The purpose of this study was to explore a valve selection criterion based on the impact force generated at valve closure, and to test a statistical mathematical model for comparing valve performance. The impact force generated at valve closure in the mitral position was measured continuously, using a load cell mounted in the left atrial section of a mock circulatory system. Eight clinical valves were tested. The data obtained from the in vitro test were subjected to multiregression analysis, to enable systematic comparison of the impact forces of these valves. Furthermore, class I quantification theory was applied to construct the statistical mathematical model. As a result, the following interaction effect was observed in the statistical model. (1) The impact force generated at valve closure had a lower value in valves of smaller diameter. (2) The ranking of 29-mm-diameter valves by impact force was different for the flow region. Under the physiological flow condition of 4-61/min, high impact forces were generated in all valves, in the order Björk-Shiley monostrut, ATS, St. Jude medical, CarboMedics. We consider that low impact force at valve closure is desirable, upon consideration of the influence on the annulus tissue at valve replacement. From these findings, the results of the multiregression analysis provide indications for choosing the optimal valve for patients with severe mitral insufficiency (MI).
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