Chordal force profile after neochordal repair of anterior mitral valve prolapse: An ex vivo study.
Chordal force profile after neochordal repair of anterior mitral valve prolapse: An ex vivo study.
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二尖瓣前瓣脱垂的新chordal修复后的串联力谱：离体研究。
DOI：
10.1016/j.xjon.2023.04.011
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发表时间：
2023-09
期刊：
影响因子：
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通讯作者：
Woo, Y Joseph
中科院分区：
文献类型：
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作者：
Yajima, Shin;Zhu, Yuanjia;Stark, Charles J;Wilkerson, Robert J;Park, Matthew H;Stefan, Elde;Woo, Y Joseph
本研究旨在利用离体心脏模拟器对伴有不同程度二尖瓣残余返流的前瓣脱垂患者进行新索修复后，对前主次索的力谱进行生物力学评价。试验选用8只健康猪二尖瓣。用光纤光栅传感器测量了A2节段主、次弦的弦力。在A2段切除2根主脊索，形成前瓣脱垂模型。采用2对新声带进行修复。不同的新索长度模拟二尖瓣修复后残余返流，返流分数分别为bbb30 %（中度）、10% ~ 30%（轻度）和<10%（完全修复）。基线、中度、轻度、完全修复组的反流率分别为4.7%±0.8%、35.8%±2.1%、19.8%±2.0%、6.0%±0.7% （P < 0.001）。中度组主前索峰值力（0.43±0.06 N）高于基线组（0.19±0.04 N, P = 0.011）、轻度组（0.23±0.05 N, P = 0.041）和完全修复组（0.21±0.03 N, P = 0.006）。此外，中度组的前次脊索峰值力（1.67±0.17 N）高于基线组（0.64±0.13 N, P = 0.003）、轻度组（0.84±0.24 N, P = 0.019）和完全修复组（0.68±0.14 N, P = 0.001）。在基线和完全修复以及轻度和完全修复之间，观察到原发性和继发性前脊索的峰值和平均力无显著差异。在我们的离体前瓣脱垂模型中，新索修复后中度残留二尖瓣反流与前原声带和继发性前索力增加有关。这种弦索力分布的差异可能影响修复的长期耐久性，为修复二尖瓣前脱垂时获得最小的反流提供了生物力学证据。
This study aimed to biomechanically evaluate the force profiles on the anterior primary and secondary chordae after neochord repair for anterior valve prolapse with varied degrees of residual mitral regurgitation using an ex vivo heart simulator. The experiment used 8 healthy porcine mitral valves. Chordal forces were measured using fiber Bragg grating sensors on primary and secondary chordae from A2 segments. The anterior valve prolapse model was generated by excising 2 primary chordae at the A2 segment. Neochord repair was performed with 2 pairs of neochords. Varying neochord lengths simulated postrepair residual mitral regurgitation with regurgitant fraction at >30% (moderate), 10% to 30% (mild), and <10% (perfect repair). Regurgitant fractions of baseline, moderate, mild, and perfect repair were 4.7% ± 0.8%, 35.8% ± 2.1%, 19.8% ± 2.0%, and 6.0% ± 0.7%, respectively (P < .001). Moderate had a greater peak force of the anterior primary chordae (0.43 ± 0.06 N) than those of baseline (0.19 ± 0.04 N; P = .011), mild (0.23 ± 0.05 N; P = .041), and perfect repair (0.21 ± 0.03 N; P = .006). In addition, moderate had a greater peak force of the anterior secondary chordae (1.67 ± 0.17 N) than those of baseline (0.64 ± 0.13 N; P = .003), mild (0.84 ± 0.24 N; P = .019), and perfect repair (0.68 ± 0.14 N; P = .001). No significant differences in peak and average forces on both primary and secondary anterior chordae were observed between the baseline and perfect repair as well as the mild and perfect repair. Moderate residual mitral regurgitation after neochord repair was associated with increased anterior primary and secondary chordae forces in our ex vivo anterior valve prolapse model. This difference in chordal force profile may influence long-term repair durability, providing biomechanical evidence in support of obtaining minimal regurgitation when repairing mitral anterior valve prolapse.
使用创新的3D打印左心模拟器的急性乳头肌肉破裂疾病模型的生物力学工程分析。
影响因子：
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作者：
通讯作者：
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一种新型的3D打印优先二尖瓣后环扩张装置描绘了离体心脏模拟器中的反流开始阈值。
影响因子：
2.2
作者：
Imbrie-Moore AM;Paullin CC;Paulsen MJ;Grady F;Wang H;Hironaka CE;Farry JM;Lucian HJ;Woo YJ
通讯作者：
Woo YJ