the middle opening condition. Then, we apply the 'Extended Valve' to clarify the valve shape effect, and find that the extended valve suppresses the pressure fluctuations in the middle opening condition completely and decreases the pressure amplitude drastically. (author)

[Aortic valve preservation in Marfan syndrome. Initial experience].

Science.gov (United States)

Forteza, Alberto; Cortina, Jose M; Sánchez, Violeta; Centeno, Jorge; López, M Jesús; Pérez de la Sota, Enrique; Rufilanchas, Juan J

2007-05-01

Preservation of the aortic valve using the technique described by David has been shown to be as effective as the Bentall-De Bono procedure. It avoids both the need for long-term anticoagulation and the complications associated with mechanical prostheses. We report our initial experience using this technique in patients with Marfan syndrome. Between April 2004 and April 2006, we used the David reimplantation technique in 40 patients with an aortic root aneurysm. Eighteen patients had Marfan syndrome. Their median age was 29 years (13-55 years). Echocardiography showed that the median diameter of the aortic sinus was 53 mm (46-59 mm). In 17 patients, aortic valve preservation was possible. No patient died during hospitalization and there were no significant complications. On echocardiography at discharge, no patient had greater than grade-II aortic regurgitation. During a median follow-up period of 8 months (1-24 months), one patient died due to rupture of an abdominal aneurysm. The others are all in New York Heart Association class I. Preservation of the aortic valve by means of valve reimplantation produced excellent results. It avoided both the thromboembolic and hemorrhagic complications associated with prostheses and the need for long-term anticoagulation. If reimplanted valves continue to function adequately over the long term, this technique should become the treatment of choice for aneurysms of the ascending aorta in patients with Marfan syndrome.

Conceptual design of a compact absolute valve for the ITER neutral beam injectors

Energy Technology Data Exchange (ETDEWEB)

Jones, Chris [Euratom/UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3DB (United Kingdom)], E-mail: chris.m.jones@jet.uk; Waldon, Chris; Martin, David; Watson, Mike [Euratom/UKAEA Fusion Association, Culham Science Centre, Abingdon, OX14 3DB (United Kingdom); Sonderegger, Kurt; Lenherr, Bruno [VAT Vakuumventile AG, CH-9469 Haag (Switzerland); Andrews, Ian; Mansbridge, Simon [VAT Vacuum Products Ltd., Edmund House, Rugby Road, Leamington Spa, Warwickshire CV32 6EL (United Kingdom)

2009-06-15

The reference design for the ITER neutral beam injectors incorporated a fast shutter to limit tritium migration to the injector vacuum enclosures. In 2005, a need for an 'absolute' isolation valve was identified to facilitate injector maintenance procedures and protect the system from an in-vessel ingress of coolant event (ICE). An outline concept for an all-metal seal valve was developed during 2006, in close cooperation with the Swiss valve manufacturer VAT. During the following year, it became apparent that the length of beamline available for the valve was significantly less than originally envisaged, resulting in a radical revision of the design concept. A casing length of 760 mm has been achieved by means of major changes to the casing structure, plate dimensions, pendulum mechanism and seal actuators. A concept for a seal protection system has been developed to prevent beam line contamination reaching the valve components and to protect the valve plate from surface heating by plasma radiation. The new design concept has been extensively validated by analysis, including a whole-system FE model of the valve.

Risk-based prioritization and its application to inspection of valves in the water sector

International Nuclear Information System (INIS)

Marlow, David R.; Beale, David J.; Mashford, John S.

2012-01-01

Isolation valves facilitate the effective operation and maintenance of water supply networks, but their sheer number presents a significant asset management challenge. If left unmanaged, valve reliability issues can become widespread. Inspections provide a means of increasing reliability, but a survey of industry practices indicated that some utilities did not have such a program in place. To improve asset management and reduce business risk exposure, such utilities need an effective means of commencing inspection programs. From a theoretical perspective, risk concepts provide a means of optimizing maintenance effort. However, in the face of poor data on reliability or condition, pragmatic approaches to risk-based prioritization are needed. One such approach, risk indexing, is considered in this paper. Background on the research is presented, including the application of risk-based inspection concepts within the water sector. The development of a risk indexing scheme is then investigated, drawing on two industry workshops in which the analytical hierarchy process was used to set relative weights. It is concluded that risk indexing provides the basis for a rational prioritization process in the absence of data on valve reliability or condition. - Highlights: ► Importance of valve inspections to water network reliability. ► Theoretical perspective of risk concepts that provide a means of optimizing inspection programs. ► Pragmatic approaches to prioritization in light of poor valve data. ► Development and assessment of a risk index scheme. ► Use of the analytical hierarchy process to set relative weights of risk factors.

Effects of the blockage ratio of a valve disk on loss coefficient in a butterfly valve

International Nuclear Information System (INIS)

Rho, Hyung Joon; Lee, Jee Keun; Choi, Hee Joo

2008-01-01

The loss coefficient of the butterfly valve which allows partial opening of the valve at closed position and is applicable to the small-sized pipe system with the diameter of 1 inch was measured for the variation of the valve disk blockage ratio. Two different types of the valve disk configuration to adjust the blockage ratio were considered. One was the solid type valve disk of which the diameter was changed into the smaller size rather than the pipe diameter, and the other was the perforate type valve disk on which some holes were perforated. The results from two types of valve disk were compared to identify their characteristics in the loss coefficient distributions. The loss coefficient and the controllable angle of the valve disk were decreased exponentially with the decrease of the blockage ratio. In addition, the perforate valve disk had the effect on the higher loss coefficient rather than the solid type valve disk

Designing Adaptable Ships: Modularity and Flexibility in Future Ship Designs

Science.gov (United States)

2016-01-01

with motors, belts, shafts , seals, valves, hose spindles , and switches. If ship installation is not installed, the system will be status quo. Ship...Impact: the current centrifugal purifiers (Alfa-Laval) have experienced frequent failures with motor, belts, shafts , seals, valves, hose spindles ... Designing Adaptable Ships Modularity and Flexibility in Future Ship Designs John F. Schank, Scott Savitz, Ken Munson, Brian Perkinson, James

Pivot design in bileaflet valves.

Science.gov (United States)

Vallana, F; Rinaldi, S; Galletti, P M; Nguyen, A; Piwnica, A

1992-01-01

The design criteria leading to the development of a new bileaflet valve (Sorin Bicarbon) were derived from the analysis of functional requirements, the performance of existing prostheses, and the availability of an advanced carbon coating technology (Carbofilm). The hinge is the critical element affecting fluid dynamics, durability, and thrombus formation in bileaflet valves. A comparative study of three existing models led to a new hinge design that was based on coupling two spheric surfaces with different radii of curvature (leaflet pivot and hinge recess) and obtained by electroerosion into a Carbofilm-coated metallic housing. In this valve, the point of contact moves continuously by rolling, not sliding. This minimizes friction and wear and allows uninterrupted washing of the blood exposed surfaces even during diastole (a finding established in patients using transesophageal echocardiography). Tricuspid implantation without anticoagulation in 33 sheep did not lead to thrombotic events (follow-up, 40-400 days). In the first 36 clinical implants observed for 15 months (mitral position, size 29; two unrelated deaths), the mean diastolic gradient by echo Doppler was 4 +/- 1.25 mmHg; the functional area was 3.2 +/- 0.6 cm2. No leaflet fracture and no thrombotic or embolic complications were observed clinically using a standard anticoagulant regimen.

Energy dynamics of the intraventricular vortex after mitral valve surgery.

Science.gov (United States)

Nakashima, Kouki; Itatani, Keiichi; Kitamura, Tadashi; Oka, Norihiko; Horai, Tetsuya; Miyazaki, Shohei; Nie, Masaki; Miyaji, Kagami

2017-09-01

Mitral valve morphology after mitral valve surgery affects postoperative intraventricular flow patterns and long-term cardiac performance. We visualized ventricular flow by echocardiography vector flow mapping (VFM) to reveal the impact of different mitral valve procedures. Eleven cases of mechanical mitral valve replacement (nine in the anti-anatomical and two in the anatomical position), three bioprosthetic mitral valve replacements, and four mitral valve repairs were evaluated. The mean age at the procedure was 57.4 ± 17.8 year, and the echocardiography VFM in the apical long-axis view was performed 119.9 ± 126.7 months later. Flow energy loss (EL), kinetic pressure (KP), and the flow energy efficiency ratio (EL/KP) were measured. The cases with MVR in the anatomical position and with valve repair had normal vortex directionality ("Clockwise"; N = 6), whereas those with MVR in the anti-anatomical position and with a bioprosthetic mitral valve had the vortex in the opposite direction ("Counterclockwise"; N = 12). During diastole, vortex direction had no effect on EL ("Clockwise": 0.080 ± 0.025 W/m; "Counterclockwise": 0.083 ± 0.048 W/m; P = 0.31) or KP ("Clockwise": 0.117 ± 0.021 N; "Counterclockwise": 0.099 ± 0.057 N; P = 0.023). However, during systole, the EL/KP ratio was significantly higher in the "Counterclockwise" vortex than that in the "Clockwise" vortex (1.056 ± 0.463 vs. 0.617 ± 0.158; P = 0.009). MVP and MVR with a mechanical valve in the anatomical position preserve the physiological vortex, whereas MVR with a mechanical valve in the anti-anatomical position and a bioprosthetic mitral valve generate inefficient vortex flow patterns, resulting in a potential increase in excessive cardiac workload.

Characterization of a bioprosthetic bicuspid venous valve hemodynamics: implications for mechanism of valve dynamics.

Science.gov (United States)

Tien, W-H; Chen, H Y; Berwick, Z C; Krieger, J; Chambers, S; Dabiri, D; Kassab, G S

2014-10-01

Chronic venous insufficiency (CVI) of the lower extremities is a common clinical problem. Although bioprosthetic valves have been proposed to treat severe reflux, clinical success has been limited due to thrombosis and neointima overgrowth of the leaflets that is, in part, related to the hemodynamics of the valve. A bioprosthetic valve that mimics native valve hemodynamics is essential. A computational model of the prosthetic valve based on realistic geometry and mechanical properties was developed to simulate the interaction of valve structure (fluid-structure interaction, FSI) with the surrounding flow. The simulation results were validated by experiments of a bioprosthetic bicuspid venous valve using particle image velocimetry (PIV) with high spatial and temporal resolution in a pulse duplicator (PD). Flow velocity fields surrounding the valve leaflets were calculated from PIV measurements and comparisons to the FSI simulation results were made. Both the spatial and temporal results of the simulations and experiments were in agreement. The FSI prediction of the transition point from equilibrium phase to valve-closing phase had a 7% delay compared to the PD measurements, while the PIV measurements matched the PD exactly. FSI predictions of reversed flow were within 10% compared to PD measurements. Stagnation or stasis regions were observed in both simulations and experiments. The pressure differential across the valve and associated forces on the leaflets from simulations showed the valve mechanism to be pressure driven. The flow velocity simulations were highly consistent with the experimental results. The FSI simulation and force analysis showed that the valve closure mechanism is pressure driven under the test conditions. FSI simulation and PIV measurements demonstrated that the flow behind the leaflet was mostly stagnant and a potential source for thrombosis. The validated FSI simulations should enable future valve design optimizations that are needed for

Cryogenic Cam Butterfly Valve

Science.gov (United States)

McCormack, Kenneth J. (Inventor)

2016-01-01

A cryogenic cam butterfly valve has a body that includes an axially extending fluid conduit formed there through. A disc lug is connected to a back side of a valve disc and has a circular bore that receives and is larger than a cam of a cam shaft. The valve disc is rotatable for a quarter turn within the body about a lug axis that is offset from the shaft axis. Actuating the cam shaft in the closing rotational direction first causes the camming side of the cam of the cam shaft to rotate the disc lug and the valve disc a quarter turn from the open position to the closed position. Further actuating causes the camming side of the cam shaft to translate the valve disc into sealed contact with the valve seat. Opening rotational direction of the cam shaft reverses these motions.

Hierarchical Adaptive Means (HAM) clustering for hardware-efficient, unsupervised and real-time spike sorting.

Science.gov (United States)

Paraskevopoulou, Sivylla E; Wu, Di; Eftekhar, Amir; Constandinou, Timothy G

2014-09-30

This work presents a novel unsupervised algorithm for real-time adaptive clustering of neural spike data (spike sorting). The proposed Hierarchical Adaptive Means (HAM) clustering method combines centroid-based clustering with hierarchical cluster connectivity to classify incoming spikes using groups of clusters. It is described how the proposed method can adaptively track the incoming spike data without requiring any past history, iteration or training and autonomously determines the number of spike classes. Its performance (classification accuracy) has been tested using multiple datasets (both simulated and recorded) achieving a near-identical accuracy compared to k-means (using 10-iterations and provided with the number of spike classes). Also, its robustness in applying to different feature extraction methods has been demonstrated by achieving classification accuracies above 80% across multiple datasets. Last but crucially, its low complexity, that has been quantified through both memory and computation requirements makes this method hugely attractive for future hardware implementation. Copyright © 2014 Elsevier B.V. All rights reserved.

Histopathology of valves in infective endocarditis, diagnostic criteria and treatment considerations.

Science.gov (United States)

Brandão, Tatiana J D; Januario-da-Silva, Carolina A; Correia, Marcelo G; Zappa, Monica; Abrantes, Jaime A; Dantas, Angela M R; Golebiovski, Wilma; Barbosa, Giovanna Ianini F; Weksler, Clara; Lamas, Cristiane C

2017-04-01

Infective endocarditis (IE) is a severe disease. Pathogen isolation is fundamental so as to treat effectively and reduce morbidity and mortality. Blood and valve culture and histopathology (HP) are routinely employed for this purpose. Valve HP is the gold standard for diagnosis. To determine the sensitivity and specificity of clinical criteria for IE (the modified Duke and the St Thomas' minor modifications, STH) of blood and valve culture compared to valve HP, and to evaluate antibiotic treatment duration. Prospective case series of patients, from 2006 to 2014 with surgically treated IE. Statistical analysis was done by the R software. There were 136 clinically definite episodes of IE in 133 patients. Mean age ± SD was 43 ± 15.6 years and IE was left sided in 81.6 %. HP was definite in 96 valves examined, which were used as gold standard. Sensitivity of blood culture was 61 % (CI 0.51, 0.71) and of valve culture 15 % (CI 0.07, 0.26). The modified Duke criteria were 65 % (CI 0.55, 0.75) sensitive and 33 % specific, while the STH's sensitivity was 72 % (CI 0.61, 0.80) with similar specificity. In multivariate analysis and logistic regression, the only variable with statistical significance was duration of antibiotic therapy postoperatively. Valve HP had high sensitivity and valve culture low sensitivity in the diagnosis of IE. The STH's criteria were more sensitive than the modified Duke criteria. Valve HP should guide duration of postoperative antibiotic treatment.

Small valve area index: its influence on early mortality after mitral valve replacement

NARCIS (Netherlands)

Yazdanbakhsh, A. P.; van den Brink, R. B.; Dekker, Egbert; de Mol, B. A.

2000-01-01

OBJECTIVE: To test the hypothesis that mitral valve prosthesis-patient mismatch increases postoperative mortality. METHODS AND RESULTS: The effect of mitral valve prosthesis-patient mismatch on survival in a cohort of consecutive patients after mitral valve replacement with a mechanical prosthesis

Effect of Ahmed valve implantation on late neovascular glaucoma

Directory of Open Access Journals (Sweden)

Ping-An Mao

2013-09-01

Full Text Available AIM: To discuss the effect and safety of Ahmed valve implantation in late neovascular glaucoma. METHODS: The Ahmed glaucoma valve were implanted in 41 eyes(41 caseswith late neovascular glaucoma, the follow-up was 12 months on average, intraocular pressure was recorded at 1 day, 1 week, 1 month, 3, 6, 12 months respectively after operation and compared with that before operation, at the same time, the complications and treatment were analyzed.RESULTS: The mean intraocular pressure before operation, 1 day, 1 week, 1 month, 3, 6, 12 months after operation was 59.83±5.53, 19.27±8.19, 19.69±6.86, 20.67±6.73, 21.05±6.93, 21.49±7.42, 22.14±8.08mmHg, the mean intraocular pressure before operation was higher than that after operation and the difference was obvious in statistics. Major complications included hyphema, low intraocular pressure early postoperation, shallow anterior chamber, obstruction of the tube, the plate wrapped or exposed.CONCLUSION: Ahmed valve implantation is an effective method to treatlate neovascular glaucoma.

Björk-Shiley convexoconcave valves: susceptibility artifacts at brain MR imaging and mechanical valve fractures.

Science.gov (United States)

van Gorp, Maarten J; van der Graaf, Yolanda; de Mol, Bas A J M; Bakker, Chris J G; Witkamp, Theo D; Ramos, Lino M P; Mali, Willem P T M

2004-03-01

To assess the relationship between heart valve history and susceptibility artifacts at magnetic resonance (MR) imaging of the brain in patients with Björk-Shiley convexoconcave (BSCC) valves. MR images of the brain were obtained in 58 patients with prosthetic heart valves: 20 patients had BSCC valve replacements, and 38 had other types of heart valves. Two experienced neuroradiologists determined the presence or absence of susceptibility artifacts in a consensus reading. Artifacts were defined as characteristic black spots that were visible on T2*-weighted gradient-echo MR images. The statuses of the 20 explanted BSCC valves-specifically, whether they were intact or had an outlet strut fracture (OSF) or a single-leg fracture (SLF)-had been determined earlier. Number of artifacts seen at brain MR imaging was correlated with explanted valve status, and differences were analyzed with nonparametric statistical tests. Significantly more patients with BSCC valves (17 [85%] of 20 patients) than patients with other types of prosthetic valves (18 [47%] of 38 patients) had susceptibility artifacts at MR imaging (P =.005). BSCC valve OSFs were associated with a significantly higher number of artifacts than were intact BSCC valves (P =.01). No significant relationship between SLF and number of artifacts was observed. Susceptibility artifacts at brain MR imaging are not restricted to patients with BSCC valves. These artifacts can be seen on images obtained in patients with various other types of fractured and intact prosthetic heart valves. Copyright RSNA, 2004

Valve-sparing aortic root replacement in Loeys-Dietz syndrome.

