scholarly journals Uniformity in bioprosthetic mitral valve sizing -- when will we get there?

2021 ◽  
Author(s):  
Cian Tan ◽  
Mohamad Bashir ◽  
Mohammed Idhrees
Keyword(s):  
Mitral Valve ◽  
Experimental Technique ◽  
Porcine Model ◽  
Biomechanical Properties ◽  
Bioprosthetic Valve ◽  
Valve Repair ◽  
Mitral Valves ◽  
Uniform Approach ◽  
Bioprosthetic Valves ◽  
Bioprosthetic Mitral Valve

Much has changed since the introduction of surgical valve repair in the 1950s, from the introduction bioprosthetic valves to percutaneous approaches to valve repair. Yet, despite substantial advancements in bioprosthetic valve technology, there has been a lack of direct, independent comparison between bioprosthetic mitral valve devices, accompanied by a marked heterogeneity in approaches to the sizing and selection thereof. Wang et al. have hence endeavoured to evaluate, head-to-head, the technical successes and biomechanical outcomes associated with three different bioprosthetic mitral valves (Epic, Abbott, IL; Mosaic, Medtronic, MN; Mitris Resilia, Edwards Lifesciences, CA) in a porcine model, under standardised haemodynamic and anatomical conditions. With a robust experimental technique, they have made clear the heterogeneity in both sizing and biomechanical properties between bioprosthetic mitral valves, and have further emphasised the need for a uniform approach to the manufacturing and sizing of bioprosthetic valves.

A novel user-friendly transcatheter edge-to-edge mitral valve repair device in a porcine model

2018 ◽  
Vol 93 (7) ◽  
pp. 1354-1360 ◽  
Author(s):  
Wenzhi Pan ◽  
Cuizhen Pan ◽  
Hasan Jilaihawi ◽  
Lai Wei ◽  
Yue Tang ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Porcine Model ◽  
Valve Repair ◽  
User Friendly

Minimally Invasive Mitral Valve Replacement Using the Valve-in-valve Technique

2009 ◽  
Vol 4 (4) ◽  
pp. 221-224 ◽  
Author(s):  
Orlando Santana ◽  
Francisco A. Tarrazzi ◽  
Joseph Lamelas
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Minimally Invasive ◽  
Pulmonary Edema ◽  
Left Atrium ◽  
Bioprosthetic Valve ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Valve In Valve ◽  
Bioprosthetic Mitral Valve

A 90-year-old woman with two previous mitral valve replacements, presented with pulmonary edema due to mitral regurgitation from degeneration of her bioprosthetic mitral valve. A minimally invasive approach was used to replace the bioprosthetic mitral valve. During surgery, the bioprosthetic valve was noted to be too adherent to the endocardium of the left atrium, making removal of the prosthesis not only difficult, but also potentially harmful. The new bioprosthetic valve was instead placed using a valve-in-valve approach.

scholarly journals Mechanical testing of glutaraldehyde cross-linked mitral valves. Part one: In vitro mechanical behaviour

2020 ◽  
pp. 095441192097589
Author(s):  
Rhiannon Northeast ◽  
Matthew Constable ◽  
Hanna E Burton ◽  
Bernard M Lawless ◽  
Vera Gramigna ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Peak Pressure ◽  
Systolic Pressure ◽  
Initial Assessment ◽  
Cross Linking ◽  
Mitral Valves ◽  
Endothelial Denudation ◽  
Glutaraldehyde Solution ◽  
Bioprosthetic Mitral Valve

