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Author Notes:

Ajit P. Yoganathan, 387 Technology Circle, Office 234, Atlanta, GA 30313-2412, Ph. (404) 894-2849, Fax.(404) 894-4243, ajit.yoganathan@bme.gatech.edu

We thank Phillips Medical systems for the use of an iE33 Matrix Echocardiography system.

We would like to acknowledge the experimental contributions of Steven A. Touchton Jr. and Joan Fernandez Esmerats.

Authors reported no conflicts of interest.

Subjects:

Research Funding:

This study was supported by a research grant awarded from the National Heart Lung and Blood Institute (R01 HL090661).

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Technology
  • Cardiac & Cardiovascular Systems
  • Engineering, Biomedical
  • Cardiovascular System & Cardiology
  • Engineering
  • Mitral valve
  • Annuloplasty
  • Computational methods
  • Chordae tendineae
  • Heart valve
  • Mitral regurgitation

Quantitative Evaluation of Annuloplasty on Mitral Valve Chordae Tendineae Forces to Supplement Surgical Planning Model Development

Tools:

Journal Title:

Cardiovascular Engineering and Technology

Volume:

Volume 5, Number 1

Publisher:

, Pages 35-43

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Computational models of the heart's mitral valve (MV) exhibit potential for preoperative surgical planning in ischemic mitral regurgitation (IMR). However challenges exist in defining boundary conditions to accurately model the function and response of the chordae tendineae to both IMR and surgical annuloplasty repair. Towards this goal, a ground-truth data set was generated by quantifying the isolated effects of IMR and mitral annuloplasty on leaflet coaptation, regurgitation, and tethering forces of the anterior strut and posterior intermediary chordae tendineae. MVs were excised from ovine hearts (N = 15) and mounted in a pulsatile heart simulator which has been demonstrated to mimic the systolic MV geometry and coaptation of healthy and chronic IMR sheep. Strut and intermediary chordae from both MV leaflets (N = 4) were instrumented with force transducers. Tested conditions included a healthy control, IMR, oversized annuloplasty, true-sized annuloplasty, and undersized mitral annuloplasty. A2-P2 leaflet coaptation length, regurgitation, and chordal tethering were quantified and statistically compared across experimental conditions. MR was successfully simulated with significant increases in MR, tethering forces for each of the chordae, and decrease in leaflet coaptation (p < .05). Compared to the IMR condition, increasing levels of downsized annuloplasty significantly reduced regurgitation, increased coaptation, reduced posteromedial papillary muscle strut chordal forces, and reduced intermediary chordal forces from the anterolateral papillary muscle (p < .05). These results provide for the first time a novel comprehensive data set for refining the ability of computational MV models to simulate IMR and varying sizes of complete rigid ring annuloplasty.

Copyright information:

© 2014 Biomedical Engineering Society.

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