Science.gov (United States)

Patel, Nishant D; Arnaoutakis, George J; George, Timothy J; Allen, Jeremiah G; Alejo, Diane E; Dietz, Harry C; Cameron, Duke E; Vricella, Luca A

2011-08-01

Loeys-Dietz syndrome (LDS) is a recently recognized aggressive aortic disorder characterized by root aneurysm, arterial tortuosity, hypertelorism, and bifid uvula or cleft palate. The results of prophylactic root replacement using valve-sparing procedures (valve-sparing root replacement [VSRR]) in patients with LDS is not known. We reviewed all patients with clinical and genetic (transforming growth factor-β receptor mutations) evidence of LDS who underwent VSRR at our institution. Echocardiographic and clinical data were obtained from hospital and follow-up clinic records. From 2002 to 2009, 31 patients with a firm diagnosis of LDS underwent VSRR for aortic root aneurysm. Mean age was 15 years, and 24 (77%) were children. One (3%) patient had a bicuspid aortic valve. Preoperative sinus diameter was 3.9±0.8 cm (z score 7.0±2.9) and 2 (6%) had greater than 2+ aortic insufficiency. Thirty patients (97%) underwent reimplantation procedures using a Valsalva graft. There were no operative deaths. Mean follow-up was 3.6 years (range, 0 to 7 years). One patient required late repair of a pseudoaneurysm at the distal aortic anastomosis, and 1 had a conversion to a David reimplantation procedure after a Florida sleeve operation. No patient suffered thromboembolism or endocarditis, and 1 (3%) patient experienced greater than 2+ late aortic insufficiency. No patient required late aortic valve repair or replacement. Loeys-Dietz syndrome is an aggressive aortic aneurysm syndrome that can be addressed by prophylactic aortic root replacement with low operative risk. Valve-sparing procedures have encouraging early and midterm results, similar to those in Marfan syndrome, and are an attractive option for young patients. Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Expanding indications for valve-sparing aortic root reconstruction: early and midterm results.

Science.gov (United States)

Valo, Johanna; Jokinen, Janne J; Kaarne, Markku; Ihlberg, Leo

2013-02-01

Valve-sparing aortic root reconstruction (VSRR) is an accepted method to treat patients with aortic root dilation. The role of the VSRR is less well defined for patients with bicuspid aortic valve, severe aortic valve insufficiency, congenital heart defects, and type A aortic dissection. We studied the clinical outcome of patients who underwent VSRR for expanded indications. Seventy-eight patients underwent VSRR between the 2005 and 2012. Seventy-two patients (92%) underwent reimplantation and 6 patients (8%) were operated on with the remodeling technique. The mean age was 51 ± 12 years (range 24 to 73). For 71 patients (91%), the operation was elective, and for 7 (9%; all with type A aortic dissection), on an emergency basis. Preoperatively, the degree of aortic insufficiency was graded as 2+ or greater for 27 patients (35%). Connective tissue disorder (Marfan or Loeys-Dietz), bicuspid aortic valve, or congenital heart disease was present in 15 (19%), 15 (19%), and 7 patients (9%), respectively. Concomitant aortic valve leaflet repair was performed for 39 patients (50%). The mean follow-up time was 2.4 ± 1.7 years (range, 0.1 to 7.0). Thirty-day mortality was zero. The rate of postoperative complications was low: stroke 3%, renal failure 3%, prosthesis infection 1%, and low cardiac output syndrome 1%. Survival was 100% at 1 year and 97% at 5 years. Freedom from recurrent aortic valve insufficiency (≥2+) during the follow-up was 94%. The midterm results of VSRR in terms of survival, freedom from recurrent aortic valve insufficiency, and the need for reoperation are excellent, even for high-risk patients. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Trabeculectomy versus Ahmed Glaucoma Valve implantation in neovascular glaucoma

Science.gov (United States)

Shen, Christopher C; Salim, Sarwat; Du, Haiming; Netland, Peter A

2011-01-01

Purpose: To compare surgical outcomes in neovascular glaucoma patients who underwent trabeculectomy with mitomycin C versus Ahmed Glaucoma Valve implantation. Patients and methods: This was a retrospective comparative case series. We reviewed 40 eyes of 39 patients with underlying diagnosis of neovascular glaucoma, divided into two groups: Ahmed Glaucoma Valve (N = 20) and trabeculectomy with mitomycin C (N = 20). Surgical success was defined as 6 mm Hg ≤ intraocular pressure ≤21 mm Hg, with or without the use of glaucoma medications, with no further glaucoma surgery, and light perception or better vision. Early postoperative hypotony was defined as intraocular pressure Ahmed Glaucoma Valve group and 25 months (6–77 months) for the trabeculectomy group. Although the mean number of postoperative intraocular pressure-lowering medications was significantly higher in the trabeculectomy group compared with the Ahmed Glaucoma Valve group at 3 and 6 month time points, there was no statistically significant difference at any other time point. There was no statistically significant difference between both groups in postoperative visual acuity and intraocular pressure. Success was 70% and 65% at 1 year and 60% and 55% at 2 years after Ahmed Glaucoma Valve and trabeculectomy, respectively. Kaplan–Meier survival curve analysis showed no significant difference in success between the two groups (P = 0.815). Hyphema was the most common complication in both groups. Conclusion: We found similar results after trabeculectomy with mitomycin C and Ahmed Glaucoma Valve implantation in eyes with neovascular glaucoma. PMID:21468334

Late presentation of posterior urethral valve: two case reports

Directory of Open Access Journals (Sweden)

Carlos Márcio Nóbrega de Jesus

Full Text Available CONTEXT: Posterior urethral valve (PUV is a widely known condition affecting males that generally presents prenatally or at birth. PUVs have also been occasionally described in literature in cases diagnosed during adolescence or adulthood. CASE REPORT: This report presents two late PUV cases, one in a teenager and the other in an adult. Both cases had had clinical signs of urinary tract infection and obstructive urinary symptoms. The diagnoses were made by means of voiding cystourethrography and urethrocystoscopy. Endoscopic valve fulguration was the treatment chosen for both. Their follow-up was uneventful.

Low noise control valve

International Nuclear Information System (INIS)

Christie, R.S.

1975-01-01

Noise is one of the problems associated with the use of any type of control valve in systems involving the flow of fluids. The advent of OSHA standards has prompted control valve manufacturers to design valves with special trim to lower the sound pressure level to meet these standards. However, these levels are in some cases too high, particularly when a valve must be located in or near an area where people are working at tasks requiring a high degree of concentration. Such locations are found around and near research devices and in laboratory-office areas. This paper describes a type of fluid control device presently being used at PPL as a bypass control valve in deionized water systems and designed to reduce sound pressure levels considerably below OSHA standards. Details of the design and construction of this constant pressure drop variable flow control valve are contained in the text and are shown in photographs and drawings. Test data taken are included

Idiopathic mitral valve prolapse with tricuspid, aortic and pulmonary valve involvement: An autopsy case report

Directory of Open Access Journals (Sweden)

Heena M Desai

2015-01-01

Full Text Available Mitral valve prolapse (MVP is usually asymptomatic, but can be associated with complications such as infective endocarditis, mitral regurgitation, thromboembolism and sudden cardiac death. It has been very rarely reported to occur in association with other valvular involvement. A 55-year-old male patient was brought dead and at autopsy the mitral valve orifice was stenotic and the leaflets were enlarged, myxoid and bulging suggestive of MVP and chordae tendinae were thickened, stretched and elongated. Similar changes were seen in the tricuspid valve. The pulmonary and aortic valves also showed myxomatous degeneration of their cusps. Myxomatous degeneration is the most common cause of MVP and it can be associated with involvement of the other valves. Concomitant involvement of the aortic valve has been reported, however it is very rare and simultaneous involvement of the pulmonary valve has not been reported in the literature so far. We report a case of MVP associated with myxomatous degeneration of the tricuspid, pulmonary and aortic valves.

Novel self-expandable, stent-based transcatheter pulmonic valve: a preclinical animal study.

Science.gov (United States)

Kim, Gi Beom; Lim, Hong-Gook; Kim, Yong Jin; Choi, Eun Young; Kwon, Bo Sang; Jeong, Saeromi

2014-04-15

Because transcatheter implantation of pulmonary valve is indicated for limited-size dysfunctional right ventricular outflow tract only as a balloon-expandable stent, we investigated the feasibility of a large-diameter self-expandable valved stent and the durability of the valve after >6 months. We made a nitinol-wire-based, self-expandable valved stent with leaflets made from porcine pericardium. The porcine pericardium was treated with α-galactosidase, glutaraldehyde, and glycine after decellularization. After cutting the inguinal or cervical area, we implanted a valved stent in 12 sheep through the femoral or jugular vein by using an 18-Fr delivery catheter, controlling the catheter handles and hook block under fluoroscopic and echocardiographic guidance. The mean body weight of sheep was 43.9 kg. We successfully implanted valved stents (diameter: 24 mm in 7 sheep, 26 mm in 5 sheep) in good position in 8 sheep, in the main pulmonary artery (PA) in 2 sheep, and in the right ventricular outlet tract (RVOT) in 2 sheep. We sacrificed 8 sheep (6 sheep in good position, 1 sheep in the main PA, and 1 sheep in the RVOT) after >6 months. Five of the 6 sheep implanted in good position showed well-preserved valve morphology at the time of sacrifice. Histologic findings after routine sacrifice showed well-maintained collagen wave structure and no visible calcification in all explanted valve leaflets. Transcatheter implantation of a nitinol-wire-based, self-expandable valved stent in the pulmonic valve was feasible, and stents implanted in good position showed well-preserved valve leaflets with functional competence in the mid-term results. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Valve for closing a steam line

International Nuclear Information System (INIS)

Meyer, W.; Potrykus, G.

1976-01-01

Instead of several control elements, the quick-closing valve, especially in the main-steam line between steam generator and turbine of a power station has the valve cone itself as the only movable part, acting with its inner surface as a piston within a second cylinder space. The valve shaft is at the same time a piston rod with a stepped piston at the upper end. This piston is loaded in a cylinder at the upspace below the valve cover on one hand by a spring, on the other hand by its own medium. Two non-return valves, one of it in a bore of the valve cone, connect the first-mentioned cylinder space with the steam-loaded inlet resp. outlet side of the valve. For controlling the valve, a magnet valve is sufficient. By automatic control of the valve cone coupled with several pistons several control lines can be omitted. There are also no pressurized control lines outside the valve which could be damaged by exterior influences. (ERA) [de

The Ahmed Glaucoma Valve in Refractory Glaucoma: Experiences in Southwest Ethiopia.

Science.gov (United States)

Gessesse, Girum W

2015-07-01

The management of refractory glaucoma is a challenging task for any glaucoma surgeon. This study is aimed to evaluate the efficacy of Ahmed Glaucoma Valve implantation in refractory glaucomas in South-West Ethiopia. A retrospective review was conducted on the charts of consecutive patients treated with Ahmed glaucoma valve implantation at Jimma University Specialized Hospital between August 2012 and August 2014. Success was defined as Intraocular Pressure (IOP) less than 22 mm Hg and greater than 5mm Hg at 6 months, with at least 30% reduction from baseline, without medical therapy (complete success) or either with or without medication (qualified successes). A total of 12 eyes of 11 patients were included. The mean age of patients was 40.7 (SD= 19.0) years; 63.6% of them were males. The main types of glaucoma were pseudoexfoliative (3 eyes), uveitic (2 eyes), chronic angle closure (2 eyes) and Juvenile Open Angle (JOAG) (2 eyes). The mean IOP was reduced from preoperative level (32.75±7.14 mmHg) to (15.75 ±4.35 mmHg) at six postoperative months, (PAhmed glaucoma valve implant appears to be effective and relatively safe for treating complicated glaucomas with success rate comparable with those reported from other studies. Ahmed glaucoma valve, refractory glaucoma, complications, Ethiopia.

Experience in procurement and processing of heart valves at the Northwest Tissue Center

International Nuclear Information System (INIS)

Strong, M.; O'Neal, P.D.; Gage, H.N.; Moogk, M.

1999-01-01

The Northwest Tissue Center established a human heart valve program in 199 1. It is one of four non-profit tissue banks and one for-profit program that recover and process heart valves in the United States. During the eight years in which the Northwest Tissue Center has been involved in heart valve banking, there have been a total of 673 hearts procured for processing. The age of the donors ranged from <1 to 44 years with a mean of 26.2 years, 66% werw male,and 6.5% of the hearts procered were discarded due to a variety of medical and criteria reason. The primary reasons for differal were questions of possible cancer and questions of high risk behavior/social history. Of the 1,264 cardiovascular tissues processed, 6% were lost because of donor history, 17% were lost because of microbiology results, and 5% were lost because of donor serology . There were total a total of 190 aortic valves and 48 pulmonic conduits transplanted over this time period. The mean age of the recipients was 23.4 with a median or 23 years; 102 of the recipients were less than one year of age. Males comprised 62% of the recipients. Since 1993, there has been a clear shift towards more use of pulmonic valves over aortic valves as a results of the acceptance of the Ross procedure. Early in the program, reports were received from surgeons that some heart valves appeared to have cracks in the conduits. Experimentations in the laboratory led to the discovery that thawing too rapidly would result in cracking of these materials. Packaging was designed to reduce the rate of thawing and this has resolved the problem with cracking. The heart valve program at the Northwest Tissue Center has been very successful in providing the necessary valves for patients in the Northwest Region of the United States

What does the Paris Agreement mean for adaptation?

NARCIS (Netherlands)

Lesnikowski, Alexandra; Ford, James; Biesbroek, Robbert; Berrang-Ford, Lea; Maillet, Michelle; Araos, Malcolm; Austin, Stephanie E.

2017-01-01

The Paris Agreement takes a significant step forward in strengthening the adaptation pillar of global climate policy. By widening the normative framing around adaptation, calling for stronger adaptation commitments from states, being explicit about the multilevel nature of adaptation governance, and

Curved butterfly bileaflet prosthetic cardiac valve

Science.gov (United States)

McQueen, David M.; Peskin, Charles S.

1991-06-25

An annular valve body having a central passageway for the flow of blood therethrough with two curved leaflets each of which is pivotally supported on an accentric positioned axis in the central passageway for moving between a closed position and an open position. The leaflets are curved in a plane normal to the eccentric axis and positioned with the convex side of the leaflets facing each other when the leaflets are in the open position. Various parameters such as the curvature of the leaflets, the location of the eccentric axis, and the maximum opening angle of the leaflets are optimized according to the following performance criteria: maximize the minimum peak velocity through the valve, maximize the net stroke volume, and minimize the mean forward pressure difference, thereby reducing thrombosis and improving the hemodynamic performance.

Initial experience with xenograft bioconduit for the treatment of complex prosthetic valve endocarditis.

Science.gov (United States)

Roubelakis, Apostolos; Karangelis, Dimos; Sadeque, Syed; Yanagawa, Bobby; Modi, Amit; Barlow, Clifford W; Livesey, Steven A; Ohri, Sunil K

2017-07-01

The treatment of complex prosthetic valve endocarditis (PVE) with aortic root abscess remains a surgical challenge. Several studies support the use of biological tissues to minimize the risk of recurrent infection. We present our initial surgical experience with the use of an aortic xenograft conduit for aortic valve and root replacement. Between October 2013 and August 2015, 15 xenograft bioconduits were implanted for complex PVE with abscess (13.3% female). In 6 patients, concomitant procedures were performed: coronary bypass (n=1), mitral valve replacement (n=5) and tricuspid annuloplasty (n=1). The mean age at operation was 60.3±15.5 years. The mean Logistic European system for cardiac operating risk evaluation (EuroSCORE) was 46.6±23.6. The median follow-up time was 607±328 days (range: 172-1074 days). There were two in-hospital deaths (14.3% mortality), two strokes (14.3%) and seven patients required permanent pacemaker insertion for conduction abnormalities (46.7%). The mean length of hospital stay was 26 days. At pre-discharge echocardiography, the conduit mean gradient was 9.3±3.3mmHg and there was either none (n=6), trace (n=6) or mild aortic insufficiency (n=1). There was no incidence of mid-term death, prosthesis-related complications or recurrent endocarditis. Xenograft bioconduits may be safe and effective for aortic valve and root replacement for complex PVE with aortic root abscess. Although excess early mortality reflects the complexity of the patient population, there was good valve hemodynamics, with no incidence of recurrent endocarditis or prosthesis failure in the mid-term. Our data support the continued use and evaluation of this biological prosthesis in this high-risk patient cohort.

Posterior leaflet preservation during mitral valve replacement for rheumatic mitral stenosis.

