HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

An annular prosthesis for the treatment of functional mitral regurgitation: finite element model analysis of a dog bone-shaped ring prosthesis.

AbstractBACKGROUND:
Undersized annuloplasty is commonly used in the treatment of functional mitral regurgitation. However, in the case of severely dilated ventricles, annuloplasty may be inadequate to counteract leaflet tethering. My colleagues and I hypothesized that modifying the shape of the annular prosthesis to account for the specific anatomy of functional mitral regurgitation could challenge extreme leaflet tethering.
METHODS:
Using finite element model simulations, we tested valve competence after the implantation of conventional D-shaped versus dog bone-shaped annuloplasty rings, the latter of which was designed to selectively reduce the septolateral dimension of the annulus. Three models were compared: model A, simulating the native mitral valve; model B, simulating the same valve after annuloplasty with a conventional D-shaped annuloplasty; and model C, simulating a dog-bone annuloplasty ring implantation. Each model was then challenged by progressively pulling the tip of the papillary muscles away from the annulus plane to simulate ventricular remodeling and leaflet tethering. Valve competence was compared in each model for each degree of leaflet tethering.
RESULTS:
After maximal leaflet tethering simulation (4-mm apical displacement of the papillary tips), the regurgitant area increase was 70.4 mm2 for model A and 52.9 mm2 for model B. In model C, the regurgitant area was only negligibly affected by papillary displacement, increasing to 3.9 mm2.
CONCLUSIONS:
An annular prosthesis with selective reduction in the septolateral dimension is more effective than a conventional prosthesis for treating leaflet tethering in functional mitral regurgitation. Use of disease-specific annular prostheses is needed to improve the results of valve reconstruction.
AuthorsFrancesco Maisano, Alberto Redaelli, Monica Soncini, Emiliano Votta, Lorenzo Arcobasso, Ottavio Alfieri
JournalThe Annals of thoracic surgery (Ann Thorac Surg) Vol. 79 Issue 4 Pg. 1268-75 (Apr 2005) ISSN: 1552-6259 [Electronic] Netherlands
PMID15797061 (Publication Type: Journal Article)
Topics
  • Animals
  • Dogs
  • Finite Element Analysis
  • Heart Valve Prosthesis Implantation (methods)
  • Mitral Valve Insufficiency (surgery)
  • Papillary Muscles (physiopathology)
  • Stress, Mechanical

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: