Ex vivo biomechanical analysis of flexible versus rigid annuloplasty rings in mitral valves using a novel annular dilation system.
Ex vivo biomechanical analysis of flexible versus rigid annuloplasty rings in mitral valves using a novel annular dilation system.
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DOI：
10.1186/s12872-022-02515-x
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发表时间：
2022-02-26
影响因子：
2.1
通讯作者：
Woo YJ
中科院分区：
文献类型：
--
作者：
Zhu Y;Imbrie-Moore AM;Wilkerson RJ;Paulsen MJ;Park MH;Woo YJ
二尖瓣环成形术环可恢复瓣环尺寸以增加瓣叶接合，是二尖瓣修复的基本组成部分。然而，缺乏瓣环成形术环的生物力学评估。我们的目标是使用离体二尖瓣环扩张模型对柔性和刚性瓣环成形术环进行生物力学分析。使用 3D 打印扩张器将连合间距离为 28 毫米的幼年猪二尖瓣 (n = 4) 扩张至连合间距离 40 毫米，并缝合到弹性支架上。光纤布拉格光栅传感器固定在天然腱索上以测量弦力。使用尺寸为 28 的刚性和柔性瓣环成形环以随机顺序修复瓣膜。收集血流动力学数据、超声心动图和弦力测量值。 二尖瓣环扩张导致小叶接合高度降低和二尖瓣反流分数增加。与扩张后相比，柔性和刚性瓣环成形术环均有效地增加了小叶接合高度。刚性环瓣环成形术修复显着降低了二尖瓣反流分数。柔性瓣环成形环修复降低了弦力变化率（7.1 ± 4.4 N/s 与 8.6± 5.9 N/s，p = 0.02）和峰值力（0.6 ± 0.5 N 与 0.7 ± 0.6 N）， p = 0.01) 与扩张后的结果相比。与柔性环瓣环成形修复相比，刚性瓣环成形环修复与更高的弦力变化率（9.8±±5.8 N/s，p = 0.0001）和峰值力（0.7± 0.5 N，p = 0.01）相关。刚性和柔性瓣环成形术环均可有效增加二尖瓣小叶接合高度。尽管与柔性瓣环成形环相比，刚性瓣环成形环的弦应力稍高，但它在减少二尖瓣反流方面更有效。这项研究可能有助于指导最佳瓣环成形术环的设计，以进一步改善患者的治疗效果。
Mitral annuloplasty rings restore annular dimensions to increase leaflet coaptation, serving a fundamental component in mitral valve repair. However, biomechanical evaluations of annuloplasty rings are lacking. We aim to biomechanically analyze flexible and rigid annuloplasty rings using an ex vivo mitral annular dilation model. Juvenile porcine mitral valves (n = 4) with intercommissural distance of 28 mm were dilated to intercommissural distances of 40 mm using a 3D-printed dilator and were sewn to an elastic mount. Fiber bragg grating sensors were anchored to native chordae to measure chordal forces. The valves were repaired using size 28 rigid and flexible annuloplasty rings in a random order. Hemodynamic data, echocardiography, and chordal force measurements were collected. Mitral annular dilation resulted in decreased leaflet coaptation height and increased mitral regurgitation fraction. Both the flexible and rigid annuloplasty rings effectively increased leaflet coaptation height compared to that post dilation. Rigid ring annuloplasty repair significantly decreased the mitral regurgitation fraction. Flexible annuloplasty ring repair reduced the chordal rate of change of force (7.1 ± 4.4 N/s versus 8.6 ± 5.9 N/s, p = 0.02) and peak force (0.6 ± 0.5 N versus 0.7 ± 0.6 N, p = 0.01) compared to that from post dilation. Rigid annuloplasty ring repair was associated with higher chordal rate of change of force (9.8 ± 5.8 N/s, p = 0.0001) and peak force (0.7 ± 0.5 N, p = 0.01) compared to that after flexible ring annuloplasty repair. Both rigid and flexible annuloplasty rings are effective in increasing mitral leaflet coaptation height. Although the rigid annuloplasty ring was associated with slightly higher chordal stress compared to that of the flexible annuloplasty ring, it was more effective in mitral regurgitation reduction. This study may help direct the design of an optimal annuloplasty ring to further improve patient outcomes.
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影响因子：
3.8
作者：
Rausch, Manuel K.;Bothe, Wolfgang;Kvitting, John-Peder Escobar;Swanson, Julia C.;Miller, D. Craig;Kuhl, Ellen
通讯作者：
Kuhl, Ellen
DOI：
10.1115/1.4044142
发表时间：
2020-01-01
影响因子：
1.7
作者：
Paulsen, Michael J.;Bae, Jung Hwa;Woo, Y. Joseph
通讯作者：
Woo, Y. Joseph
影响因子：
24
作者：
Gertz, Zachary M.;Raina, Amresh;Silvestry, Frank E.
通讯作者：
Silvestry, Frank E.
影响因子：
168.9
作者：
Nkomo, Vuyisile T.;Gardin, Julius M.;Enriquez-Sarano, Maurice
通讯作者：
Enriquez-Sarano, Maurice
DOI：
10.1111/j.1540-8175.2009.00904.x
发表时间：
2009-09-01
影响因子：
1.5
作者：
Kihara, Takashi;Gillinov, A. Marc;Shiota, Takahiro
通讯作者：
Shiota, Takahiro