Science.gov (United States)

Djukić, P L; Obrenović-Kirćanski, B B; Vranes, M R; Kocica, M J; Mikić, A Dj; Velinović, M M; Kacar, S M; Kovacević, N S; Parapid, B J

2006-01-01

Mitral valve replacement with posterior leaflet preservation was shown beneficial for postoperative left vetricular (LV) performance in patients with mitral regurgitation. Some authors find it beneficial even for the long term LV function. We investigated a long term effect of this technique in patients with rheumatic mitral stenosis. We studied 20 patents with mitral valve replacement due to rheumatic mitral stenosis, in the period from January 1988 to December 1989. In group A (10 patients) both leaflets and coresponding chordal excision was performed, while in group B (10 patients) the posterior leaflet was preserved. In all patients a Carbomedics valve was inserted. We compared clinical pre and postoperative status, as well as hemodynamic characteristics of the valve and left ventricle in both groups. Control echocardiographyc analysis included: maximal (PG) and mean (MG) gradients; effective valve area (AREA); telediastolic (TDV) and telesystolic (TSV) LV volume; stroke volume (SV); ejection fraction (EF); fractional shortening (FS) and segmental LV motion. The mean size of inserted valve was 26.6 in group A and 27.2 in group B. Hemodynamic data: PG (10.12 vs 11.1); MG (3.57 vs 3.87); AREA (2.35 vs 2.30); TDV 126.0 vs 114.5); TSV (42.2 vs 36.62); SV (83.7 vs 77.75); EF (63.66 vs 67.12); FS (32.66 vs 38.25). Diaphragmal segmental hypokinesis was evident in one patient from group A and in two patients from group B. In patients with rheumatic stenosis, posterior leaflet preservation did not have increased beneficial effect on left ventricular performance during long-term follow-up. An adequate posterior leaflet preservation does not change hemodynamic valvular characteristics even after long-term follow-up.

Impact of bicuspid aortic valve on complications and death in infective endocarditis of native aortic valves.

Science.gov (United States)

Kahveci, Gokhan; Bayrak, Fatih; Pala, Selcuk; Mutlu, Bulent

2009-01-01

We retrospectively investigated the impact of bicuspid aortic valve on the prognosis of patients who had definite infective endocarditis of the native aortic valve.Of 51 patients, a bicuspid aortic valve was present in 22 (43%); the other 29 had tricuspid aortic valves. On average, the patients who had bicuspid valves were younger than those who had tricuspid valves. Patients with a tricuspid valve had larger left atrial diameters and were more likely to have severe mitral regurgitation.Periannular complications, which we detected in 19 patients (37%), were much more common in the patients who had a bicuspid valve (64% vs 17%, P = 0.001). The presence of a bicuspid valve was the only significant independent predictor of periannular complications. The in-hospital mortality rate in the bicuspid group was lower than that in the tricuspid group; however, this figure did not reach statistical significance (9% vs 24%, P = 0.15). In multivariate analysis, left atrial diameter was the only independent predictor associated with an increased risk of death (hazard ratio, 2.19; 95% confidence interval, 1.1-4.5; P = 0.031).In our study, patients with infective endocarditis in a bicuspid aortic valve were younger and had a higher incidence of periannular complications. Although a worse prognosis has been reported previously, we found that infective endocarditis in a native bicuspid aortic valve is not likely to increase the risk of death in comparison with infective endocarditis in native tricuspid aortic valves.

Gate valve performance prediction

International Nuclear Information System (INIS)

Harrison, D.H.; Damerell, P.S.; Wang, J.K.; Kalsi, M.S.; Wolfe, K.J.

1994-01-01

The Electric Power Research Institute is carrying out a program to improve the performance prediction methods for motor-operated valves. As part of this program, an analytical method to predict the stem thrust required to stroke a gate valve has been developed and has been assessed against data from gate valve tests. The method accounts for the loads applied to the disc by fluid flow and for the detailed mechanical interaction of the stem, disc, guides, and seats. To support development of the method, two separate-effects test programs were carried out. One test program determined friction coefficients for contacts between gate valve parts by using material specimens in controlled environments. The other test program investigated the interaction of the stem, disc, guides, and seat using a special fixture with full-sized gate valve parts. The method has been assessed against flow-loop and in-plant test data. These tests include valve sizes from 3 to 18 in. and cover a considerable range of flow, temperature, and differential pressure. Stem thrust predictions for the method bound measured results. In some cases, the bounding predictions are substantially higher than the stem loads required for valve operation, as a result of the bounding nature of the friction coefficients in the method

Mitral Valve Prolapse

Science.gov (United States)

... valve syndrome . What happens during MVP? Watch an animation of mitral valve prolapse When the heart pumps ( ... our brochures Popular Articles 1 Understanding Blood Pressure Readings 2 Sodium and Salt 3 Heart Attack Symptoms ...

Application of ceramics to the sliding seat of valve bridge; Valve bridge yodobu eno ceramics tekiyo

Energy Technology Data Exchange (ETDEWEB)

Matsui, T; Ono, T [Mitsubishi Motors Corp., Tokyo (Japan)

1997-10-01

For use in the valve train, using an OHV (over head valve) configuration. of a 4 valve diesel engine for trucks and buses; we developed a valve bridge, a component of a valve train, with a ceramic head that is made of silicon nitride(Si3N4) in contact with a rocker arm in order to reduce cost and improve wear resistance for further diesel engine emissions regulations. In order to evaluate the effect of this valve bridge, RIG tests and durability tests on actual engines were carried out. 7 figs., 2 tabs.

Transcatheter Mitral Valve-in-Ring Implantation

LENUS (Irish Health Repository)

Tanner, RE

2018-05-01

Failed surgical mitral valve repair using an annuloplasty ring has traditionally been treated with surgical valve replacement or repair1. For patients at high risk for repeat open heart surgery, placement of a trans-catheter aortic valve (i.e., TAVI valve) within the mitral ring (i.e., Mitral-Valve-in-Ring, MViR) has emerged as a novel alternative treatment strategy2-5 . We describe our experience of a failed mitral valve repair that was successfully treated with a TAVI valve delivered via the trans-septal approach, and summarise the data relating to this emerging treatment strategy.

A new one-step procedure for pulmonary valve implantation of the melody valve: Simultaneous prestenting and valve implantation.

Science.gov (United States)

Boudjemline, Younes

2018-01-01

To describe a new modification, the one-step procedure, that allows interventionists to pre-stent and implant a Melody valve simultaneously. Percutaneous pulmonary valve implantation (PPVI) is the standard of care for managing patients with dysfunctional right ventricular outflow tract, and the approach is standardized. Patients undergoing PPVI using the one-step procedure were identified in our database. Procedural data and radiation exposure were compared to those in a matched group of patients who underwent PPVI using the conventional two-step procedure. Between January 2016 and January 2017, PPVI was performed in 27 patients (median age/range, 19.1/10-55 years) using the one-step procedure involving manual crimping of one to three bare metal stents over the Melody valve. The stent and Melody valve were delivered successfully using the Ensemble delivery system. No complications occurred. All patients had excellent hemodynamic results (median/range post-PPVI right ventricular to pulmonary artery gradient, 9/0-20 mmHg). Valve function was excellent. Median procedural and fluoroscopic times were 56 and 10.2 min, respectively, which significantly differed from those of the two-step procedure group. Similarly, the dose area product (DAP), and radiation time were statistically lower in the one-step group than in the two-step group (P step procedure is a safe modification that allows interventionists to prestent and implants the Melody valve simultaneously. It significantly reduces procedural and fluoroscopic times, and radiation exposure. © 2017 Wiley Periodicals, Inc.

Space Vehicle Valve System

Science.gov (United States)

Kelley, Anthony R. (Inventor); Lindner, Jeffrey L. (Inventor)

2014-01-01

The present invention is a space vehicle valve system which controls the internal pressure of a space vehicle and the flow rate of purged gases at a given internal pressure and aperture site. A plurality of quasi-unique variable dimension peaked valve structures cover the purge apertures on a space vehicle. Interchangeable sheet guards configured to cover valve apertures on the peaked valve structure contain a pressure-activated surface on the inner surface. Sheet guards move outwardly from the peaked valve structure when in structural contact with a purge gas stream flowing through the apertures on the space vehicle. Changing the properties of the sheet guards changes the response of the sheet guards at a given internal pressure, providing control of the flow rate at a given aperture site.

Coronary artery disease in patients undergoing valve replacement at a tertiary care cardiac centre

International Nuclear Information System (INIS)

Shaikh, A.H.; Hanif, B.; Hasan, K.; Hashmani, S.

2011-01-01

To determine the prevalence of coronary artery disease in patients undergoing valve surgery at a tertiary care cardiac centre. The medical records of 144 consecutive patients who underwent mitral, aortic or dual (mitral and aortic) valve replacement surgery at the Tabba Heart Institute between January 2006 to December 2008 were retrospectively reviewed. All patients underwent coronary angiogram. Significant coronary artery disease (CAD) is defined as coronary stenosis of > 50%. There were 74 (51.4%) males and 70 (48.6%) females in the study. The mean age was 51.64 +- 11 years. Of all, 73 (50.7%) underwent mitral valve replacement, 47 (32.6%) had aortic and 24 (16.7%) had dual valve replacement. Out of 144 patients, 99 (68.8%) had 50% stenosis. In patients who had undergone mitral valve replacement (MVR), significant coronary disease was found in 32.9%, whereas in patients who had undergone aortic valve replacement (AVR) and dual valve replacement (DVR) the prevalence of coronary disease was 31.9% and 25% respectively. Our results suggest that the overall prevalence of coronary artery disease in patients undergoing valve surgery in our population is comparable with prevalence reported in international data. (author)

Transcatheter valve-in-valve implantation due to severe aortic regurgitation in a degenerated aortic homograft

DEFF Research Database (Denmark)

Olsen, Lene Kjaer; Engstrøm, Thomas; Søndergaard, Lars

2009-01-01

Transcatheter aortic valve implantation (TAVI) in severe aortic stenosis has proven to be a feasible and effective treatment modality for inoperable patients. Until now, neither aortic regurgitation nor degenerated bioprostheses has been an indication for TAVI. However, this article reports...... a successful valve-in-valve implantation of a CoreValve aortic valve prosthesis through the right subclavian artery in a case of severe aortic regurgitation within a degenerated aortic homograft. The case exemplifies the possibilities of expanding the indications for TAVI, as well as other vascular access...

Thermally induced pressure locking of gate valves: A survey of valve bonnet pressurization rates

International Nuclear Information System (INIS)

Ezekoye, L.I.; Moore, W.E.

1996-01-01

Closed, water filled gate valves run the risk of becoming pressurized due to heat input from the environment or from adjacent connected piping. Thermal pressurization of gate valve bonnets may lead to the valves failing to open on demand and can even induce structural failure of valves. This paper presents an analytical prediction of the pressurization rate of a closed pressure vessel subject to uniform heating which may be considered as an upper bound to the pressurization rate that may occur in the field. Then actual valve experiences described in the literature are reviewed to determine the expected pressurization rate in existing hardware designs. A statistical approach is applied to reconcile the differing pressurization rates reported in the literature and determine a rate that can be applied in valve evaluations. The limitations of the reconciled rate are discussed

Unsupervised Cryo-EM Data Clustering through Adaptively Constrained K-Means Algorithm.

Science.gov (United States)

Xu, Yaofang; Wu, Jiayi; Yin, Chang-Cheng; Mao, Youdong

2016-01-01

In single-particle cryo-electron microscopy (cryo-EM), K-means clustering algorithm is widely used in unsupervised 2D classification of projection images of biological macromolecules. 3D ab initio reconstruction requires accurate unsupervised classification in order to separate molecular projections of distinct orientations. Due to background noise in single-particle images and uncertainty of molecular orientations, traditional K-means clustering algorithm may classify images into wrong classes and produce classes with a large variation in membership. Overcoming these limitations requires further development on clustering algorithms for cryo-EM data analysis. We propose a novel unsupervised data clustering method building upon the traditional K-means algorithm. By introducing an adaptive constraint term in the objective function, our algorithm not only avoids a large variation in class sizes but also produces more accurate data clustering. Applications of this approach to both simulated and experimental cryo-EM data demonstrate that our algorithm is a significantly improved alterative to the traditional K-means algorithm in single-particle cryo-EM analysis.

Traumatic Mitral Valve and Pericardial Injury

Directory of Open Access Journals (Sweden)

Nissar Shaikh

2013-01-01

Full Text Available Cardiac injury after blunt trauma is common but underreported. Common cardiac trauma after the blunt chest injury (BCI is cardiac contusion; it is very rare to have cardiac valve injury. The mitral valve injury during chest trauma occurs when extreme pressure is applied at early systole during the isovolumic contraction between the closure of the mitral valve and the opening of the aortic valve. Traumatic mitral valve injury can involve valve leaflet, chordae tendineae, or papillary muscles. For the diagnosis of mitral valve injury, a high index of suspicion is required, as in polytrauma patients, other obvious severe injuries will divert the attention of the treating physician. Clinical picture of patients with mitral valve injury may vary from none to cardiogenic shock. The echocardiogram is the main diagnostic modality of mitral valve injuries. Patient’s clinical condition will dictate the timing and type of surgery or medical therapy. We report a case of mitral valve and pericardial injury in a polytrauma patient, successfully treated in our intensive care unit.

Denervation of pulmonary artery during mitral valve surgery in patients with high pulmonary hypertension

Directory of Open Access Journals (Sweden)

А. В. Богачев-Прокофьев

2016-01-01

Full Text Available Objective. Pulmonary hypertension impairs the mitral valve and often leads to more severe symptoms of heart failure, low exercise tolerance and thus higher rates of morbidity and mortality. The purpose of this study is to evaluate the safety and efficacy of simultaneous radiofrequency ablation of ganglionated plexi of the pulmonary artery in patients with high pulmonary hypertension during mitral valve surgery.Methods. The inclusion criteria were based on patients’ echocardiography/right heart catheterization data. The main criteria were mean pulmonary artery pressure ≥40 mm Hg at rest and a positive reactive test with nitric oxide inhalation. From January 2014 to May 2015, 14 patients underwent radiofrequency denervation of the pulmonary artery in addition to planned mitral valve surgery. Mean patient age was 53.4±7.8 years, with 57.1% of patients being females.Results. Mean cardiopulmonary bypass time was 116±12 minutes, mean cross-clamp time was 95±13 minutes, and mean ablation time amounted to 9.5±3.1 minutes. Pulmonary artery pressure decreased significantly from a mean of 56.5±9.8 mmHg to 32.0±7.3 mmHg immediately after the operation (p<0.001, and to 28.4±5.2 mmHg and 29.7±4.4 mmHg on the first and third days at ICU respectively. Mean ICU stay was 3.1±1.2 days. There were neither early deaths nor specific complications.Conclusions. Simultaneous radiofrequency ablation of pulmonary artery ganglionated plexi when performing mitral valve surgery in patients with pulmonary hypertension is a safe and effective procedure. Further research and long-term follow-up would help to determine whether a decrease in the mean pressure of the pulmonary artery can be interpreted as a clinical advantage.

Mechanisms of mechanical heart valve cavitation: investigation using a tilting disk valve model.

Science.gov (United States)

He, Z; Xi, B; Zhu, K; Hwang, N H

2001-09-01

The induction of mechanical heart valve (MHV) cavitation was investigated using a 27 mm Medtronic Hall (MH27) tilting disk valve. The MH27 valve was mounted in the mitral position of a simulating pulse flow system, and stroboscopic lighting used to visualize cavitation bubbles on the occluder inflow surface at the instant of valve closure. MHV cavitation was monitored using a digital camera with 0.04 mm/pixel resolution sufficient to render the tiny bubbles clearly visible on the computer monitor screen. Cavitation on MH27 valve was classified as five types according to the time, site and shape of the cavitation bubbles. Valve cavitation occurred at the instant of occluder impact with the valve seat at closing. The impact motion was subdivided into three temporal phases: (i) squeezing flow; (ii) elastic collision; and (iii) leaflet rebound. MHV cavitation caused by vortices was found to be initiated by the squeezing jet and/or by the transvalvular leakage jets. By using a tension wave which swept across the occluder surface immediately upon elastic impact, nuclei in the vortex core were expanded to form cavitation bubbles. Analysis of the shape and location of the cavitation bubbles permitted a better understanding of MHV cavitation mechanisms, based on the fluid dynamics of jet vortex and tension wave propagations.

A Study of System Pressure Transients Generated by Isolation Valve Open/Closure in Orifice Manifold

Energy Technology Data Exchange (ETDEWEB)

Kim, M. [KEPCO, Daejeon (Korea, Republic of); Bae, S. W.; Kim, J. I.; Park, S. J. [KHNP, Abu Dhabi (United Arab Emirates)

2016-05-15

In this study, we explore the effects of pressure transients on peak and minimal pressures caused by the actuation of isolation valve and control valve reacting to the combined orifice operation of orifice manifold with motor-operated valve installed in the rear of the orifice. We then use the collected data to direct our effort towards cause analysis and propose improvements to efficiency and safety of operation. This formation is used to by domestic and foreign nuclear power plants as a mean to control flow rate, producing required flow rate jointly together by combination of the orifices. No significant impacts on the internals of manifold orifice due to peak pressure has been observed, although chance of cavitation at the outlet of control valve is significant. Considering the peak pressure, as well as minimum pressure occurs in low flow rate conditions, the pressure transient is more so affected by the characteristics (modified equal percentage) of control valve. Isolation valve of the orifice and control valve operate organically, therefore stroke time for valves need to be applied in order for both valves to cooperatively formulate an optimized operation.

