San Donato

Researchers are comparing the blood flow and valve function of different types of aortic valve replacements, both surgical and transcatheter, in patients with severe aortic valve stenosis and small aortic annulus. The study aims to better understand how valve design and implantation techniques affect valve performance and long-term outcomes. This includes testing valves in a laboratory setting using a special mock circulation system and advanced imaging, as well as validating those findings in patients. The study features in vitro testing with a pulsatile pump and 3D printed models to simulate blood flow through various valve types, including tissue valves, sutureless valves, and mechanical valves. Patients who had surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) will undergo evaluations using echocardiograms and a special MRI scan called 4D Flow MRI about 1 to 3 months after their procedure. These tests measure how well the valves work and the flow patterns around them. Participants will have routine clinical data collected, including echocardiograms and MRI scans without contrast, to assess valve structure and blood flow. The main outcomes measured over 24 months include performance of the valves on bench tests and imaging results from MRI and echocardiography. The study monitors valve function, flow dynamics, and potential complications to help guide better treatment choices for future patients.