Beating-heart, off-pump mitral valve repair by implantation of artificial chordae tendineae: An acute in vivo animal study
Beating-heart, off-pump mitral valve repair by implantation of artificial chordae tendineae: An acute in vivo animal study
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DOI：
10.1016/j.jtcvs.2008.09.004
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发表时间：
2009-01-01
影响因子：
6
通讯作者：
Speziali, Giovanni
中科院分区：
文献类型：
--
作者：
Bajona, Pietro;Katz, William E.;Speziali, Giovanni
目的：评价一种新的非体外循环二尖瓣修复技术在猪急性二尖瓣返流模型中恢复瓣膜功能的有效性。方法：在6只麻醉猪中通过切割前叶腱索诱导急性二尖瓣返流。然后在心外膜超声心动图引导下经心尖将人工腱索植入脱垂节段并固定在左心室心尖外。所有的心内操作进行非体外循环，通过刺伤切口上的左心室application.Results：切割前叶腱索造成偏心，后定向喷射二尖瓣返流，可以通过彩色多普勒超声显像。经左心室心尖部植入腱索后，4只动物的瓣膜返流完全消除，2只动物的返流减少。人工腱索张力的术中测量给出了类似的值，为本地chorde.Conclusions：关闭泵，经心尖植入人工腱索之间的脱垂二尖瓣前叶和左心室心尖部是有效的，在减少急性诱导二尖瓣返流。计划进行长期研究，以评估该动物模型的稳定性。
Objective: To evaluate the effectiveness of a new off-pump mitral valve repair technology in restoring valve competency in a porcine model of acute mitral regurgitation.Methods: Acute mitral regurgitation was induced in 6 anesthetized pigs by cutting anterior leaflet chordae. Artificial chordae were then transapically implanted on the prolapsing segment under epicardial echocardiographic guidance and secured outside the left ventricular apex. All intracardiac manipulations were performed off-pump, through a stab wound incision on the left ventricular apex.Results: Cutting the anterior leaflet chordae caused an eccentric, posteriorly directed jet of mitral regurgitation that could be visualized by color Doppler sonography. Implantation of chordae through the left ventricular apex completely eliminated valve regurgitation in 4 animals and reduced regurgitation in 2. Intraoperative measurement of artificial chordal tensions gave similar values to those reported for native chordae.Conclusions: Off-pump, transapical implantation of artificial chordae between a prolapsing anterior mitral valve leaflet and the left ventricular apex was effective in reducing acutely induced mitral regurgitation. Long-term studies are planned to assess the stability in this animal model.