Fluid-structure interaction dynamic simulation of spring-loaded pressure relief valves under seismic wave

Science.gov (United States)

Lv, Dongwei; Zhang, Jian; Yu, Xinhai

2018-05-01

In this paper, a fluid-structure interaction dynamic simulation method of spring-loaded pressure relief valve was established. The dynamic performances of the fluid regions and the stress and strain of the structure regions were calculated at the same time by accurately setting up the contact pairs between the solid parts and the coupling surfaces between the fluid regions and the structure regions. A two way fluid-structure interaction dynamic simulation of a simplified pressure relief valve model was carried out. The influence of vertical sinusoidal seismic waves on the performance of the pressure relief valve was preliminarily investigated by loading sine waves. Under vertical seismic waves, the pressure relief valve will flutter, and the reseating pressure was affected by the amplitude and frequency of the seismic waves. This simulation method of the pressure relief valve under vertical seismic waves can provide effective means for investigating the seismic performances of the valves, and make up for the shortcomings of the experiment.

Numerical simulation on flow field of nuclear safety grade 2 single-seat pneumatic diaphragm control valve

International Nuclear Information System (INIS)

Zhong Yun; Zhang Jige; Wang Dezhong; Shi Jianzhong

2010-01-01

The Computational Fluid Dynamics (CFD) method is employed to simulate numerically the steady flow and transient flow under variable openings of the nuclear safety grade 2 single-seat pneumatic diaphragm control valve, which is a sleeve valve. The steady simulations under rated condition tells that there is a large amount of vortex in the valve seat necking and around the valve cone, which leads to a much greater flow impact on the head of the valve cone and uneven pressure distribution on spool face. More consideration should be taken on the characteristics of the valve cone accordingly, when designing a valve of this kind. Then the transient flow under 100% and 40% openings is simulated numerically on the basis of steady simulations. The pulsation of the pressure magnitude at the points with large vorticity, in the valve seat necking and around the valve cone, is monitored. The main pulsation frequencies differ from the low natural frequencies of the model, which means that it is safe from leading to structural resonance. (authors)

Fairchild Stratos Division's Type II prototype lockhopper valve: METC Prototype Test Valve No. F-1 prototype lockhopper valve-testing and development project. Static test report

Energy Technology Data Exchange (ETDEWEB)

Goff, D. R.; Cutright, R. L.; Griffith, R. A.; Loomis, R. B.; Maxfield, D. A.; Moritz, R. S.

1981-10-01

METC Prototype Test Valve No. F-1 is a hybrid design, based on a segmented ball termed a visor valve, developed and manufactured by Fairchild Stratos Division under contract to the Department of Energy. The valve uses a visor arm that rotates into position and then translates to seal. This valve conditionally completed static testing at METC with clean gas to pressures of 1600 psig and internal valve temperatures to 600/sup 0/F. External leakage was excessive due to leakage through the stuffing box, purge fittings, external bolts, and other assemblies. The stuffing box was repacked several times and redesigned midway through the testing, but external leakage was still excessive. Internal leakage through the seats, except for a few anomalies, was very low throughout the 2409 cycles of testing. As shown by the low internal leakage, the visor valve concept appears to have potential for lock-hopper valve applications. The problems that are present with METC Prototype Test Valve No. F-1 are in the seals, which are equivalent to the shaft and bonnet seals in standard valve designs. The operating conditions at these seals are well within the capabilities of available seal designs and materials. Further engineering and minor modifications should be able to resolve the problems identified during static testing.

Minimally invasive right lateral thoracotomy without aortic cross-clamping: an attractive alternative to repeat sternotomy for reoperative mitral valve surgery.

Science.gov (United States)

Umakanthan, Ramanan; Petracek, Michael R; Leacche, Marzia; Solenkova, Nataliya V; Eagle, Susan S; Thompson, Annemarie; Ahmad, Rashid M; Greelish, James P; Ball, Stephen K; Hoff, Steven J; Absi, Tarek S; Balaguer, Jorge M; Byrne, John G

2010-03-01

The study aim was to determine the safety and benefits of minimally invasive mitral valve surgery without aortic cross-clamping for mitral valve surgery after previous cardiac surgery. Between January 2006 and August 2008, a total of 90 consecutive patients (38 females, 52 males; mean age 66 +/- 9 years) underwent minimally invasive mitral valve surgery after having undergone previous cardiac surgery. Of these patients, 80 (89%) underwent mitral valve replacement and 10 (11%) mitral valve repair utilizing a small (5 cm) right lateral thoracotomy along the 4th or 5th intercostal space under fibrillatory arrest (mean temperature 28 +/- 2 degrees C). The predicted mortality, calculated using the Society of Thoracic Surgeons (STS) algorithm, was compared to the observed mortality. The mean ejection fraction was 45 +/- 13%, mean NYHA class 3 +/- 1, while 66 patients (73%) had previous coronary artery bypass grafting and 37 (41%) had previous valve surgery. Twenty-six patients (29%) underwent non-elective surgery. Cardiopulmonary bypass was instituted through axillary (n = 19), femoral (n = 70) or direct use aortic (n = 1) cannulation. Operative mortality was 2% (2/90), lower than the STS-predicted mortality of 7%. Three patients (3%) developed acute renal failure postoperatively, one patient (1%) required new-onset hemodialysis, and one (1%) developed postoperative stroke. No patients developed postoperative myocardial infarction. The mean postoperative packed red blood cell transfusion requirement at 48 h was 2 +/- 3 units. Minimally invasive right thoracotomy without aortic cross-clamping is an excellent alternative to conventional redo-sternotomy for reoperative mitral valve surgery. The present study confirmed that this technique is safe and effective in reducing operative mortality in high-risk patients undergoing reoperative cardiac surgery.

Design And Analysis Of A Camless Valve Mechanism For I.C Engines Using Rotary Disc Valves

Directory of Open Access Journals (Sweden)

Vivek Jitendra Panchal

2017-09-01

Full Text Available It is the object of the presented paper to provide an electromechanical rotary valve actuating system for opening and closing valves of an internal combustion engine capable of separately controlling both the inlet and exhaust valve operations of each individual cylinder in a multi-cylinder engine. This indicates that only one valve will be required for each cylinder of the engine. Previously published versions of this concept require a separate valve for intake and exhaust in each cylinder. The system provides an alternative to the camshaft assembly in an attempt to overcome the limitations and inadequacies inevitably posed by a fully mechanical system. The prototype development is approached in a theoretical manner beginning with the conceptualization and design of a rotating disk with a notches and corresponding closure surfaces to open and close the flow path. The actuated disk and notch design is then refined and followed by the design of an inlet and exhaust manifold to correspond to the valve design and the theorizing and design of a sealing gasket. The rotating speed of the valve is determined by a general idling speed and can be varied to provide variable valve timing with the motor. The final assembly eliminates a majority of the moving parts currently used in camshaft systems like the cam camshaft rocker arm push rod and springs and results in a significantly lighter valve actuation system. By eliminating the translatory motion of valves the problem of valves slamming on the valve seats at high velocities is eliminated thus greatly reducing engine wear.

Simulant Development for Hanford Tank Farms Double Valve Isolation (DVI) Valves Testing

Energy Technology Data Exchange (ETDEWEB)

Wells, Beric E.

2012-12-21

Leakage testing of a representative sample of the safety-significant isolation valves for Double Valve Isolation (DVI) in an environment that simulates the abrasive characteristics of the Hanford Tank Farms Waste Transfer System during waste feed delivery to the Waste Treatment and Immobilization Plant (WTP) is to be conducted. The testing will consist of periodic leak performed on the DVI valves after prescribed numbers of valve cycles (open and close) in a simulated environment representative of the abrasive properties of the waste and the Waste Transfer System. The valve operations include exposure to cycling conditions that include gravity drain and flush operation following slurry transfer. The simulant test will establish the performance characteristics and verify compliance with the Documented Safety Analysis. Proper simulant development is essential to ensure that the critical process streams characteristics are represented, National Research Council report “Advice on the Department of Energy's Cleanup Technology Roadmap: Gaps and Bridges”

Nasal valve evaluation in the Mexican-Hispanic (mestizo) nose.

Science.gov (United States)

Jasso-Ramírez, Elizabeth; Sánchez Y Béjar, Fernando; Arcaute Aizpuru, Fernando; Maulen Radován, Irene E; de la Garza Hesles, Héctor

2018-04-01

Our aim in this study was to determine the angle of the internal nasal valve in Mexican patients with the "mestizo nose" feature and without nasal obstructive symptoms. The work was prospective, comparative, and observational in nature and included patients >14 years of age who were seen in the Otolaryngology Department at the Los Angeles Lomas Hospital between April and May 2016. The angle of the internal nasal valve was measured in 30 patients without obstructive symptoms. Endoscopic examination was performed with a 0° endoscope framed with tape at a 13-mm distance from the endoscope's tip, and digital photographs of the internal nasal valve were taken. The measurement of the angle of the internal nasal valve was made in sexagesimal degrees using Golden Ratio v3.1 (2012) software. Statistical analysis was performed using Excel v15.13.3. The angles of the internal nasal valve of the patients were (mean ± standard deviation) 24.07 ± 4.8° for the right nasal cavity and 25.07 ± 5.0° for the left nasal cavity, wider than the angle reported in the normal Caucasian nose established in the literature. According to our results, the Mexican-Hispanic mestizo nose has a wider angle in the internal nasal valve than that considered normal in the literature (10°-15°). We believe it is necessary to undertake a second study and add an airflow resistance measurement with a rhinomanometry procedure so we can compare the results with those in the Caucasian population. © 2018 ARS-AAOA, LLC.

Effect of endobronchial valve therapy on pulmonary perfusion and ventilation distribution.

Directory of Open Access Journals (Sweden)

Carmen Pizarro

Full Text Available Endoscopic lung volume reduction (ELVR is an emerging therapy for emphysematous COPD. However, any resulting changes in lung perfusion and ventilation remain undetermined. Here, we report ELVR-mediated adaptations in lung perfusion and ventilation, as investigated by means of pulmonary scintigraphy.In this observational study, we enrolled 26 patients (64.9 ± 9.4 yrs, 57.7% male with COPD heterogeneous emphysema undergoing ELVR with endobronchial valves (Zephyr, Pulmonx, Inc.. Mean baseline FEV1 and RV were 32.9% and 253.8% predicted, respectively. Lung scintigraphy was conducted prior to ELVR and eight weeks thereafter. Analyses of perfusion and ventilation shifts were performed and complemented by correlation analyses between paired zones.After ELVR, target zone perfusion showed a mean relative reduction of 43.32% (p<0.001, which was associated with a significant decrease in target zone ventilation (p<0.001. Perfusion of the contralateral untreated zone and of the contralateral total lung exhibited significant increases post-ELVR (p = 0.002 and p = 0.005, respectively; both correlated significantly with the corresponding target zone perfusion adaptations. Likewise, changes in target zone ventilation correlated significantly with ventilatory changes in the contralateral untreated zone and the total contralateral lung (Pearson's r: -0.42, p = 0.04 and Pearson's r: -0.42, p = 0.03, respectively. These effects were observed in case of clinical responsiveness to ELVR, as assessed by changes in the six-minute walk test distance.ELVR induces a relevant decrease in perfusion and ventilation of the treated zone with compensatory perfusional and ventilatory redistribution to the contralateral lung, primarily to the non-concordant, contralateral zone.

Cyclonic valve test: preliminary results

Energy Technology Data Exchange (ETDEWEB)

Monteiro, Andre Sampaio; Moraes, Carlos Alberto C.; Marins, Luiz Philipe M.; Soares, Fabricio; Oliveira, Dennis; Lima, Fabio Soares de; Airao, Vinicius [Petroleo Brasileiro S.A. (PETROBRAS), Rio de Janeiro, RJ (Brazil); Ton, Tijmen [Twister BV, Rijswijk (Netherlands)

2012-07-01

For many years, the petroleum industry has been developing a valve that input less shear to the flow for a given required pressure drop and this can be done using the cyclonic concept. This paper presents a comparison between the performances of a cyclonic valve (low shear) and a conventional globe valve. The aim of this work is to show the advantages of using a cyclonic low shear valve instead of the commonly used in the primary separation process by PETROBRAS. Tests were performed at PETROBRAS Experimental Center (NUEX) in Aracaju/SE varying some parameters: water cut; pressure loss (from 4 kgf/cm2 to 10 kgf/cm2); flow rates (30 m3/h and 45 m3/h). Results indicates a better performance of the cyclonic valve, if compared with a conventional one, and also that the difference of the performance, is a function of several parameters (emulsion stability, water content free, and oil properties). The cyclonic valve tested can be applied as a choke valve, as a valve between separation stages (for pressure drop), or for controlling the level of vessels. We must emphasize the importance to avoid the high shear imposed by conventional valves, because once the emulsion is created, it becomes more difficult to break it. New tests are being planned to occur in 2012, but PETROBRAS is also analyzing real cases where the applications could increase the primary process efficiency. In the same way, the future installations are also being designed considering the cyclonic valve usage. (author)

Infusion of the solid coal using pressure independent valves to regulate flow

Energy Technology Data Exchange (ETDEWEB)

Goretz, H G; Betting, K

1979-01-01

In order to improve infusion into the solid coal, attempts were made to effect this through several holes using a single pump; however, the regulation of the quantity of water directed into each hole by a ball-valve tap connected to the injection pump was shown to lack precision - gives the causes of this defect. Satisfactory regulation was obtained by means of pressure- independent flow valves which operate on the principle of hydrodynamic pressure balance; describes method of operation. Underground tests proved satisfactory even with large pressure variations. The problem of dirt penetration during down times was eliminated by installing a check valve. The system proves economical to run.

Bioprinting a cardiac valve.

Science.gov (United States)

Jana, Soumen; Lerman, Amir

2015-12-01

Heart valve tissue engineering could be a possible solution for the limitations of mechanical and biological prostheses, which are commonly used for heart valve replacement. In tissue engineering, cells are seeded into a 3-dimensional platform, termed the scaffold, to make the engineered tissue construct. However, mimicking the mechanical and spatial heterogeneity of a heart valve structure in a fabricated scaffold with uniform cell distribution is daunting when approached conventionally. Bioprinting is an emerging technique that can produce biological products containing matrix and cells, together or separately with morphological, structural and mechanical diversity. This advance increases the possibility of fabricating the structure of a heart valve in vitro and using it as a functional tissue construct for implantation. This review describes the use of bioprinting technology in heart valve tissue engineering. Copyright © 2015 Elsevier Inc. All rights reserved.

Simulation of a chain of collapsible contracting lymphangions with progressive valve closure.

Science.gov (United States)

Bertram, C D; Macaskill, C; Moore, J E

2011-01-01

The aim of this investigation was to achieve the first step toward a comprehensive model of the lymphatic system. A numerical model has been constructed of a lymphatic vessel, consisting of a short series chain of contractile segments (lymphangions) and of intersegmental valves. The changing diameter of a segment governs the difference between the flows through inlet and outlet valves and is itself governed by a balance between transmural pressure and passive and active wall properties. The compliance of segments is maximal at intermediate diameters and decreases when the segments are subject to greatly positive or negative transmural pressure. Fluid flow is the result of time-varying active contraction causing diameter to reduce and is limited by segmental viscous and valvular resistance. The valves effect a smooth transition from low forward-flow resistance to high backflow resistance. Contraction occurs sequentially in successive lymphangions in the forward-flow direction. The behavior of chains of one to five lymphangions was investigated by means of pump function curves, with variation of valve opening parameters, maximum contractility, lymphangion size gradation, number of lymphangions, and phase delay between adjacent lymphangion contractions. The model was reasonably robust numerically, with mean flow-rate generally reducing as adverse pressure was increased. Sequential contraction was found to be much more efficient than synchronized contraction. At the highest adverse pressures, pumping failed by one of two mechanisms, depending on parameter settings: either mean leakback flow exceeded forward pumping or contraction failed to open the lymphangion outlet valve. Maximum pressure and maximum flow-rate were both sensitive to the contractile state; maximum pressure was also determined by the number of lymphangions in series. Maximum flow-rate was highly sensitive to the transmural pressure experienced by the most upstream lymphangions, suggesting that many

North American trial results at 1 year with the Sorin Freedom SOLO pericardial aortic valve.

Science.gov (United States)

Heimansohn, David; Roselli, Eric E; Thourani, Vinod H; Wang, Shaohua; Voisine, Pierre; Ye, Jian; Dabir, Reza; Moon, Michael

2016-02-01

A North American prospective, 15-centre Food and Drug Administration (FDA) valve trial was designed to assess the safety and effectiveness of the Freedom SOLO stentless pericardial aortic valve in the treatment of surgical aortic valve disease. Beginning in 2010, 251 patients (mean: 74.7 ± 7.5 years), were recruited in the Freedom SOLO aortic valve trial. One hundred eighty-nine patients have been followed for at least 1 year and are the basis for this review. Preoperatively, 54% of patients had NYHA functional class III or IV symptoms, and the majority of patients had a normal ejection fraction (EF) (median EF = 61%). Concomitant procedures were performed in 61.9% of patients, with coronary artery bypass grafting (CABG) (48.7%) being the most common followed by a MAZE procedure (13.7%). Reoperations were performed in 8.5% of patients in the study. The entire cohort of 251 patients enrolled had 7 deaths prior to 30 days, 2 of which were valve-related (aspiration pneumonia and sudden death) and 5 were not valve-related. There were 11 deaths after 30 days, 1 valve-related (unknown cardiac death) and 10 not valve-related. Five valves were explanted, 3 early (endocarditis, acute insufficiency and possible root dissection) and 2 late (endocarditis). Thirty-day adverse events include arrhythmias requiring permanent pacemaker (4.2%), thromboembolic events (3.7%) and thrombocytopenia (7.4%). One-year follow-up of all 189 patients demonstrated mean gradients for valve sizes 19, 21, 23, 25 and 27 mm of 11.7, 7.8, 6.3, 4.6 and 5.0 mmHg, respectively. Effective orifice areas for the same valve sizes were 1.2, 1.3, 1.6, 1.8 and 1.9 cm(2), respectively. Ninety-six percent of patients (181/189) were in NYHA class I or II at the 1-year follow-up. The Freedom SOLO stentless pericardial aortic valve demonstrated excellent haemodynamics and a good safety profile out to the 1 year of follow-up. © The Author 2015. Published by Oxford University Press on behalf of the European

A hydraulic hybrid propulsion method for automobiles with self-adaptive system

International Nuclear Information System (INIS)

Wu, Wei; Hu, Jibin; Yuan, Shihua; Di, Chongfeng

2016-01-01

A hydraulic hybrid vehicle with the self-adaptive system is proposed. The mode-switching between the driving mode and the hydraulic regenerative braking mode is realised by the pressure cross-feedback control. Extensive simulated and tested results are presented. The control parameters are reduced and the energy efficiency can be increased by the self-adaptive system. The mode-switching response is fast. The response time can be adjusted by changing the controlling spool diameter of the hydraulic operated check valve in the self-adaptive system. The closing of the valve becomes faster with a smaller controlling spool diameter. The hydraulic regenerative braking mode can be achieved by changing the hydraulic transformer controlled angle. Compared with the convention electric-hydraulic system, the self-adaptive system for the hydraulic hybrid vehicle mode-switching has a higher reliability and a lower cost. The efficiency of the hydraulic regenerative braking is also increased. - Highlights: • A new hybrid system with a self-adaptive system for automobiles is presented. • The mode-switching is realised by the pressure cross-feedback control. • The energy efficiency can be increased with the self-adaptive system. • The control parameters are reduced with the self-adaptive system.