The aim of this study was to perform an initial assessment, in vitro, of the feasibility of using a glutaraldehyde cross-linked porcine mitral valve to retain acute functionality, focusing on assessing mitral regurgitation. Six porcine hearts were tested using an in vitro simulator. Testing was repeated following cross-linking of mitral valves; where cross-linking was achieved by placing them in a glutaraldehyde solution. The simulator enabled systolic pressure on the ventricular side of the valve to be mimicked. Following testing, mitral valve leaflets underwent Scanning Electron Microscopy of the ventricular surface of both the anterior and posterior leaflets (1 cm2 samples). The peak pressure withstood by cross-linked valves was significantly lower than for untreated valves (108 mmHg cf. 128 mmHg for untreated valves; p  < 0.05). The peak pressure was typically reached 0.5 s later than for the untreated valve. While both cross-linked and untreated valves exhibited endothelium denudation, the unfixed valve had less endothelial loss. Glutaraldehyde cross-linking of porcine mitral valves may be of potential value in assessing improved bioprosthetic mitral valve replacements. However, a more immobile valve exhibiting endothelial denudation (i.e. sclerosis) was a possible concerns identified following in vitro acute assessment.

Biomechanical Properties of Human Coronary Sinus for Minimally Invasive Mitral Valve Repair

2010 ◽  
Author(s):  
Thuy Pham ◽  
Wei Sun
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Operative Mortality ◽  
Treatment Options ◽  
Mitral Valve Regurgitation ◽  
Biomechanical Properties ◽  
Current Treatment ◽  
Valve Repair ◽  
Surgical Treatments

Mitral valve regurgitation, the leakage of blood back to the left atrium during systole, is a significant cause of morbidity and mortality. The current treatment options for symptomatic mitral regurgitation are mitral valve repair and replacement. However, the operative mortality for both of these treatments remains substantial (1). Furthermore, these treatments are often not referred for elderly patients with comorbidities. Thus, there is a pressing need for less invasive, non-surgical treatments of mitral regurgitation.

scholarly journals A Case of Acute Massive Bioprosthetic Mitral Valve Thrombosis Leading to Fulminant Heart Failure

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Zeid Nesheiwat ◽  
Pinang Shastri ◽  
Rohit Vyas ◽  
Cameron Burmeister ◽  
Robert Grande ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mitral Valve ◽  
Bioprosthetic Valve ◽  
Diagnosis And Management ◽  
Valve Thrombosis ◽  
Bioprosthetic Mitral Valve

Bioprosthetic valve thrombosis has been considered to be extremely unlikely, typically freeing patients from the potential complications of long-term anticoagulation. However, there have been several documented cases of bioprosthetic valve thrombosis and there are concerns that its incidence may be underreported. Experience with diagnosis and management of this condition is limited. Here, we present a case of acute massive bioprosthetic mitral thrombosis manifesting as fulminant heart failure.

Obstructive bioprosthetic mitral valve thrombosis

2020 ◽  
Vol 16 (5) ◽  
pp. 433-438
Author(s):  
Suchith Shetty ◽  
Aaqib H Malik ◽  
Wilbert S Aronow ◽  
Kimberly S Staffey ◽  
Ramzi El Accaoui
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Multimodality Imaging ◽  
Case Series ◽  
Disease Status ◽  
Bioprosthetic Valve ◽  
Surveillance Imaging ◽  
Valve Thrombosis ◽  
History Of ◽  
Bioprosthetic Mitral Valve

Bioprosthetic valve thrombosis (BPVT) is not uncommon but can be under diagnosed due to the lack of awareness and technical limitations of echocardiography. When suspecting BPVT, it is imperative to consider multimodality imaging to establish the diagnosis as early treatment can alter the clinical course. Here we present a case series of two patients with a history of rheumatic heart disease status post bioprosthetic mitral valve replacement who presented with acute heart failure symptoms. In both cases, supplemental imaging with real-time 3D echocardiography was critical in establishing a diagnosis of BPVT, resulting in timely treatment. These cases support updating current guidelines for the management of patients with bioprosthetic valve replacement to include more frequent surveillance imaging even if patients are asymptomatic.

