Mitral valve posterior leaflet reconstruction using extracellular matrix: an acute porcine study
| Autor: | Farhad Waziri, Leila Louise Benhassen, Mona Sharghbin, Diana M Røpcke, Marcell Juan Tjørnild, Lisa Carlson Hanse, Sten Lyager Nielsen, Karen B Poulsen, Søren Skov, J. Michael Hasenkam |
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| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
Aortic valve medicine.medical_specialty Sus scrofa Regurgitation (circulation) 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Mitral valve stenosis Postoperative Complications Intestinal mucosa Internal medicine Mitral valve Intestine Small Medicine Animals Mitral Valve Stenosis cardiovascular diseases Systole Intestinal Mucosa Mitral regurgitation business.industry Hemodynamics Mitral Valve Insufficiency General Medicine medicine.disease Extracellular Matrix Stenosis Disease Models Animal medicine.anatomical_structure 030228 respiratory system Echocardiography Aortic Valve cardiovascular system Cardiology Feasibility Studies Mitral Valve Surgery Cardiology and Cardiovascular Medicine business |
| Zdroj: | Tjørnild, M J, Skov, S N, Poulsen, K B, Sharghbin, M, Benhassen, L L, Carlson Hanse, L, Waziri, F, Røpcke, D M, Nielsen, S L & Hasenkam, J M 2018, ' Mitral valve posterior leaflet reconstruction using extracellular matrix : an acute porcine study ', European Journal of Cardio-Thoracic Surgery, vol. 54, no. 5, pp. 832-840 . https://doi.org/10.1093/ejcts/ezy152 |
| ISSN: | 1873-734X |
| DOI: | 10.1093/ejcts/ezy152 |
| Popis: | OBJECTIVES: To investigate mitral valve posterior leaflet and subvalvular reconstruction using a 2-ply small intestinal submucosal extracellular matrix sheet.METHODS: Mitral valve posterior leaflet and subvalvular reconstruction was characterized in an acute 80-kg porcine model with 7 pigs acting as their own controls. The characterization was based on pressure catheter measurements of pressure differences to identify mitral regurgitation, stenosis and systolic anterior motion. Furthermore, echocardiography was used for the evaluation of leaflet mobility and geometry, whereas sonomicrometry was used to describe annular and subvalvular geometry.RESULTS: The reconstructed mitral valve was fully functional without any signs of regurgitation (peak left atrial pressure for baseline and reconstruction 12 ± 2 mmHg vs 11 ± 2 mmHg, P = 0.550), mitral valve stenosis (mean pressure difference across the mitral valve 4.8 ± 2.3 mmHg vs 4.1 ± 2.3 mmHg, P = 0.589) or systolic anterior motion. The echocardiographic characterization revealed septal-lateral downsizing, reduced tenting area, increased coaptation length (6.0 ± 0.6 mm vs 8.7 ± 2.3 mm, P = 0.002) and an atrial bend of the reconstructed posterior leaflet. A ballooning effect of the patch material was present at the posterior annular segment.CONCLUSIONS: Mitral valve posterior leaflet and subvalvular reconstruction using a 2-ply small intestinal submucosal extracellular matrix sheet as patch material was possible in an acute porcine model. The reconstructed mitral valve was fully functional without signs of mitral valve stenosis, valve regurgitation, stenosis or systolic anterior motion. The ballooning appearance of the patch material might, however, constitute an altered leaflet stress distribution in this area. |
| Databáze: | OpenAIRE |
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