Optimal results of aortic valve replacement with small mechanical valves (< 19 mm).

Science.gov (United States)

Kato, Yasuyuki; Hattori, Koji; Motoki, Manabu; Takahashi, Yosuke; Kotani, Shinsuke; Nishimura, Shinsuke; Shibata, Toshihiko

2013-07-01

Controversy exists regarding the optimal operative method or type of prosthesis for patients with a small aortic root. The aim of this retrospective study was to investigate the early and mid-term outcomes of standard aortic valve replacement (AVR) using 16 mm or 18 mm ATS Advanced Performance (AP) or 17 mm St. Jude Medical (SJM) Regent valves for a small aortic root. Between April 2003 and August 2009, 78 patients (age range: 50-86 years; 86% aged > or = 65 years) underwent AVR with 16 mm or 18 mm ATS AP valves (16AP group: n = 21, 18AP group: n = 32), or a 17 mm SJM Regent valve (17Regent group: n = 25). Fifty-six patients (72%) had a body surface area (BSA) of regression was similar among the groups (-30%, -25% and -28% in the 16AP, 17Regent and 18AP groups, respectively; p = 0.844). The early and mid-term results of AVR with 16 mm or 18 mm ATS AP valves, or with a 17 mm SJM Regent valve, were satisfactory. Therefore, standard AVR using these small mechanical prostheses, which avoids the need to enlarge the annulus or to conduct stentless bioprosthesis implantation, might represent an acceptable method, especially in elderly patients with a small aortic root.

Analysis of fatigue reliability for high temperature and high pressure multi-stage decompression control valve

Science.gov (United States)

Yu, Long; Xu, Juanjuan; Zhang, Lifang; Xu, Xiaogang

2018-03-01

Based on stress-strength interference theory to establish the reliability mathematical model for high temperature and high pressure multi-stage decompression control valve (HMDCV), and introduced to the temperature correction coefficient for revising material fatigue limit at high temperature. Reliability of key dangerous components and fatigue sensitivity curve of each component are calculated and analyzed by the means, which are analyzed the fatigue life of control valve and combined with reliability theory of control valve model. The impact proportion of each component on the control valve system fatigue failure was obtained. The results is shown that temperature correction factor makes the theoretical calculations of reliability more accurate, prediction life expectancy of main pressure parts accords with the technical requirements, and valve body and the sleeve have obvious influence on control system reliability, the stress concentration in key part of control valve can be reduced in the design process by improving structure.

Transcatheter mitral valve repair in osteogenesis imperfecta associated mitral valve regurgitation.

Science.gov (United States)

van der Kley, Frank; Delgado, Victoria; Ajmone Marsan, Nina; Schalij, Martin J

2014-08-01

Osteogenesis imperfecta is associated with increased prevalence of significant mitral valve regurgitation. Surgical mitral valve repair and replacement are feasible but are associated with increased risk of bleeding and dehiscence of implanted valves may occur more frequently. The present case report describes the outcomes of transcatheter mitral valve repair in a patient with osteogenesis imperfecta. A 60 year-old patient with osteogenesis imperfecta and associated symptomatic moderate to severe mitral regurgitation underwent transthoracic echocardiography which showed a nondilated left ventricle with preserved systolic function and moderate to severe mitral regurgitation. On transoesophageal echocardiography the regurgitant jet originated between the anterolateral scallops of the anterior and posterior leaflets (A1-P1). Considering the comorbidities associated with osteogenesis imperfecta the patient was accepted for transcatheter mitral valve repair using the Mitraclip device (Abbott vascular, Menlo, CA). Under fluoroscopy and 3D transoesophageal echocardiography guidance, a Mitraclip device was implanted between the anterolateral and central scallops with significant reduction of mitral regurgitation. The postoperative evolution was uneventful. At one month follow-up, transthoracic echocardiography showed a stable position of the Mitraclip device with no mitral regurgitation. Transcatheter mitral valve repair is feasible and safe in patients with osteogenesis imperfecta and associated symptomatic significant mitral regurgitation. Copyright © 2014 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Development of an effective valve packing program

Energy Technology Data Exchange (ETDEWEB)

Hart, K.A.

1996-12-01

Current data now shows that graphite valve packing installed within the guidance of a controlled program produces not only reliable stem sealing but predictable running loads. By utilizing recent technological developments in valve performance monitoring for both MOV`s and AOV`s, valve packing performance can be enhanced while reducing maintenance costs. Once known, values are established for acceptable valve packing loads, the measurement of actual valve running loads via the current MOV/AOV diagnostic techniques can provide indication of future valve stem sealing problems, improper valve packing installation or identify the opportunity for valve packing program improvements. At times the full benefit of these advances in material and predictive technology remain under utilized due to simple past misconceptions associated with valve packing. This paper will explore the basis for these misconceptions, provide general insight into the current understanding of valve packing and demonstrate how with this new understanding and current valve diagnostic equipment the key aspects required to develop an effective, quality valve packing program fit together. The cost and operational benefits provided by this approach can be significant impact by the: elimination of periodic valve repacking, reduction of maintenance costs, benefits of leak-free valve operation, justification for reduced Post Maintenance Test Requirements, reduced radiation exposure, improved plant appearance.

Incidence of cerebrovascular accidents in patients undergoing minimally invasive valve surgery.

Science.gov (United States)

LaPietra, Angelo; Santana, Orlando; Mihos, Christos G; DeBeer, Steven; Rosen, Gerald P; Lamas, Gervasio A; Lamelas, Joseph

2014-07-01

Minimally invasive valve surgery has been associated with increased cerebrovascular complications. Our objective was to evaluate the incidence of cerebrovascular accidents in patients undergoing minimally invasive valve surgery. We retrospectively reviewed all the minimally invasive valve surgery performed at our institution from January 2009 to June 2012. The operative times, lengths of stay, postoperative complications, and mortality were analyzed. A total of 1501 consecutive patients were identified. The mean age was 73 ± 13 years, and 808 patients (54%) were male. Of the 1501 patients, 206 (13.7%) had a history of a cerebrovascular accident, and 225 (15%) had undergone previous heart surgery. The procedures performed were 617 isolated aortic valve replacements (41.1%), 658 isolated mitral valve operations (43.8%), 6 tricuspid valve repairs (0.4%), 216 double valve surgery (14.4%), and 4 triple valve surgery (0.3%). Femoral cannulation was used in 1359 patients (90.5%) and central cannulation in 142 (9.5%). In 1392 patients (92.7%), the aorta was clamped, and in 109 (7.3%), the surgery was performed with the heart fibrillating. The median aortic crossclamp and cardiopulmonary bypass times were 86 minutes (interquartile range [IQR], 70-107) minutes and 116 minutes (IQR, 96-143), respectively. The median intensive care unit length of stay was 47 hours (IQR, 29-74), and the median postoperative hospital length of stay was 7 days (IQR, 5-10). A total of 23 cerebrovascular accidents (1.53%) and 38 deaths (2.53%) had occurred at 30 days postoperatively. Minimally invasive valve surgery was associated with an acceptable stroke rate, regardless of the cannulation technique. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Inverse spin-valve effect in nanoscale Si-based spin-valve devices

Science.gov (United States)

Hiep, Duong Dinh; Tanaka, Masaaki; Hai, Pham Nam

2017-12-01

We investigated the spin-valve effect in nano-scale silicon (Si)-based spin-valve devices using a Fe/MgO/Ge spin injector/detector deposited on Si by molecular beam epitaxy. For a device with a 20 nm Si channel, we observed clear magnetoresistance up to 3% at low temperature when a magnetic field was applied in the film plane along the Si channel transport direction. A large spin-dependent output voltage of 20 mV was observed at a bias voltage of 0.9 V at 15 K, which is among the highest values in lateral spin-valve devices reported so far. Furthermore, we observed that the sign of the spin-valve effect is reversed at low temperatures, suggesting the possibility of a spin-blockade effect of defect states in the MgO/Ge tunneling barrier.

Mechanical versus bioprosthetic aortic valve replacement.

Science.gov (United States)

Head, Stuart J; Çelik, Mevlüt; Kappetein, A Pieter

2017-07-21

Mechanical valves used for aortic valve replacement (AVR) continue to be associated with bleeding risks because of anticoagulation therapy, while bioprosthetic valves are at risk of structural valve deterioration requiring reoperation. This risk/benefit ratio of mechanical and bioprosthetic valves has led American and European guidelines on valvular heart disease to be consistent in recommending the use of mechanical prostheses in patients younger than 60 years of age. Despite these recommendations, the use of bioprosthetic valves has significantly increased over the last decades in all age groups. A systematic review of manuscripts applying propensity-matching or multivariable analysis to compare the usage of mechanical vs. bioprosthetic valves found either similar outcomes between the two types of valves or favourable outcomes with mechanical prostheses, particularly in younger patients. The risk/benefit ratio and choice of valves will be impacted by developments in valve designs, anticoagulation therapy, reducing the required international normalized ratio, and transcatheter and minimally invasive procedures. However, there is currently no evidence to support lowering the age threshold for implanting a bioprosthesis. Physicians in the Heart Team and patients should be cautious in pursuing more bioprosthetic valve use until its benefit is clearly proven in middle-aged patients. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

Latest design of gate valves

Energy Technology Data Exchange (ETDEWEB)

Kurzhofer, U.; Stolte, J.; Weyand, M.

1996-12-01

Babcock Sempell, one of the most important valve manufacturers in Europe, has delivered valves for the nuclear power industry since the beginning of the peaceful application of nuclear power in the 1960s. The latest innovation by Babcock Sempell is a gate valve that meets all recent technical requirements of the nuclear power technology. At the moment in the United States, Germany, Sweden, and many other countries, motor-operated gate and globe valves are judged very critically. Besides the absolute control of the so-called {open_quotes}trip failure,{close_quotes} the integrity of all valve parts submitted to operational forces must be maintained. In case of failure of the limit and torque switches, all valve designs have been tested with respect to the quality of guidance of the gate. The guidances (i.e., guides) shall avoid a tilting of the gate during the closing procedure. The gate valve newly designed by Babcock Sempell fulfills all these characteristic criteria. In addition, the valve has cobalt-free seat hardfacing, the suitability of which has been proven by friction tests as well as full-scale blowdown tests at the GAP of Siemens in Karlstein, West Germany. Babcock Sempell was to deliver more than 30 gate valves of this type for 5 Swedish nuclear power stations by autumn 1995. In the presentation, the author will report on the testing performed, qualifications, and sizing criteria which led to the new technical design.

Thermal fatigue behavior of valves

International Nuclear Information System (INIS)

Moinereau, D.; Scliffet, L.; Capion, J.C.; Genette, P.

1991-01-01

This paper reports that valves of pressurized water reactors are exposed to thermal shocks during transient operations. The numerous thermal shock tests performed on valves on the EDF test facilities have shown the sensibility of fillets and geometrical discontinuities to thermal fatigue: cracks can appear in those areas and grow through the valve body. Valves systems designated as level 1 must be designed to withstand fatigue up to the second isolation valve: the relevant rule is specified in the paragraph B 3500 of the French RCCM code. It is a simplified method which doesn't require finite element calculations. Many valve systems have been designed according to this rule and have been operated without accident. However, in one case, important cracks were found in the fillet of a check-valve after numerous thermal shocks. Calculation of the valve's behavior according to the RCCM code to estimate the fatigue damage resulting from thermal shocks led to a low damage factor, which doesn't agree with the experimental results. This was confirmed by new testings and showed the inadequacy of B 3500 rule for thermal transients. On this base a new rule is proposed to estimate fatigue damage resulting from thermal shocks. An experimental program has been realized to validate this rule. Axisymetrical analytical mock-ups with different geometries and one check-valve in austenitic stainless steel 316 L have been submitted to hot thermal shocks of 210 degrees C magnitude

Patient-prosthesis mismatch has no influence on in-hospital mortality after aortic valve replacement.

Science.gov (United States)

Yottasurodom, Chaiwut; Namthaisong, Kriengkrai; Porapakkham, Pramote; Kasemsarn, Choosak; Chotivatanapong, Taweesak; Chaiseri, Pradistchai; Wongdit, Suwannee; Yasotarin, Suwanna

2012-08-01

To analyze the relationship between prosthetic aortic valve orifice and body surface area (Effective Orifice Area Index, EOAI) and in-hospital mortality after aortic valve replacement. A prospective study was conducted between October 2007 to September 2010, 536 patients underwent isolated aortic valve replacement (AVR) was recorded on preoperative, operative and postoperative data. Patient Prosthesis Mismatch (PPM) was classified by Effective Orifice Area Indexed (EOAI) by prosthetic valve area divided by body surface area as mild or no significance if the EOAI is greater than 0.85 cm2/m2, moderate if between 0.65 cm2/m2 and 0.85 cm2/m2, and severe if less than 0.65 cm2/m2. Statistical differences were analyzed by Chi-square and student t-test with p-value less than 0.05 considered significant. There were 304 men, mean age was 60.98 years, mean valve orifice area 1.69 cm2, body surface area 1.60 m2, cross clamp time 1.13 hrs., bypass time 1.67 hrs. Mechanical valves were used in 274 patients (51.2%) and Bioprosthesis were used in 181 patients (48.8%). PPM was found in 33.7%, 6.7% was severe PPM, 27% was moderate PPM and 66.3% has no significant PPM Over all in-hospital mortality was 1.5%. There was no significant difference in hospital mortality between no PPM group, moderate PPM and severe PPM group (1.4% vs. 1.4% vs. 5.4%, p-value = 0.86). In a large aortic valve surgery population, moderate and severe patient prosthesis mismatch occurred in 35.6% of patients but had no influence on in-hospital mortality.

Surge-damping vacuum valve

International Nuclear Information System (INIS)

Bullock, J.C.; Kelley, B.E.

1977-01-01

A valve for damping out flow surges in a vacuum system is described. The surge-damping mechanism consists of a slotted, spring-loaded disk adjacent to the valve's vacuum port (the flow passage to the vacuum roughing pump). Under flow surge conditions, the differential pressure forces the disk into a sealing engagement with the vacuum port, thereby restricting the gas flow path to narrow slots in the disk's periphery. The increased flow damps out the flow surge. When pressure is equalized on both sides of the valve, the spring load moves the disk away from the port to restore full flow conductance through the valve

Characteristic analysis of servo valve

International Nuclear Information System (INIS)

Ko, J. H.; Ryu, D. R.; Lee, J. H.; Kim, Y. S.; Na, J. C.; Kim, D. S.

2008-01-01

Electro-pneumatic servo valve is an electro-mechanical device which converts electric signals into a proper pneumatic flow rate or pressure. In order to improve the overall performance of pneumatic servo systems, electro-pneumatic servo valves are required, which have fast dynamic characteristics, no air leakage at a null point, and can be fabricated at a low-cost. The first objective of this research is to design and to fabricate a new electro-pneumatic servo valve which satisfies the above-mentioned requirements. In order to design the mechanism of the servo valve optimally, the flow inside the valve depending upon the position of spool was analyzed variously, and on the basis of such analysis results, the valve mechanism, which was formed by combination of the spool and the sleeve, was designed and manufactured. And a tester for conducting an overall performance test was designed and manufactured, and as a result of conducting the flow rate test, the pressure test and the frequency test on the developed pneumatic servo valve

Small sodium valve design and operating experience

International Nuclear Information System (INIS)

Abramson, R.; Elie, X.; Vercasson, M.; Nedelec, J.

1974-01-01

Conventionally, valves for sodium pipes smaller than 125 mm in diameter are called ''small sodium valves''. However, this limit should rather be considered as the lower limit o ''large sodium valves''. In fact, both the largest sizes of small valves and the smallest of large valves can be found in the range of 125-300 mm in diameter. Thus what is said about small valves also applies, for a few valve types, above the 125 mm limit. Sodium valves are described here in a general manner, with no manufacturing details except when necessary for understanding valve behavior. Operating experience is pointed out wherever possible. Finally, some information is given about ongoing or proposed development plans. (U.S.)

Griswold Tempered Water Flow Regulator Valves Used as Anti-Siphon Valves

International Nuclear Information System (INIS)

MISKA, C.

