Mitral Valve Posterior Leaflet Reconstruction Using Extracellular Matrix:In Vitro Evaluation
| Autor: | Lisa Carlson Hanse, Diana M Røpcke, Søren Skov, Sten Lyager Nielsen, Søren W Sørensen, Marcell Juan Tjørnild, J. Michael Hasenkam |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Mitral valve reconstruction
medicine.medical_treatment 0206 medical engineering Sus scrofa Biomedical Engineering Posterior leaflet reconstruction 02 engineering and technology Regurgitation (circulation) 030204 cardiovascular system & hematology Papillary muscle force Extracellular matrix 03 medical and health sciences 0302 clinical medicine Posterior leaflet Mitral valve Intestine Small medicine Animals cardiovascular diseases 2-ply small intestinal submucosa extracellular matrix Cardiac Surgical Procedures Papillary muscle Mitral valve repair Leaflet (botany) business.industry Hemodynamics CorMatrix Anatomy 020601 biomedical engineering Extracellular Matrix medicine.anatomical_structure Models Animal cardiovascular system Chordae Tendineae Mitral Valve Chordae tendineae Cardiology and Cardiovascular Medicine business |
| Zdroj: | Tjørnild, M J, Sørensen, S W, Carlson Hanse, L, Skov, S N, Røpcke, D M, Nielsen, S L & Hasenkam, J M 2020, ' Mitral Valve Posterior Leaflet Reconstruction Using Extracellular Matrix : In Vitro Evaluation ', Cardiovascular Engineering and Technology, vol. 11, no. 4, pp. 405-415 . https://doi.org/10.1007/s13239-020-00472-0 |
| Popis: | PURPOSE: To investigate the anatomical and functional effects of complete surgical reconstruction of the posterior mitral leaflet and associated chordae tendineae with a patch made of 2-ply small intestinal submucosal extracellular matrix in vitro.METHODS: Seven explanted mitral valves with intact subvalvular apparatus from 80-kg pigs were evaluated in a left heart simulator and served as their own controls. After testing the native valve, the mitral posterior leaflet and associated chordae tendineae were excised and reconstructed by using the 2-ply small intestinal submucosa extracellular matrix patch. The characterization of the reconstruction was based on geometric data from digital images, papillary muscle force, annular tethering force and leaflet pressure force.RESULTS: The reconstructed valves were fully functional without regurgitation, tearing or rupture during incrementally increased pressure from 0 to 120 mmHg. The leaflet areas were preserved after reconstruction, with a normal configuration of the coaptation line. However, the coaptation midpoint moved posteriorly after reconstruction (A2: 15.8 ± 1.4 vs. 18.9 ± 1.5 mm, p = 0.002, diff = 3.1 mm, 95% CI 1.3 to 4.8 mm). The anterior papillary muscle force increased significantly (3.9 vs. 4.6 N, p = 0.029, diff = 0.7 N, 95% CI 0.1 to 1.4 N at 120mmHg) after reconstruction. The posterior papillary muscle force, leaflet pressure force and annular pressure force did not change significantly.CONCLUSIONS: In this in vitro model, mitral valve anatomy and function were comparable between the native mitral valve and our new surgical technique for complete reconstruction of the posterior mitral leaflet and associated chordae tendineae. These promising results warrant further in vivo evaluation. |
| Databáze: | OpenAIRE |
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