Human Ex Vivo Working-Heart Evaluation of Coronet-Framed Valve-Sparing Aortic Root Replacement.

BACKGROUND

Valve-sparing aortic root reconstruction (VSARR) requires durable annular stabilization and preservation of commissural geometry. Translational evaluation of stabilization platforms in anatomically authentic human tissue remains limited.

OBJECTIVES

The authors aimed to evaluate the structural feasibility and qualitative functional performance of a coronet-framed annular stabilization platform during VSARR using an ex vivo human working-heart model.

METHODS

Bench VSARR using a coronet-framed stabilization device was performed in a human heart explanted during orthotopic transplantation. Following reconstruction, the heart was mounted on a cardiopulmonary bypass-based ex vivo perfusion platform permitting transition from Langendorff reperfusion to a loaded working-heart configuration. Dynamic valve competence was additionally assessed using saline-filled endoscopic visualization.

RESULTS

Bench reconstruction and device implantation were technically feasible and resulted in a geometrically stable root construct. Following reperfusion and repeated electrical defibrillation, intrinsic ventricular ejection was restored and maintained in a working-heart configuration with sustained coronary recirculation. Endoscopic assessment demonstrated preserved central leaflet coaptation without visible prolapse or commissural distortion under simulated loading conditions.

CONCLUSIONS

An ex vivo human working-heart platform enabled translational structural and qualitative functional evaluation of a coronet-framed annular stabilization concept during VSARR using anatomically authentic human tissue.