2000-01-01

FCV-1*22 and 1*23 are Griswold constant flow regulators used as anti-siphon valves in the tempered water system, they fail closed but valve cartridge orifice allows minimum flow to prevent loss of water from the MCO/CASK annulus

Effects of aging and service wear on main steam isolation valves and valve operators

International Nuclear Information System (INIS)

Clark, R.L.

1996-03-01

In recent years main steam isolation valve (MSIV operating problems have resulted in significant operational transients (e.g., spurious reactor trips, steam generator dry out, excessive valve seat leakage), increased cost, and decreased plant availability. A key ingredient to an engineering-oriented reliability improvement effort is a thorough understanding of relevant historical experience. A detailed review of historical failure data available through the Institute of Nuclear Power Operation's Nuclear Plant Reliability Data System has been conducted for several types of MSIVs and valve operators for both boiling-water reactors and pressurized-water reactors. The focus of this review is on MSIV failures modes, actuator failure modes, consequences of failure on plant operations, method of failure detection, and major stressors affecting both valves and valve operators

Experimental substantiation of the design of a prosthetic heart valve for «valve-in-valve» implantation

Directory of Open Access Journals (Sweden)

K. Yu. Klyshnikov

2017-01-01

Full Text Available The aim of the study was to perform a series of in vitro tests of a prototype of the developing heart valve prosthesis to evaluate its functional characteristics. Materials and methods. In this work we have used the frames and full prototypes of the prosthesis, consisting of a stent-like stainless steel support frame with mounted biological leaflets and cover. The authors evaluated the calculated and experimental forces necessary for the displacement of the sutureless implanted prosthesis using the test machine under uniaxial tension. The risk of defects and damages to the supporting framework as a result of implantation was evaluated by scanning electron microscopy. The hydrodynamic characteristics of the prosthesis were investigated under physiological conditions and «valvein-valve» implantation. Evaluation of the ergonomics and applicability of the proposed construction on the cadaver heart model of cattle was carried out. Results. As a result of the forces assessment, it was found that the force required to shear the prosthesis was 3.12 ± 0.37 N, while the calculated value was 1.7 N, which is significantly lower than the obtained value. The comparison of the images obtained with small and large magnifications demonstrated the absence of critical surface defects. Additional analysis under the super-large magnifications also did not reveal problem areas. During the hydrodynamic study, it was shown that the average transplant gradient increased slightly from 2.8–3.4 to 3.2–4.5 mm Hg for the initial prosthesis and the «valve-in-valve» complex, respectively. The decrease of the effective orifice area was 6–9% relative to the initial one. Evaluation of the implantation technique demonstrated the consistency of the approach: the use of the developed holder in combination with the balloon implantation system made it possible to position the prosthesis throughout the procedure. Conclusion. The series of tests demonstrates the consistency

Aortic root surgery in Marfan syndrome: Comparison of aortic valve-sparing reimplantation versus composite grafting.

Science.gov (United States)

Karck, Matthias; Kallenbach, Klaus; Hagl, Christian; Rhein, Christine; Leyh, Rainer; Haverich, Axel

2004-02-01

The objective of this study was to compare the results of aortic valve-sparing reimplantation and aortic root replacement with mechanical valve conduits in patients with Marfan syndrome undergoing operation for aortic root aneurysms. Patients and methods Between March 1979 and April 2002, 119 patients with clinical evidence of Marfan syndrome underwent composite graft replacement with mechanical valve conduits (n = 74) or aortic valve-sparing reimplantation according to David (n = 45). The underlying causes were aortic dissection type A (43 patients) and aneurysms (76 patients). Patients undergoing aortic valve reimplantation were younger compared with patients undergoing composite grafting (28 vs 35 years, P =.002) and had longer intraoperative aortic crossclamp times (125 vs 78 minutes, P valve reimplantation (P =.15). Mean follow-up was 30 months for patients undergoing aortic valve reimplantation and 114 months for patients undergoing composite grafting. Freedom from reoperation and death after 5 years postoperatively was 92% and 89% in patients undergoing composite grafting and 84% and 96% in patients undergoing aortic valve reimplantation (P =.31; P =.54), respectively. Thromboembolic complications or late postoperative bleeding occurred in 17 patients undergoing composite grafting, and an early postoperative event occurred in 1 patient undergoing aortic valve reimplantation. The results of aortic valve reimplantation and composite grafting of the aortic valve and ascending aorta with mechanical valve conduits are similar with regard to early and mid-term postoperative mortality and to the incidence of late reoperations in patients with Marfan syndrome. The low risk of thromboembolic or bleeding complications favors aortic valve reimplantation in these patients.

Valve-sparing aortic root replacement†

NARCIS (Netherlands)

Koolbergen, David R.; Manshanden, Johan S. J.; Bouma, Berto J.; Blom, Nico A.; Mulder, Barbara J. M.; de Mol, Bas A. J. M.; Hazekamp, Mark G.

2015-01-01

To evaluate our results of valve-sparing aortic root replacement and associated (multiple) valve repair. From September 2003 to September 2013, 97 patients had valve-sparing aortic root replacement procedures. Patient records and preoperative, postoperative and recent echocardiograms were reviewed.

Mitral valve-sparing procedures and prosthetic heart valve failure: A case report

Science.gov (United States)

Khan, Nasir A; Butany, Jagdish; Leong, Shaun W; Rao, Vivek; Cusimano, Robert J; Ross, Heather J

2009-01-01

Prosthetic heart valve dysfunction due to thrombus or pannus formation can be a life-threatening complication. The present report describes a 47-year-old woman who developed valvular cardiomyopathy after chorda-sparing mitral valve replacement, and subsequently underwent heart transplantation for progressive heart failure. The explanted mitral valve prosthesis showed significant thrombus and pannus leading to reduced leaflet mobility and valvular stenosis. The present report illustrates the role of the subvalvular apparatus and pannus in prosthesis dysfunction. PMID:19279993

Study on the Fluid Leak Diagnosis for Steam Valve in Power Plant

International Nuclear Information System (INIS)

Lee, Sang-Guk; Park, Jong-Hyuck; Yoo, Keun-Bae; Lee, Sun-Ki; Hong, Sung-Yull

2006-01-01

This study aims to estimate the applicability of acoustic emission(AE) method for the internal fluid leak from the valves. In this study, 4 inch gate steam valve leak tests were performed in order to analyze AE properties when leaks arise in valve seat. As a result of leak test for valve seat in a secondary system of power plant, we conformed that leak sound level increased in proportion to the increase of leak rate, and leak rates were compared to simulated tests. The resulting plots of leak rate versus peak frequency and AE signal level were the primary basis for determining the feasibility of quantifying leak acoustically. Previously, the large amount of data attained also allowed a favorable investigation of the effects of different leak paths, leak rates, pressure differentials through simulated test. All results of application tests are compared with results of simulated test. From the application tests, it was suggested that the AE method for diagnosis of steam leak was applicable. This paper presents quantitative measurements of fluid valve leak conditions by the analysis of AE parameter, FFT(fast fourier transform) and RMS(root mean square) level. Test apparatus were fabricated to accept a variety of leaking steam valves in order to determine what characteristics of AE signal change with leak conditions. The data for each valve were generated by varying the leak rate and recording the averaged RMS level versus time and frequency versus amplitude(FFT). Leak rates were varied by the valve differential pressure and valve size and leaking valves were observed in service. Most of the data analysis involved plotting the leak rate versus RMS level at a specific frequency to determine how well the two variables correlate in terms of accuracy, resolution, and repeatability

Simple Check Valves for Microfluidic Devices

Science.gov (United States)

Willis, Peter A.; Greer, Harold F.; Smith, J. Anthony

2010-01-01

A simple design concept for check valves has been adopted for microfluidic devices that consist mostly of (1) deformable fluorocarbon polymer membranes sandwiched between (2) borosilicate float glass wafers into which channels, valve seats, and holes have been etched. The first microfluidic devices in which these check valves are intended to be used are micro-capillary electrophoresis (microCE) devices undergoing development for use on Mars in detecting compounds indicative of life. In this application, it will be necessary to store some liquid samples in reservoirs in the devices for subsequent laboratory analysis, and check valves are needed to prevent cross-contamination of the samples. The simple check-valve design concept is also applicable to other microfluidic devices and to fluidic devices in general. These check valves are simplified microscopic versions of conventional rubber- flap check valves that are parts of numerous industrial and consumer products. These check valves are fabricated, not as separate components, but as integral parts of microfluidic devices. A check valve according to this concept consists of suitably shaped portions of a deformable membrane and the two glass wafers between which the membrane is sandwiched (see figure). The valve flap is formed by making an approximately semicircular cut in the membrane. The flap is centered over a hole in the lower glass wafer, through which hole the liquid in question is intended to flow upward into a wider hole, channel, or reservoir in the upper glass wafer. The radius of the cut exceeds the radius of the hole by an amount large enough to prevent settling of the flap into the hole. As in a conventional rubber-flap check valve, back pressure in the liquid pushes the flap against the valve seat (in this case, the valve seat is the adjacent surface of the lower glass wafer), thereby forming a seal that prevents backflow.

Expression of uPA, tPA, and PAI-1 in Calcified Aortic Valves

Directory of Open Access Journals (Sweden)

Najlah Kochtebane

2014-01-01

Full Text Available Purpose. Our physiopathological assumption is that u-PA, t-PA, and PAI-1 are released by calcified aortic valves and play a role in the calcification of these valves. Methods. Sixty-five calcified aortic valves were collected from patients suffering from aortic stenosis. Each valve was incubated for 24 hours in culture medium. The supernatants were used to measure u-PA, t-PA, and PAI-1 concentrations; the valve calcification was evaluated using biphotonic absorptiometry. Results. Aortic stenosis valves expressed normal plasminogen activators concentrations and overexpressed PAI-1 (u-PA, t-PA, and PAI-1 mean concentrations were, resp., 1.69 ng/mL ± 0.80, 2.76 ng/mL ± 1.33, and 53.27 ng/mL ± 36.39. There was no correlation between u-PA and PAI-1 (r=0.3 but t-PA and PAI-1 were strongly correlated with each other (r=0.6. Overexpression of PAI-1 was proportional to the calcium content of the AS valves. Conclusions. Our results demonstrate a consistent increase of PAI-1 proportional to the calcification. The overexpression of PAI-1 may be useful as a predictive indicator in patients with aortic stenosis.

Pannus Formation Leads to Valve Malfunction in the Tricuspid Position 19 Years after Triple Valve Replacement.

Science.gov (United States)

Alskaf, Ebraham; McConkey, Hannah; Laskar, Nabila; Kardos, Attila

2016-06-20

The Medtronic ATS Open Pivot mechanical valve has been successfully used in heart valve surgery for more than two decades. We present the case of a patient who, 19 years following a tricuspid valve replacement with an ATS prosthesis as part of a triple valve operation following infective endocarditis, developed severe tricuspid regurgitation due to pannus formation.

Recurrent pannus formation causing prosthetic aortic valve dysfunction: is excision without valve re-replacement applicable?

Science.gov (United States)

Darwazah, Ahmad K

2012-06-29

Prosthetic valve dysfunction at aortic position is commonly caused by pannus formation. The exact etiology is not known. It arises from ventricular aspect of the prosthesis encroaching its leaflets causing stenosis or it may remain localized causing left ventricular outflow tract obstruction without affecting valve function.The difference in location entails different approaches in management. Such a pathology requires surgical excision of the pannus with or without valve re-replacement.A recurrent pannus was observed in a female patient who needed repeated surgical intervention to excise a localized pannus without re-replacement of a well functioning prosthetic valve.Management of our case presents several questions, whether recurrence of pannus is caused by sparing the prosthetic valve, is it simply an exaggeration of an inflammatory healing process in certain individuals or is it ideal to re-replace the valve despite a well preserved function.

Numerical study on cavitation inception in the rotary valve of the hydraulic power steering system

International Nuclear Information System (INIS)

Ryu, Gwang Nyeon; Cho, Myung Hwan; Yoo, Jung Yul; Park, Sun Hong

2009-01-01

The rotary valve directs the power steering oil to either side of a power piston and relieves the driver of the effort to turn the wheel, when a driver begins to operate the vehicle. It is well known that the hiss noise occurring at that moment is caused mainly by cavitation of the oil inside the rotary valve. In this paper, two types of rotary valve (round and straight type) have been analyzed numerically using three-dimensional cavitation model embedded in the commercial code, FLUENT v6.2 and the results have been compared with the measured hiss noise level in a semi-anechoic chamber. The volume of the oil vapor generated from cavitation was larger in Round type valve which has a convex shape of the sleeve grooves than in Straight type valve which has a rectangular shape of the sleeve grooves. The hiss noise level of Round type valve was higher than that of Straight type valve as well. These results mean that the hiss noise can be reduced by the change of the shape of the grooves.

The Neopuff's PEEP valve is flow sensitive.

LENUS (Irish Health Repository)

Hawkes, Colin Patrick

2012-01-31

AIM: The current recommendation in setting up the Neopuff is to use a gas flow of 5-15 L\\/min. We investigated if the sensitivity of the positive end expiratory pressure (PEEP) valve varies at different flow rates within this range. METHODS: Five Neopuffs were set up to provide a PEEP of 5 cm H(2) O. The number of clockwise revolutions to complete occlusion of the PEEP valve and the mean and range of pressures at each quarter clockwise revolution were recorded at gas flow rates between 5 and 15 L\\/min. Results: At 5, 10 and 15 L\\/min, 0.5, 1.7 and 3.4 full clockwise rotations were required to completely occlude the PEEP valve, and pressures rose from 5 to 11.4, 18.4 and 21.5 cm H(2) O, respectively. At a flow rate of 5 L\\/min, half a rotation of the PEEP dial resulted in a rise in PEEP from 5 to 11.4cm H(2) O. At 10 L\\/min, half a rotation resulted in a rise from 5 to 7.7cm H(2) O, and at 15 L\\/min PEEP rose from 5 to 6.8cm H(2) O. CONCLUSION: Users of the Neopuff should be aware that the PEEP valve is more sensitive at lower flow rates and that half a rotation of the dial at 5 L\\/min gas flow can more than double the PEEP.

Axial computed tomography evaluation of the internal nasal valve correlates with clinical valve narrowing and patient complaint.

Science.gov (United States)

Moche, Jason A; Cohen, Justin C; Pearlman, Steven J

2013-07-01

The objective of this work was to explore the utility of axial computed tomography (CT) imaging to objectively define a narrow internal nasal valve, and compare those findings with clinical examination and patient complaint. Retrospective review from a single facial plastic surgery center. We reviewed 40 consecutive patients evaluated for either sinusitis or nasal airway obstruction for which a CT scan was obtained at a single radiology institution. Thirty-six complete office records were examined for the presence of clinical internal valve narrowing and complaints of nasal obstruction. In total, 72 internal nasal valves were analyzed using axial plane CT and measurements were compared to clinical findings and presence of airway obstruction. Measured valve areas for clinically normal internal nasal valves averaged 0.47 cm(2) vs 0.28 cm(2) for clinically narrow valves, a decrease of 40.4%. In unobstructed nasal airways the valve area averaged 0.51 cm(2) vs 0.38 cm(2) in obstructed airways, a difference of 25.5%. A radiographically measured valve area of <0.30 cm(2) suggests clinical narrowing with a sensitivity of 71.4%, specificity of 88.9%, positive predictive value of 62.5%, and negative predictive value of 92.3%. Using standard axial CT imaging we describe an objective method of radiographically evaluating the nasal valve, demonstrating strong correlation with physical examination and patient complaint. Additionally, radiographic valve areas can be used to screen for clinically narrow nasal valves with good sensitivity and specificity, providing a novel straightforward method for nasal valve assessment. © 2012 ARS-AAOA, LLC.

Small sodium valve design and operating experience

International Nuclear Information System (INIS)

McGough, C.B.

1974-01-01

The United States Liquid Metal Fast Breeder Reactor program (LMFBR) includes an extensive program devoted to the development of small sodium valves. This program is now focused on the development and production of valves for the Fast Flux Test Facility (FFTF) now under construction near Richland, Washington. Other AEC support facilities, such as various test loops located at the Liquid Metal Engineering Center (LMEC), Los Angeles, California, and at the Hanford Engineering Development Laboratory (HEDL), Richland, Washington, also have significant requirements for small sodium valves, and valves similar in design to the FFTF valves are being supplied to these AEC laboratories for use in their critical test installations. A principal motivation for these valve programs, beyond the immediate need to provide high-reliability valves for FFTF and the support facilities, is the necessity to develop small valve technology for the Clinch River Breeder Reactor Plant (CRBRP). FFTF small sodium valve design and development experience will be directly applied to the CRBRP program. Various test programs have been, and are being, conducted to verify the performance and integrity of the FFTF valves, and to uncover any potential problems so that they can be corrected before the valves are placed in service in FFTF. The principal small sodium valve designs being utilized in current U.S. programs, the test and operational experience obtained to date on them, problems uncovered, and future development and testing efforts being planned are reviewed. The standards and requirements to which the valves are being designed and fabricated, the valve designs in current use, valve operators, test and operating experience, and future valve development plans are summarized. (U.S.)

Developments in mechanical heart valve prosthesis

Indian Academy of Sciences (India)

Artificial heart valves are engineered devices used for replacing diseased or damaged natural valves of the heart. Most commonly used for replacement are mechanical heart valves and biological valves. This paper briefly outlines the evolution, designs employed, materials being used,. and important factors that affect the ...

Ball check valve

International Nuclear Information System (INIS)

Bevilacqua, F.

