Mitral annuloplasty ring with selective flexibility for septal-lateral contraction and remodelling properties.

Autor:	Tjørnild MJ; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark., Skov SN; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark., Røpcke DM; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark., Ilkjær C; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark., Rasmussen J; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark., Couetil JP; Department of Thoracic and Cardiovascular Surgery, University Hospital Group Henri Mondor, APHP, Paris-Est Créteil University, Créteil, France., Nielsen SL; Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
Jazyk:	angličtina
Zdroj:	Interactive cardiovascular and thoracic surgery [Interact Cardiovasc Thorac Surg] 2019 Jan 01; Vol. 28 (1), pp. 65-70.
DOI:	10.1093/icvts/ivy194
Abstrakt:	Objectives: To develop and evaluate a novel mitral annuloplasty ring with selective flexibility for septal-lateral contraction and rigidity for septal-lateral dilatation in an acute porcine model. Methods: The novel mitral annuloplasty ring was designed with slits in the luminal posterior segment and annular lateral segments. The slits were designed to allow inward motion during contraction and to block outward motion during dilation. The novel mitral annuloplasty ring was tested in vitro with a dedicated mechanical test bench, followed by in vivo characterization, using sonomicrometry and echocardiography for annular and leaflet geometry, in an acute porcine model. Results: From the in vitro characterization, we verified that the ring could easily contract (0.7 mm/N) in the septal-lateral dimension, while dilatation was restrained (0.4 mm/N). In vivo characterization showed a cyclic range of 2.8 ± 0.0 mm for septal-lateral contraction. Conclusions: A novel saddle-shaped remodelling mitral annuloplasty ring was developed with selective flexibility for septal-lateral contraction and rigidity for septal-lateral dilatation. The advantages of this specific ring is that it re-establishes the coaptation plane, ensures leaflet mobility and septal-lateral flexibility and at the same time improves tissue adaptation and thereby decreases the risk of ring dehiscence and redilatation of the mitral annulus. This concept may prove beneficial for patients with ischaemic mitral valve regurgitation or degenerative valve disease.
Databáze:	MEDLINE
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