TY - JOUR
T1 - Mitral Valve Translocation
T2 - Optimization of Patch Geometry in an Ex Vivo Model of Secondary Mitral Regurgitation
AU - Quinn, Rachael W.
AU - Pasrija, Chetan
AU - Bernstein, Daniel A.
AU - Holmes, Sari D.
AU - Gammie, James S.
N1 - Funding Information:
This work was supported through grateful patient funds from the University of Maryland’s Division of Cardiac Surgery.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022/6
Y1 - 2022/6
N2 - Abstract: Optimal translocation patch width for functional mitral regurgitation (FMR) treatment was evaluated in an air-filled ex vivo system. FMR was created in 19 isolated swine hearts by annular dilation and papillary muscle displacement. Frustum-shaped pericardial patches of varying widths (Group 1 = 0.5 cm; Group 2 = 1.0 cm; Group 3 = 1.5 cm) were implanted and imaged via a 3D-structured light scanner. Median leaflet coaptation decreased (P < 0.001) from 5.5 ± 2.0 mm at baseline to 2.4 ± 1.3 mm following FMR creation. Translocation repair increased coaptation length over FMR levels by 2.2 mm in Group 1 (P < 0.001), 4.6 mm in Group 2 (P < 0.001), and 4.7 mm in Group 3 (P < 0.001). After repair, no significant differences were found between groups for annular height, circularity index, tenting height, tenting area, and non-coapting surface area. The supranormal coaptation and minimal valve geometric changes support using a 1.0- or 1.5-cm translocation patch for FMR treatment. Graphical abstract: Implantation of a 1.0-cm or 1.5-cm circumferential pericardial patch (mitral valve translocation) increases leaflet coaptation length without significantly altering valve geometry.
AB - Abstract: Optimal translocation patch width for functional mitral regurgitation (FMR) treatment was evaluated in an air-filled ex vivo system. FMR was created in 19 isolated swine hearts by annular dilation and papillary muscle displacement. Frustum-shaped pericardial patches of varying widths (Group 1 = 0.5 cm; Group 2 = 1.0 cm; Group 3 = 1.5 cm) were implanted and imaged via a 3D-structured light scanner. Median leaflet coaptation decreased (P < 0.001) from 5.5 ± 2.0 mm at baseline to 2.4 ± 1.3 mm following FMR creation. Translocation repair increased coaptation length over FMR levels by 2.2 mm in Group 1 (P < 0.001), 4.6 mm in Group 2 (P < 0.001), and 4.7 mm in Group 3 (P < 0.001). After repair, no significant differences were found between groups for annular height, circularity index, tenting height, tenting area, and non-coapting surface area. The supranormal coaptation and minimal valve geometric changes support using a 1.0- or 1.5-cm translocation patch for FMR treatment. Graphical abstract: Implantation of a 1.0-cm or 1.5-cm circumferential pericardial patch (mitral valve translocation) increases leaflet coaptation length without significantly altering valve geometry.
KW - Autologous pericardium
KW - Functional mitral regurgitation
KW - Heart failure
KW - Mitral valve repair
KW - Secondary mitral regurgitation
UR - http://www.scopus.com/inward/record.url?scp=85119071833&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85119071833&partnerID=8YFLogxK
U2 - 10.1007/s12265-021-10182-0
DO - 10.1007/s12265-021-10182-0
M3 - Article
C2 - 34782943
AN - SCOPUS:85119071833
SN - 1937-5387
VL - 15
SP - 666
EP - 675
JO - Journal of cardiovascular translational research
JF - Journal of cardiovascular translational research
IS - 3
ER -