1978-01-01

A pressurized nuclear reactor having an instrument assembly sheathed in a metallic tube which is extended vertically upward into the reactor core by traversing a metallic guide tube which is welded to the wall of the vessel is described. Sensors in each instrument assembly are connected to instruments outside the vessel to manifest the conditions within the core. Each instrument assembly probe is moved into position within a metallic guide channel. The guide channel penetrates the wall of the vessel and forms part of the barrier to the environment within the pressure vessel. Each channel includes a ball check valve which is opened by the instrument assembly probe when the probe passes through the valve. A ball valve element is moved from its seat by the probe to a position lateral of the bore of the channel and is guided to its seat along a sloped path within the valve body when the probe is removed. 5 claims, 3 figures

Evaluation of the tightness of contact between 
limbal sclera tunnel and tube following Ahmed 
glaucoma valve implantation.

Science.gov (United States)

Holló, Gábor; Naghizadeh, Farzaneh

2013-01-01

To investigate whether the tightness of contact between the tube and the limbal sclera tunnel can be evaluated with high-magnification anterior segment optical coherence tomography (OCT) imaging following Ahmed glaucoma valve implantation. Tightness between the tube and the limbal sclera tunnel was investigated with the CAM-L cornea lens adapter of the Optovue Fourier-domain OCT (RTVue-OCT) for 21 uncomplicated Ahmed glaucoma valves implanted in 20 eyes of 19 patients with glaucoma. Nineteen valves were implanted 4 to 124 months earlier (late postoperative cases) and 2 valves 1 day prior to the imaging (early postoperative cases). All valves were introduced into the anterior chamber via a limbal sclera tunnel. The limbal intratunnel part of the tube was successfully imaged in all but 2 cases where an additional full-thickness sclera patch was used. In 14 cases, the contact was tight without tube compression. In 
5 cases, the tube was partially compressed but remained open in the limbal sclera tunnel, and redilated behind the limbus. No case with loose contact or peritubular filtration was seen. The posterior run of the tube was successfully imaged in all 19 cases without a full-thickness sclera patch. High-magnification imaging with the CAM- L anterior segment adapter of the RTVue-OCT allows detailed examination of the limbal insertion area of tubes in both the early and late postoperative periods. Therefore this method may potentially be applied for detection of complications related to tube insertion after glaucoma drainage device surgery.

LOFT pressurizer safety: relief valve reliability

Energy Technology Data Exchange (ETDEWEB)

Brown, E.S.

1978-01-18

The LOFT pressurizer self-actuating safety-relief valves are constructed to the present state-of-the-art and should have reliability equivalent to the valves in use on PWR plants in the U.S. There have been no NRC incident reports on valve failures to lift that would challenge the Technical Specification Safety Limit. Fourteen valves have been reported as lifting a few percentage points outside the +-1% Tech. Spec. surveillance tolerance (9 valves tested over and 5 valves tested under specification). There have been no incident reports on failures to reseat. The LOFT surveillance program for assuring reliability is equivalent to nuclear industry practice.

LOFT pressurizer safety: relief valve reliability

International Nuclear Information System (INIS)

Brown, E.S.

1978-01-01

The LOFT pressurizer self-actuating safety-relief valves are constructed to the present state-of-the-art and should have reliability equivalent to the valves in use on PWR plants in the U.S. There have been no NRC incident reports on valve failures to lift that would challenge the Technical Specification Safety Limit. Fourteen valves have been reported as lifting a few percentage points outside the +-1% Tech. Spec. surveillance tolerance (9 valves tested over and 5 valves tested under specification). There have been no incident reports on failures to reseat. The LOFT surveillance program for assuring reliability is equivalent to nuclear industry practice

Means for preventing radioactive fluid leaking

International Nuclear Information System (INIS)

Akatsu, Jun-ichi.

1975-01-01

Object: To permit prevention of leakage of radioactive fluid from line and valve leak sections while also recovering the liquid by producing a vacuum state in a leak-off line by means of a water ejector. Structure: A portion of the water from a condenser is forced by a condensed water pump through a water ejector tank to a recovery tank while controlling an orifice and valve, whereby a vacuum state is produced in the leak-off line to withdraw the leakage fluid. (Kamimura, M.)

Long-term results of aortic valve-sparing operations in patients with Marfan syndrome.

Science.gov (United States)

David, Tirone E; Armstrong, Sue; Maganti, Manjula; Colman, Jack; Bradley, Timothy J

2009-10-01

The appropriateness of aortic valve-sparing operations in patients with Marfan syndrome has been questioned. This study examines the long-term results of these operations in patients with Marfan syndrome. From 1988 to 2006, 103 consecutive patients with Marfan syndrome (mean age, 37 +/- 12 years) and aortic root aneurysm had aortic valve-sparing operations. Emergency surgery was performed in 11 patients: 8 for acute type A aortic dissection and 3 for unexplained persistent chest pain. Fourteen patients also had mitral valve surgery. The technique of aortic valve reimplantation was used in 77 patients, and aortic root remodeling was used in 26 patients. Patients were followed prospectively and underwent annual echocardiographic studies. The mean follow-up was 7.3 +/- 4.2 years and 100% complete. There was 1 operative death and 5 late deaths. Four of the 6 deaths were due to complications of aortic dissections. The patients' survival at 15 years was 87.2% compared with 95.6% for the general population of Ontario matched for age and sex. Seven patients had important aortic insufficiency: 4 mild to moderate, 2 moderate, and 1 moderate to severe. Freedom from greater than mild aortic insufficiency at 15 years was 79.2%. Three patients, all after aortic root remodeling, had aortic valve replacement, 2 for aortic insufficiency and 1 for endocarditis. At the most recent follow-up, 97 patients were alive: 86 were in functional class I, and 11 were in functional class II. Aortic valve-sparing operations provided excellent clinical outcomes in this series of patients with Marfan syndrome. Postoperatively, complications of aortic dissections were the leading cause of death.

Cavitation guide for control valves

Energy Technology Data Exchange (ETDEWEB)

Tullis, J.P. [Tullis Engineering Consultants, Logan, UT (United States)

1993-04-01

This guide teaches the basic fundamentals of cavitation to provide the reader with an understanding of what causes cavitation, when it occurs, and the potential problems cavitation can cause to a valve and piping system. The document provides guidelines for understanding how to reduce the cavitation and/or select control valves for a cavitating system. The guide provides a method for predicting the cavitation intensity of control valves, and how the effect of cavitation on a system will vary with valve type, valve function, valve size, operating pressure, duration of operation and details of the piping installation. The guide defines six cavitation limits identifying cavitation intensities ranging from inception to the maximum intensity possible. The intensity of the cavitation at each limit Is described, including a brief discussion of how each level of cavitation influences the valve and system. Examples are included to demonstrate how to apply the method, including making both size and pressure scale effects corrections. Methods of controlling cavitation are discussed providing information on various techniques which can be used to design a new system or modify an existing one so it can operate at a desired level of cavitation.

Cavitation guide for control valves

International Nuclear Information System (INIS)

Tullis, J.P.

1993-04-01

This guide teaches the basic fundamentals of cavitation to provide the reader with an understanding of what causes cavitation, when it occurs, and the potential problems cavitation can cause to a valve and piping system. The document provides guidelines for understanding how to reduce the cavitation and/or select control valves for a cavitating system. The guide provides a method for predicting the cavitation intensity of control valves, and how the effect of cavitation on a system will vary with valve type, valve function, valve size, operating pressure, duration of operation and details of the piping installation. The guide defines six cavitation limits identifying cavitation intensities ranging from inception to the maximum intensity possible. The intensity of the cavitation at each limit Is described, including a brief discussion of how each level of cavitation influences the valve and system. Examples are included to demonstrate how to apply the method, including making both size and pressure scale effects corrections. Methods of controlling cavitation are discussed providing information on various techniques which can be used to design a new system or modify an existing one so it can operate at a desired level of cavitation

Outcome of pregnancy in women after pulmonary autograft valve replacement for congenital aortic valve disease

NARCIS (Netherlands)

Yap, Sing-Chien; Drenthen, Willem; Pieper, Petronella G.; Moons, Philip; Mulder, Barbara J. M.; Klieverik, Loes M.; Vliegen, Hubert W.; van Dijk, Arie P. J.; Meijboom, Folkert J.; Roos-Hesselink, Jolien W.

Background and aim of the study: The pulmonary autograft has been recommended as the valve of choice for aortic valve replacement (AVR) in young women contemplating pregnancy. However, current information on maternal and perinatal outcome of pregnancy in women with pulmonary autograft valve

Outcome of pregnancy in women after pulmonary autograft valve replacement for congenital aortic valve disease

NARCIS (Netherlands)

Yap, Sing-Chien; Drenthen, Willem; Pieper, Petronella G.; Moons, Philip; Mulder, Barbara J. M.; Klieverik, Loes M.; Vliegen, Hubert W.; van Dijk, Arie P. J.; Meijboom, Folkert J.; Roos-Hesselink, Jolien W.

2007-01-01

Background and aim of the study: The pulmonary autograft has been recommended as the valve of choice for aortic valve replacement (AVR) in young women contemplating pregnancy. However, current information on maternal and perinatal outcome of pregnancy in women with pulmonary autograft valve

Outcome of pregnancy in women after pulmonary autograft valve replacement for congenital aortic valve disease.

NARCIS (Netherlands)

Yap, S.C.; Drenthen, W.; Pieper, P.G.; Moons, P.; Mulder, B.J.M.; Klieverik, L.M.; Vliegen, H.W.; Dijk, A.P.J. van; Meijboom, F.J.; Roos-Hesselink, J.W.

2007-01-01

BACKGROUND AND AIM OF THE STUDY: The pulmonary autograft has been recommended as the valve of choice for aortic valve replacement (AVR) in young women contemplating pregnancy. However, current information on maternal and perinatal outcome of pregnancy in women with pulmonary autograft valve

Recurrent pannus formation causing prosthetic aortic valve dysfunction: Is excision without valve re-replacement applicable?

Directory of Open Access Journals (Sweden)

Darwazah Ahmad K

2012-06-01

Full Text Available Abstract Prosthetic valve dysfunction at aortic position is commonly caused by pannus formation. The exact etiology is not known. It arises from ventricular aspect of the prosthesis encroaching its leaflets causing stenosis or it may remain localized causing left ventricular outflow tract obstruction without affecting valve function. The difference in location entails different approaches in management. Such a pathology requires surgical excision of the pannus with or without valve re-replacement. A recurrent pannus was observed in a female patient who needed repeated surgical intervention to excise a localized pannus without re-replacement of a well functioning prosthetic valve. Management of our case presents several questions, whether recurrence of pannus is caused by sparing the prosthetic valve, is it simply an exaggeration of an inflammatory healing process in certain individuals or is it ideal to re-replace the valve despite a well preserved function.

Aging and malfunction of valves in CANDU special safety systems. Phase 1

International Nuclear Information System (INIS)

1989-03-01

Aging and wear related valve malfunctions have been reported in American nuclear generating systems. This report documents the first attempt to study these phenomena on a global basis in Canadian nuclear power plants. A general methodology outlines an approach to this type of study which is amenable to use within existing information structures. Nuclear regulatory requirements which influence the testing of valves in Canadian nuclear power plants are reviewed. The reporting systems which emanate from these requirements are discussed and sources of valve failure data are reviewed. It is determined that modifications to existing failure reporting systems are required before practical means of collecting data necessary for the analysis of age related valve malfunctions can be developed. In spite of limitations in reported failure data, a partial data base is compiled for valve failures in Special Safety Systems of domestic nuclear plants. Data are reported for the period 1982 to 1986. The valve population and basic parameters of each valve such as type, operator, function, etc., and the reported failures against this population are compiled and reviewed for evidence of time dependent versus random failure trends. Results suggest that there is no clear age related failure trend. In fact, some systems and stations, experienced a reduction in failure rates with years of servicing, suggesting that some earlier generic valve problems may have been solved. Present inspection, test, and maintenance practices are reviewed and their effectiveness for purposes of predicting or preventing incipient failures is assessed to be of moderate value. Modern failure prevention methods are highlighted and their applicability discussed

Butterfly valve of all rubber lining type

International Nuclear Information System (INIS)

Shimada, Shosaku; Nakatsuma, Sumiya; Sasaki, Iwao; Aoki, Naoshi.

1982-01-01

The valves used for the circulating water pipes for condensers in nuclear and thermal power stations have become large with the increase of power output, and their specifications have become strict. The materials for the valves change from cast iron to steel plate construction. To cope with sea water corrosion, rubber lining has been applied to the internal surfaces of valve boxes, and the build-up welding of stainless steel has been made on the edges of valves. However, recently it is desired to develop butterfly valves, of which the whole valve disks are lined with hard rubber. For the purpose of confirming the performance of large bore valves, a 2600 mm bore butterfly valve of all rubber lining type was used, and the opening and closing test of 1100 times was carried out by applying thermal cycle and pressure difference and using artifical sea water. Also the bending test of hard rubber lining was performed with test pieces. Thus, it was confirmed that the butterfly valves of all rubber lining type have the performance exceeding that of the valves with build-up welding. The course of development of the valves of all rubber lining type, the construction and the items of confirmation by tests of these valves, and the tests of the valve and the hard rubber lining described above are reported. (Kako, I.)

Sliding-gate valve for use with abrasive materials

Science.gov (United States)

Ayers, Jr., William J.; Carter, Charles R.; Griffith, Richard A.; Loomis, Richard B.; Notestein, John E.

1985-01-01

The invention is a flow and pressure-sealing valve for use with abrasive solids. The valve embodies special features which provide for long, reliable operating lifetimes in solids-handling service. The valve includes upper and lower transversely slidable gates, contained in separate chambers. The upper gate provides a solids-flow control function, whereas the lower gate provides a pressure-sealing function. The lower gate is supported by means for (a) lifting that gate into sealing engagement with its seat when the gate is in its open and closed positions and (b) lowering the gate out of contact with its seat to permit abrasion-free transit of the gate between its open and closed positions. When closed, the upper gate isolates the lower gate from the solids. Because of this shielding action, the sealing surface of the lower gate is not exposed to solids during transit or when it is being lifted or lowered. The chamber containing the lower gate normally is pressurized slightly, and a sweep gas is directed inwardly across the lower-gate sealing surface during the vertical translation of the gate.

Tricuspid valve repair for severe tricuspid regurgitation due to pacemaker leads.

Science.gov (United States)

Uehara, Kyokun; Minakata, Kenji; Watanabe, Kentaro; Sakaguchi, Hisashi; Yamazaki, Kazuhiro; Ikeda, Tadashi; Sakata, Ryuzo

2016-07-01

Tricuspid valve regurgitation due to pacemaker leads is a well-known complication. Although some reports have suggested that pacemaker leads should be surgically explanted, strongly adhered leads cannot always be removed. The aim of this study was to describe our tricuspid valve repair techniques with pacemaker leads left in situ. Our retrospective study investigated 6 consecutive patients who required tricuspid valve surgery for severe regurgitation induced by pacemaker leads. From the operative findings, we identified 3 patterns of tricuspid valve and pacemaker lead involvement. In 3 patients, the leads were caught in the chordae, in 2 patients, tricuspid regurgitation was caused by lead impingement on the septal leaflet, and in 3 patients, tricuspid valve leaflets had been perforated by the pacemaker leads. During surgery, all leads were left in situ after being separated from the leaflet or valvular apparatus. In addition, suture annuloplasty was performed for annular dilatation in all cases. In one patient, the lead was reaffixed to the annulus after the posterior leaflet was cut back towards the annulus, and the leaflet was then closed. There was one hospital death due to sepsis. The degree of tricuspid regurgitation was trivial in all surviving patients at discharge. During a mean follow-up of 21 months, one patient died from pneumonia 20 months after tricuspid valve repair. In patients undergoing tricuspid valve surgery due to severe tricuspid regurgitation caused by pacemaker leads, the leads can be left in situ after proper repair with annuloplasty. © The Author(s) 2016.

Pump having pistons and valves made of electroactive actuators

Science.gov (United States)

Bar-Cohen, Yoseph (Inventor)

1997-01-01

The present invention provides a pump for inducing a displacement of a fluid from a first medium to a second medium, including a conduit coupled to the first and second media, a transducing material piston defining a pump chamber in the conduit and being transversely displaceable for increasing a volume of the chamber to extract the fluid from the first medium to the chamber and for decreasing the chamber volume to force the fluid from the chamber to the second medium, a first transducing material valve mounted in the conduit between the piston and the first medium and being transversely displaceable from a closed position to an open position to admit the fluid to the chamber, and control means for changing a first field applied to the piston to displace the piston for changing the chamber volume and for changing a second field applied to the first valve to change the position of the first valve.

Initial experience with the Freedom Solo® stentless aortic valve in a low volume centre.

Science.gov (United States)

Kolseth, Solveig Moss; Nordhaug, Dag; Stenseth, Roar; Wahba, Alexander

2010-10-01

Freedom Solo is a stentless biological aortic valve which is implanted supra-annularly with a single suture line. An increased risk of postoperative thrombocytopenia in the early postoperative period has been reported in recent studies. In our study we evaluated postoperative haemodynamic performance and thrombocyte-levels. Thirty seven patients who underwent valve implantation of the Sorin Freedom Solo stentless valve were included. The haemodynamic performance of the valve was evaluated by transthoracic echocardiography postoperatively at the fourth day (mean) and after a median of 4.2 months. The mean gradient (mmHg) of Freedom Solo was 7.5 at four days and 8.6 at 4.2 months. Postoperatively no patient had more than grade 1 leakage. Seven percent of the patients had a reduction of thrombocytes to less than 20% of the preoperative level. Seventy six percent had a minimum postoperative thrombocyte level less than 100*10(9)/L. The 30 days mortality in our patient material was zero. Implantation of the Freedom Solo valve was uncomplicated in our experience. Favourable transvalvular gradients and no significant leaks were found. In accordance with the literature, we found a high percentage of patients having a postoperative level of thrombocytes less than 100*10(9)/L after implantation of Freedom Solo.

Supra-annular Valve-in-Valve implantation reduces blood stasis on the transcatheter aortic valve leaflets.

Science.gov (United States)

Vahidkhah, Koohyar; Azadani, Ali N

2017-06-14

Leaflet thrombosis following transcatheter aortic valve replacement (TAVR) and Valve-in-Valve (ViV) procedures has been increasingly recognized. This study aimed to investigate the effect of positioning of the transcatheter aortic valve (TAV) in ViV setting on the flow dynamics aspect of post-ViV thrombosis by quantifying the blood stasis in the intra-annular and supra-annular settings. To that end, two idealized computational models, representing ViV intra-annular and supra-annular positioning of a TAV were developed in a patient-specific geometry. Three-dimensional flow fields were then obtained via fluid-solid interaction modeling to study the difference in blood residence time (BRT) on the TAV leaflets in the two settings. At the end of diastole, a strip of high BRT (⩾1.2s) region was observed on the TAV leaflets in the ViV intra-annular positioning at the fixed boundary where the leaflets are attached to the frame. Such a high BRT region was absent on the TAV leaflets in the supra-annular positioning. The maximum value of BRT on the surface of non-, right, and left coronary leaflets of the TAV in the supra-annular positioning were 53%, 11%, and 27% smaller compared to the intra-annular positioning, respectively. It was concluded that the geometric confinement of TAV by the leaflets of the failed bioprosthetic valve in ViV intra-annular positioning increases the BRT on the leaflets and may act as a permissive factor in valvular thrombosis. The absence of such a geometric confinement in the ViV supra-annular positioning leads to smaller BRT and subsequently less likelihood of leaflet thrombosis. Copyright © 2017 Elsevier Ltd. All rights reserved.

Patient-prosthesis mismatch and left ventricular remodelling after implantation of Shelhigh SuperStentless aortic valve prostheses.

Science.gov (United States)

Germing, A; Lindstaedt, M; Holt, S; Reber, D; Mügge, A; Laczkovics, A; Fritz, M

2008-08-01

Aortic valve replacement is a standard procedure for the treatment of severe aortic valve stenosis. Due to lower flow velocities stentless valves are associated with a more effective regression of left ventricular hypertrophy in comparison to stented valves. However, mismatch between body surface area and valve size supports unfavourable hemodynamic results. The aim of the study was to analyze hemodynamic parameters by echocardiography after implantation of the Shelhigh SuperStentless bioprosthesis and to analyze the occurrence of patient-prosthesis mismatch and left ventricular remodelling in this specific valve type. A total of 20 patients with severe aortic stenosis underwent implantation of a Shelhigh Super Stentless prosthesis. Clinical and echocardiographic assessment was done prior to, immediate after and six months after surgery. All surgical procedures were successful, no surgery-related complication was documented perioperatively. One patient died after development of multiorgan failure. Echocardiography during the first eight days after surgery showed mean gradients of 16 mmHg, mean valve orifice areas of 1.8 cm(2) and indexed effective orifice areas at 0.95 cm(2)/m(2). Six-months follow-up data were obtained in 19/20 patients. There were no relevant changes in echocardiographic hemodynamic findings at the time of follow-up measurements. Significant regression of left ventricular hypertrophy was shown (P=0.0088). A patient-prosthesis mismatch occurred in one patient (0.54 cm(2)/m(2)). No recurrent symptoms were documented. Patient-prosthesis mismatch after implantation of SuperStentless Shelhigh prosthesis is rare. A significant regression of left ventricular hypertrophy could be shown after six months. Hemodynamic valve function assessed by echocardiography may be predicted early after surgery.

Preoperative planning with three-dimensional reconstruction of patient's anatomy, rapid prototyping and simulation for endoscopic mitral valve repair.

Science.gov (United States)

Sardari Nia, Peyman; Heuts, Samuel; Daemen, Jean; Luyten, Peter; Vainer, Jindrich; Hoorntje, Jan; Cheriex, Emile; Maessen, Jos

2017-02-01

Mitral valve repair performed by an experienced surgeon is superior to mitral valve replacement for degenerative mitral valve disease; however, many surgeons are still deterred from adapting this procedure because of a steep learning curve. Simulation-based training and planning could improve the surgical performance and reduce the learning curve. The aim of this study was to develop a patient-specific simulation for mitral valve repair and provide a proof of concept of personalized medicine in a patient prospectively planned for mitral valve surgery. A 65-year old male with severe symptomatic mitral valve regurgitation was referred to our mitral valve heart team. On the basis of three-dimensional (3D) transoesophageal echocardiography and computed tomography, 3D reconstructions of the patient's anatomy were constructed. By navigating through these reconstructions, the repair options and surgical access were chosen (minimally invasive repair). Using rapid prototyping and negative mould fabrication, we developed a process to cast a patient-specific mitral valve silicone replica for preoperative repair in a high-fidelity simulator. Mitral valve and negative mould were printed in systole to capture the pathology when the valve closes. A patient-specific mitral valve silicone replica was casted and mounted in the simulator. All repair techniques could be performed in the simulator to choose the best repair strategy. As the valve was printed in systole, no special testing other than adjusting the coaptation area was required. Subsequently, the patient was operated, mitral valve pathology was validated and repair was successfully done as in the simulation. The patient-specific simulation and planning could be applied for surgical training, starting the (minimally invasive) mitral valve repair programme, planning of complex cases and the evaluation of new interventional techniques. The personalized medicine could be a possible pathway towards enhancing reproducibility

Resurgery for recurrent heart valve diseases

Directory of Open Access Journals (Sweden)

Chong-lei REN

2017-02-01

Full Text Available Objective　To summarize the experience with resurgery for recurrent valvular heart diseases. Methods　From June 2004 to June 2015, 28 patients (15 males and 13 females with ages ranging from 44 to 67 years (55.6±6.5 years with recurrent heart valve disease underwent resurgery. The reasons for resurgery included perivalvular leakage (7 cases, bioprosthetic valve decline (6 cases in mitral valve and 3 in tricuspid valve, mechanical prostheses dysfunction (2cases, infective endocarditis after valve replacement (2 cases, restenosis of repaired native valve (1 case, and severe tricuspid insufficiency after left-side valve surgery (7 cases. Resurgery included mitral valve replacement in 18 patients and tricuspid valve replacement in 10. All the patients underwent third or fourth or even fifth cardiac surgery for valve replacement. Results　There were 2 hospital deaths with a mortality of 7.1% (2/28. The main causes of early-stage deaths were low cardiac output syndrome. The main postoperative complications were respiratory failure in 3, low cardiac output syndrome in 2, reexploration for bleeding in 2 and serious infectious shock in 1. All the patients were found with the great improvement in heart function and the re-implanted prostheses worked well during follow-up. Conclusions　Although resurgery for recurrent heart valve disease poses a continuing challenge to cardiac surgeon, it could be performed with the satisfactory results. The keys to a successful cardiac resurgery include appropriate operational timing, refined surgical technique and reasonable perioperative managements. DOI: 10.11855/j.issn.0577-7402.2017.01.11

The development of fusion sensor techniques for condition monitoring of a check valve

International Nuclear Information System (INIS)

Seong, S.H.; Kim, J.S.; Hur, S.; Kim, J.T.; Park, W.M.; Cha, D.B.

2004-01-01

The failures of check valves are one of the most important problems in nuclear power plants because the reverse flows through the failed check valve impact on the healthy hydraulic loop. The present test method of finding out the mechanical failure of a check valve is very risky in the radiated environments during normal operation. In addition, the detection of failures in the overhaul period is very costly and tedious because many check valves are used in the plants and manual disassembly work is required. We have suggested the fusion sensor technology for detecting the failures of check valves through measuring and analyzing the backward leakage flow and mechanical vibration without disassembling the check valve. The fusion sensor means that more than two sensors are used in order to identify and analyze the changes of the frequency response between the failed check valve and healthy check valve. We use the accelerometer and acoustic emission sensor as an alternative to the fusion sensor methodology. We have found that the acoustic emission sensor would be capable of directly detecting a high frequency acoustic wave generated from backward leakage flow itself at a low pressure and temperature. The accelerometer for detecting the mechanical vibration induced from leakage flows would, also, be useful at a high pressure and temperature from the previous studies. The effectiveness of this system is that it is possible for predictive maintenance and information of the problem valve will be captured and it reduces the radiation exposure for the maintenance personnel during power operation as well as the maintenance period. (orig.)

Remote maintenance of a combined regeneration-isolation valve for the ITER Torus vacuum pumping system

International Nuclear Information System (INIS)

Stringer, J.; Blevins, J.

1992-01-01

A large diameter valve suitable for high vacuum operation is under study for ITER Torus evacuation. The valves must comply with specifications for leak-tightness, radiation resistance, dust tolerance, overpressure, and thermal gradients. Remote maintenance of the seal and valve moving parts without disturbance to the rest of the valve system is a requirement. This paper describes tow methods of seal exchange by remote means. In the first method, a flask is proposed for the valve moving parts exchange in inert gas, when the machine is shut down. In the second method a novel concept is described for seal exchange while under vacuum, without having to bring the machine up to atmosphere. The advantages of this method are that scheduled remote handling (RH) operations and outages for seal replacement are not required. Also, the need for a flask is avoided

The optimal management of anti-thrombotic therapy after valve replacement: certainties and uncertainties.

Science.gov (United States)

Iung, Bernard; Rodés-Cabau, Josep

2014-11-07

Anti-thrombotic therapy after valve replacement encompasses a number of different situations. Long-term anticoagulation of mechanical prostheses uses vitamin K antagonists with a target international normalized ratio adapted to the characteristics of the prosthesis and the patient. The association of low-dose aspirin is systematic in the American guidelines and more restrictive in the European guidelines. Early heparin therapy is frequently used early after mechanical valve replacement, although there are no precise recommendations regarding timing, type, and dose of drug. Direct oral anticoagulants are presently contraindicated in patients with mechanical prosthesis. The main advantage of bioprostheses is the absence of long-term anticoagulant therapy. Early anticoagulation is indicated after valve replacement for mitral bioprostheses, whereas aspirin is now favoured early after bioprosthetic valve replacement in the aortic position. Early dual antiplatelet therapy is indicated after transcatheter aortic valve implantation, followed by single antiplatelet therapy. However, this relies on low levels of evidence and optimization of anti-thrombotic therapy is warranted in these high-risk patients. Although guidelines are consistent in most instances, discrepancies and the low-level of evidence of certain recommendations highlight the need for further controlled trials, in particular with regard to the combination of antiplatelet therapy with oral anticoagulant and the early post-operative anti-thrombotic therapy following the procedure. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

Design of the Modular Pneumatic Valve Terminal

Directory of Open Access Journals (Sweden)

Jakub E. TAKOSOGLU

2015-11-01

Full Text Available The paper presents design of the modular pneumatic valve terminal, which was made on the basis of the patent application No A1 402905 „A valve for controlling fluid power drives, specially for pneumatic actuators, and the control system for fluid power drives valves”. The authors describe a method of operation of the system with double-acting valve and 5/2 (five ways and two position valve. Functions of the valve, and an example of application of the valve terminal in the production process were presented. 3D solid models of all the components of the valve were made. The paper presents a complete 3D model of the valve in various configurations. Using CAD-embedded SOLIDWORKS Flow Simulation computational fluid dynamics CFD analysis was also carried out of compressed air flow in the ways of the valve elements

Valve-stem-packing improvement study. Final report

International Nuclear Information System (INIS)

Adey, C.W.; Klein, J.J.

1982-08-01

By employing questionnaires and face-to-face interviews with valve and valve packing manufacturers, as well as nuclear plant personnel, an understanding of valve stem packing leakage problems from each of the three viewpoints was developed. This information, in-house experience, and available technical literature were used to develop specific recommendations for valve manufacturers, valve packing manufacturers, and nuclear plant valve users. It was generally recommended that each these groups make better use of graphite packing. The questionnaires and interviews indicated that increased usage of graphite packing over the last few years has reduced the incidence of valve packing problems. To confirm this, a survey of Licensee Event Reports (LERs) from 1972 to 1980 was undertaken using the keywords Valve and Packing. A statistical analysis of the LER data confirms that the adoption of graphite packing has significantly reduced valve stem leakage

Clinical and echocardiographic assessment of the Medtronic Advantage aortic valve prosthesis: the Scandinavian multicentre, prospective study

DEFF Research Database (Denmark)

Haaverstad, Rune; Vitale, Nicola; Karevold, Asbjørn

2006-01-01

OBJECTIVE: The aim of this report is the prospective, multicentre evaluation of clinical results and haemodynamic performance of the Medtronic Advantage aortic valve prosthesis. METHODS: From April 2001 to June 2003, 166 patients (male:female 125:41; mean (SD) age 61.8 (11.8) years) received...... an aortic advantage valve prosthesis. Complete cumulative follow-up was 242.7 patient-years (maximum 3.2; mean 1.6 years). Postoperatively, patients underwent early (within 30 days) and 1 year transthoracic echocardiography. RESULTS: 30 day mortality was 2.4% (n = 4). Kaplan-Meier estimates of freedom from...... echocardiography. CONCLUSIONS: Haemodynamic performance and early clinical results of Medtronic advantage in the aortic position were satisfactory and comparable with those of other bileaflet valves in current clinical use....

Short-term and mid-term results with the Sorin Freedom Solo aortic valve.

Science.gov (United States)

Ustunsoy, Hasim; Yasim, Alptekin; Deniz, Hayati; Gokaslan, Gokhan; Ozcaliskan, Ozerdem

2013-03-01

The study aim was to present the short- and mid-term results for patients who underwent aortic valve replacement (AVR) with the Sorin Freedom Solo third-generation stentless prosthetic valve. AVR with a Sorin Freedom Solo valve was performed in 14 patients between March 2006 and March 2011. Patients aged > or = 60 years (male:female ratio 6:8; mean age 73.28 +/- 5.42 years) who required AVR with the Sorin Freedom Solo valve according to the surgeon's choice were included in the study. The valvular prosthesis was implanted in the supra-annular position, using a single suture line. Eight patients underwent an isolated AVR; combined interventions were carried out in the other patients due to concomitant cardiac disease. One patient died during the immediate perioperative period, and two more during the follow up, from non-cardiac causes. The mean maximum transvalvular gradient of patients with aortic stenosis was 88.1 +/- 20.2 mmHg, and this fell to 26.4 +/- 7.6 mmHg during the early postoperative period. The mean gradient at one year of follow up was further decreased to 19.4 +/- 5.3 mmHg. The left ventricular end-diastolic and end-systolic diameters were also significantly reduced, from 4.8 +/- 0.9 to 4.3 +/- 0.6 cm and from 3.2 +/- 0.6 to 2.8 +/- 5.3 cm, respectively. The average left ventricular ejection fraction was 60.2 +/- 4.9% preoperatively, and 63.2 +/- 2.1% at one year after surgery (p = NS). No paravalvular leakage, endocarditis, prosthesis failure or neurologic events were reported among patients. The Sorin Freedom Solo stentless valve has provided good early and intermediate-term results. Implantation of the prosthesis is straightforward, with low rates of morbidity and mortality. However, these data require further support from larger patient series and long-term follow up.

Double-reed exhaust valve engine

Science.gov (United States)

Bennett, Charles L.

2015-06-30

An engine based on a reciprocating piston engine that extracts work from pressurized working fluid. The engine includes a double reed outlet valve for controlling the flow of low-pressure working fluid out of the engine. The double reed provides a stronger force resisting closure of the outlet valve than the force tending to open the outlet valve. The double reed valve enables engine operation at relatively higher torque and lower efficiency at low speed, with lower torque, but higher efficiency at high speed.

Left Ventricular Function Improves after Pulmonary Valve Replacement in Patients with Previous Right Ventricular Outflow Tract Reconstruction and Biventricular Dysfunction

Science.gov (United States)

Kane, Colin; Kogon, Brian; Pernetz, Maria; McConnell, Michael; Kirshbom, Paul; Rodby, Katherine; Book, Wendy M.

2011-01-01

Congenital heart defects that have a component of right ventricular outflow tract obstruction, such as tetralogy of Fallot, are frequently palliated in childhood by disruption of the pulmonary valve. Although this can provide an initial improvement in quality of life, these patients are often left with severe pulmonary valve insufficiency. Over time, this insufficiency can lead to enlargement of the right ventricle and to the deterioration of right ventricular systolic and diastolic function. Pulmonary valve replacement in these patients decreases right ventricular volume overload and improves right ventricular performance. To date, few studies have examined the effects of pulmonary valve replacement on left ventricular function in patients with biventricular dysfunction. We sought to perform such an evaluation. Records of adult patients who had undergone pulmonary valve replacement from January 2003 through November 2006 were analyzed retrospectively. We reviewed preoperative and postoperative echocardiograms and calculated left ventricular function in 38 patients. In the entire cohort, the mean left ventricular ejection fraction increased by a mean of 0.07 after pulmonary valve replacement, which was a statistically significant change (P < 0.01). In patients with preoperative ejection fractions of less than 0.50, mean ejection fractions increased by 0.10. We conclude that pulmonary valve replacement in patients with biventricular dysfunction arising from severe pulmonary insufficiency and right ventricular enlargement can improve left ventricular function. Prospective studies are needed to verify this finding. PMID:21720459

Role of passive valves & devices in poison injection system of advanced heavy water reactor