Active mitral ring for post-surgical remote correction of residual mitral regurgitation on the beating heart.

Détails

ID Serval
serval:BIB_1CE33C8F4EFF
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Active mitral ring for post-surgical remote correction of residual mitral regurgitation on the beating heart.
Périodique
European Journal of Cardio-Thoracic Surgery
Auteur(s)
Tozzi P., Locca D., Gronchi F., Hayoz D., Ferrari E., von Segesser L.K., Hullin R.
ISSN
1010-7940
1873-734X (Electronic)
ISSN-L
1010-7940
Statut éditorial
Publié
Date de publication
2013
Volume
44
Numéro
2
Pages
370-374
Langue
anglais
Notes
Publication types: Journal ArticlePublication Status: ppublish. PDF type: original article
Résumé
OBJECTIVES: Residual mitral regurgitation after valve repair worsens patients' clinical outcome. Postimplant adjustable mitral rings potentially address this issue, allowing the reshaping of the annulus on the beating heart under echocardiography control. We developed an original mitral ring allowing valve geometry remodelling after the implantation and designed an animal study to assess device effectiveness in correcting residual mitral regurgitation.
METHODS: The device consists of two concentric rings: one internal and flexible, sutured to the mitral annulus and a second external and rigid. A third conic element slides between the two rings, modifying the shape of the flexible ring. This sliding element is remotely activated with a rotating tool. Animal model: in adult swine, under cardio pulmonary bypass and cardiac arrest, we shortened the primary chordae of P2 segment to reproduce Type III regurgitation and implanted the active ring. We used intracardiac ultrasound to assess mitral regurgitation and the efficacy of the active ring to correct it.
RESULTS: Severe mitral regurgitation (3+ and 4+) was induced in eight animals, 54 ± 6 kg in weight. Vena contracta width decreased from 0.8 ± 0.2 to 0.1 cm; proximal isovelocity surface area radius decreased from 0.8 ± 0.2 to 0.1 cm and effective regurgitant orifice area decreased from 0.50 ± 0.1 to 0.1 ± 0.1 cm(2). Six animals had a reversal of systolic pulmonary flow that normalized following the activation of the device. All corrections were reversible.
CONCLUSIONS: Postimplant adjustable mitral ring corrects severe mitral regurgitation through the reversible modification of the annulus geometry on the beating heart. It addresses the frequent and morbid issue of recurrent mitral valve regurgitation.
Pubmed
Web of science
Open Access
Oui
Création de la notice
13/08/2013 15:18
Dernière modification de la notice
08/05/2019 15:21
Données d'usage