Suture Forces in Undersized Mitral Annuloplasty: Novel Device and Measurements

• Type of Material: Article
• Authors: Andrew Siefert, Emory University; Eric Pierce, Emory University; Madonna Lee, University of Pennsylvania; Morten Jensen, Aarhus University Hospital; Chikashi Aoki, University of Pennsylvania; Satoshi Takebayashi, University of Pennsylvania; Robert Gorman, University of Pennsylvania; Joseph Gorman, University of Pennsylvania; Ajit Yoganathan, Emory University
• Language: English
• Date: 2014-07-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 by The Society of Thoracic Surgeons.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.athoracsur.2014.02.036
• Title of Journal or Parent Work: Annals of Thoracic Surgery
• ISSN: 0003-4975
• Volume: 98
• Issue: 1
• Start Page: 305
• End Page: 309
• Grant/Funding Information: This study was supported by a grant from the National Heart, Lung and Blood Institute (R01HL113216).
• Keywords: Surgery; Cardiac & Cardiovascular Systems; RING DEHISCENCE; Respiratory System; Life Sciences & Biomedicine; Science & Technology; REGURGITATION; Cardiovascular System & Cardiology
• Research Categories: Engineering, Biomedical; Health Sciences, Medicine and Surgery

Abstract

Purpose: To demonstrate the first use of a novel technology for quantifying suture forces on annuloplasty rings to better understand the mechanisms of ring dehiscence. Description: Force transducers were developed, attached to a size 24 Physio ring, and implanted in the mitral annulus of an ovine animal. Ring suture forces were measured after implantation and for cardiac cycles reaching peak left ventricular pressures (LVP) of 100, 125, and 150 mm Hg. Evaluation: After implantation of the undersized ring to the flaccid annulus, the mean suture force was 2.0 ± 0.6 N. During cyclic contraction, the anterior ring suture forces were greater than the posterior ring suture forces at peak LVPs of 100 mm Hg (4.9 ± 2.0 N vs 2.1 ± 1.1 N), 125 mm Hg (5.4 ± 2.3 N vs 2.3 ± 1.2 N), and 150 mm Hg (5.7 ± 2.4 N vs 2.4 ± 1.1 N). The largest force was 7.4 N at 150 mm Hg. Conclusions: The preliminary results demonstrate trends in annuloplasty suture forces and their variation with location and LVP. Future studies will significantly contribute to clinical knowledge by elucidating the mechanisms of ring dehiscence while improving annuloplasty ring design and surgical repair techniques.