Quantitative Imaging Assessment of an Alternative Approach to Surgical Mitral Valve Leaflet Resection: An Acute Porcine Study
| Autor: | Michael N. Young, Douglas M. Dumont, Joseph L. Fredi, W. David Merryman, Brett Byram, Phillip E. Williams, Steven M. Boronyak |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Percutaneous Radiofrequency ablation Swine 0206 medical engineering Biomedical Engineering 02 engineering and technology 030204 cardiovascular system & hematology Article law.invention 03 medical and health sciences 0302 clinical medicine law Mitral valve Cardiopulmonary bypass Medicine Animals cardiovascular diseases Mitral regurgitation Leaflet (botany) business.industry technology industry and agriculture Mitral Valve Insufficiency 020601 biomedical engineering Surgery Catheter medicine.anatomical_structure cardiovascular system Catheter Ablation Mitral Valve lipids (amino acids peptides and proteins) business Percutaneous Mitral Valve Repair |
| Popis: | This study reports the initial in vivo use of a combined radiofrequency ablation and cryo-anchoring (RFC) catheter as an alternative to surgical mitral valve (MV) leaflet resection. Radiofrequency ablation thermally shrinks enlarged collagenous tissues, providing an alternative to leaflet resection, and cryo-anchoring provides reversible attachment of a catheter to freely mobile MV leaflets. Excised porcine MVs (n = 9) were tested in a left heart flow simulator to establish treatment efficacy criteria. Resected leaflet area was quantified by tracking markers on the leaflet surface, and leaflet length reductions were directly measured on echocardiography. Leaflet area decreased by 38 ± 2.7%, and leaflet length decreased by 9.2 ± 1.8% following RFC catheter treatment. The RFC catheter was then tested acutely in healthy pigs (n = 5) under epicardial echocardiographic guidance, open-chest without cardiopulmonary bypass, using mid-ventricular free wall access. Leaflet length was quantified using echocardiography. Quantitative assessment of MV leaflet length revealed that leaflet resection was successful in 4 of 5 pigs, with a leaflet length reduction of 13.3 ± 4.6%. Histological, mechanical, and gross pathological findings also confirmed that RFC catheter treatment was efficacious. The RFC catheter significantly reduces MV leaflet size in an acute animal model, providing a possible percutaneous alternative to surgical leaflet resection. |
| Databáze: | OpenAIRE |
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