How Do Annuloplasty Rings Affect Mitral Annular Strains in the Normal Beating Ovine Heart?
How Do Annuloplasty Rings Affect Mitral Annular Strains in the Normal Beating Ovine Heart?
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DOI：
10.1161/circulationaha.111.084046
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发表时间：
2012-09-11
期刊：
影响因子：
37.8
通讯作者：
Miller, D. Craig
中科院分区：
文献类型：
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作者：
Bothe, Wolfgang;Rausch, Manuel K.;Miller, D. Craig
背景-我们假设在正常的绵羊心脏跳动准备中，瓣环成形术可以改变二尖瓣环的应变。方法和结果-绵羊有16个不透X线的标记被等间距地缝合在二尖瓣环周围。分别植入Edwards Cosgrove部分弹性带(COS；n=12)、St Jude全硬鞍形成形环(RSA；n=10)、Carpentier-Edwards Physio(PHY；n=11)、Edwards IMR ETlogix(ETL；n=11)和GeoForm(GEO；n=12)成形环。置环后(环)和松开环后(对照组)，用双平面电视透视获得四维标记物坐标。根据标记坐标，通过使用16条分段三次厄米特样条线的最佳拟合，生成了每个环的函数时空表示。根据二尖瓣环收缩末期从对照到二尖瓣环状态的应变与二尖瓣环切向量长度的相对变化，计算二尖瓣环的绝对总应变。此外，还计算了从对照到环状状态的平均格林-拉格朗日应变。二尖瓣环绝对总应变COS最小，ETL最大。RSA、PHY和GEO的菌株相似。结论：在健康的绵羊心脏，瓣环成形环(COS、RSA、PHY、ETL和GEO)引起的压缩应变主要集中在外侧环区，弹性部分环(COS)最小，不对称刚性环型(ETL)最大，并伴有固有的间隔-侧向缩小(ETL)。然而，具有最剧烈的固有间隔-侧向缩小(GEO)的环型引入了与生理形状的环(RSA和PHY)相似的应变，表明环对环状应变分布的影响不能从间隔-侧向缩小的程度来估计。(发行量。2012；126[附录1]：S231-S238。)
Background-We hypothesized that annuloplasty ring implantation alters mitral annular strains in a normal beating ovine heart preparation.Methods and Results-Sheep had 16 radiopaque markers sewn equally spaced around the mitral annulus. Edwards Cosgrove partial flexible band (COS; n = 12), St Jude complete rigid saddle-shaped annuloplasty ring (RSA; n = 10), Carpentier-Edwards Physio (PHY; n = 11), Edwards IMR ETlogix (ETL; n = 11), and GeoForm (GEO; n = 12) annuloplasty rings were implanted in a releasable fashion. Four-dimensional marker coordinates were obtained using biplane videofluoroscopy with the ring inserted (ring) and after ring release (control). From marker coordinates, a functional spatio-temporal representation of each annulus was generated through a best fit using 16 piecewise cubic Hermitian splines. Absolute total mitral annular ring strains were calculated from the relative change in length of the tangent vector to the annular curve as strains occurring from control to ring state at end-systole. In addition, average Green-Lagrange strains occurring from control to ring state at end-systole along the annulus were calculated. Absolute total mitral annular ring strains were smallest for COS and greatest for ETL. Strains for RSA, PHY, and GEO were similar. Except for COS in the septal mitral annular segment, all rings induced compressive strains along the entire annulus, with greatest values occurring at the lateral mitral annular segment.Conclusions-In healthy, beating ovine hearts, annuloplasty rings (COS, RSA, PHY, ETL, and GEO) induce compressive strains that are predominate in the lateral annular region, smallest for flexible partial bands (COS) and greatest for an asymmetrical rigid ring type with intrinsic septal-lateral downsizing (ETL). However, the ring type with the most drastic intrinsic septal-lateral downsizing (GEO) introduced strains similar to physiologically shaped rings (RSA and PHY), indicating that ring effects on annular strain profiles cannot be estimated from the degree of septal-lateral downsizing. (Circulation. 2012; 126[suppl 1]:S231-S238.)