P916The effect of a novel, user-friendly, transcatheter edge-to-edge mitral valve repair device in a porcine model of mitral regurgitation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
Z Ge ◽  
C Pan ◽  
X Shu ◽  
W Pan ◽  
D Zhou ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Porcine Model ◽  
P Value ◽  
Hemodynamic Parameters ◽  
Valve Repair ◽  
A New Technique ◽  
Grade 3 ◽  
User Friendly

Abstract Objective A new technique has been devised to treat mitral regurgitation (MR) through the transapical route by replicating the edge-to-edge repair surgery. This system encompasses an easy-to-use leaflet clamp and a smaller-sized delivery system (14F–16F). We aimed to evaluate the effectiveness of this device in a porcine model of acute MR. Methods Acute MR was induced in 36 anesthetized porcine subjects by severing the major chordae supporting the corresponding segment of the leaflet. This device was then transapically implanted on the prolapsing segment under 3D epicardial echocardiographic guidance. All of the animals were killed 30 days after the procedure to verify the proper location of the implanted devices. Results Cutting the major chordae induced an eccentric MR jet (MR grade: 3+, 27.8%/4+, 72.2%) in all of the animals. Every single pig was then successfully implanted with one clamp. The duration of catheterization ranged from 18 to 40 minutes. Overt MR reduction was observed following the procedure through echocardiography; residual MR was mild in 8 cases, trivial in 19 cases, and absent in 9 cases. In terms of hemodynamic parameters, the mean and maximum mitral valve pressure gradients were increased significantly (p<0.01), but these values were less than 4 mmHg in all of the cases. Autopsy demonstrated that all but one device were precisely placed to clip the prolapsing segment of the mitral valve, and there was no evidence of thrombosis, thromboembolism or impairment of the cardiac structure. Table 1. Changes in hemodynamic parameters, cardiac size, and functional parameters after the procedure Preoperation Postoperation P value MR-maxA (mm2) 7.27±2.13 1.54±1.29 0.000 MVPG-max (mmHg) 1.95±0.47 3.66±0.62 0.000 MVPG-mean (mmHg) 0.87±0.31 1.7±0.28 0.000 LVEDD (mm) 46.08±2.85 46.44±3.53 0.239 LVESD (mm) 29.11±3.44 29.08±3.62 0.940 LVEF (%) 66.53±6.4 67.14±4.93 0.256 LAD (mm) 35.75±2.24 36.42±1.99 0.057 LAA (mm2) 12.95±2.22 12.64±1.55 0.301 Figure 1 Conclusions Transapical implantation of the novel mitral valve repair device is effective and safe in reducing acutely induced MR in pigs; thus, suggesting that it has great potential for clinical benefit in patients with MR. Acknowledgement/Funding Shanghai Science and Technology Committee

scholarly journals Finite Element Modeling of Mitral Valve Repair

2016 ◽  
Vol 138 (2) ◽  
Author(s):  
Ashley E. Morgan ◽  
Joe Luis Pantoja ◽  
Jonathan Weinsaft ◽  
Eugene Grossi ◽  
Julius M. Guccione ◽  
...  
Keyword(s):  
Finite Element ◽  
Mitral Valve ◽  
Complex Structure ◽  
Dynamic Structure ◽  
Biomechanical Properties ◽  
Proper Function ◽  
Valve Repair ◽  
Native Valve ◽  
Complex Interactions ◽  
Valve Diseases

The mitral valve is a complex structure regulating forward flow of blood between the left atrium and left ventricle (LV). Multiple disease processes can affect its proper function, and when these diseases cause severe mitral regurgitation (MR), optimal treatment is repair of the native valve. The mitral valve (MV) is a dynamic structure with multiple components that have complex interactions. Computational modeling through finite element (FE) analysis is a valuable tool to delineate the biomechanical properties of the mitral valve and understand its diseases and their repairs. In this review, we present an overview of relevant mitral valve diseases, and describe the evolution of FE models of surgical valve repair techniques.

scholarly journals Comparison of a new bioprosthetic mitral valve to other commercially available devices under controlled conditions in a porcine model

2021 ◽  
Author(s):  
Dee Dee Wang ◽  
Thomas G. Caranasos ◽  
Brian P. O'Neill ◽  
Richard S. Stack ◽  
William W. O'Neill ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Porcine Model ◽  
Controlled Conditions ◽  
Bioprosthetic Mitral Valve
Sign in / Sign up

Export Citation Format

Share Document