Isolated effect of geometry on mitral valve function for in silico model development.
Andrew W. Siefert,Jean-Pierre Rabbah,Neelakantan Saikrishnan,Karyn S. Kunzelman,Ajit Prithivaraj Yoganathan +4 more
TLDR
A ground-truth data-set is generated by quantifying the effects of isolated mitral annular flattening, asymmetric annular dilatation, symmetric papillary muscle (PM) displacement and asymmetric PM displacement on leaflet coaptation, mitral regurgitation (MR) and anterior leaflet strain to improve MV computational models and provide a platform for the development of future surgical planning tools.Abstract:
Computational models for the heart's mitral valve (MV) exhibit several uncertainties that may be reduced by further developing these models using ground-truth data-sets. This study generated a ground-truth data-set by quantifying the effects of isolated mitral annular flattening, symmetric annular dilatation, symmetric papillary muscle (PM) displacement and asymmetric PM displacement on leaflet coaptation, mitral regurgitation (MR) and anterior leaflet strain. MVs were mounted in an in vitro left heart simulator and tested under pulsatile haemodynamics. Mitral leaflet coaptation length, coaptation depth, tenting area, MR volume, MR jet direction and anterior leaflet strain in the radial and circumferential directions were successfully quantified at increasing levels of geometric distortion. From these data, increase in the levels of isolated PM displacement resulted in the greatest mean change in coaptation depth (70% increase), tenting area (150% increase) and radial leaflet strain (37% increase) while a...read more
Citations
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Utilization of Engineering Advances for Detailed Biomechanical Characterization of the Mitral–Ventricular Relationship to Optimize Repair Strategies: A Comprehensive Review
A. van Kampen,Jordan Morningstar,G. Goudot,Neil B. Ingels,Jonathan F. Wenk,Yasufumi Nagata,Koushiar M Yaghoubian,Russell A. Norris,Michael A. Borger,Serguei Melnitchouk,Robert A. Levine,Morten O. Jensen +11 more
TL;DR: In this article , an overview and narrative of the evolution of mitral valve therapy with special focus on two diseases frequently encountered by cardiac surgeons and interventional cardiologists: ischemic and degenerative mitral regurgitation.
References
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Benjamin H. Trichon,G. Michael Felker,Linda K. Shaw,Christopher H. Cabell,Christopher M. O'Connor +4 more
TL;DR: MR was found to be an independent predictor of mortality after multivariable analysis and present in those with ischemic and nonischemic cardiomyopathies who underwent cardiac catheterization between 1986 and 2000.
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Integrated mechanism for functional mitral regurgitation: leaflet restriction versus coapting force: in vitro studies.
TL;DR: Functional mitral regurgitation also paradoxically decreases in midsystole, despite peak transmitral driving pressure, suggesting a change in the force balance acting to create a regurgitant orifice, with rising transmitral pressure counteracting forces that restrict leaflet closure.
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Restrictive Mitral Annuloplasty Cures Ischemic Mitral Regurgitation and Heart Failure
Jerry Braun,Nico R. Van de Veire,Robert J.M. Klautz,Michel I.M. Versteegh,Eduard R. Holman,Jos J.M. Westenberg,Eric Boersma,Ernst E. van der Wall,Jeroen J. Bax,Robert A.E. Dion +9 more
TL;DR: Intermediate-term cutoff values for left ventricular reverse remodeling proved to be predictors for late mortality, and for patients with preoperative LVEDD of 65 mm or less, restrictive mitral annuloplasty with revascularization provides a cure for ischemic mitral regurgitation and heart failure; however, whenLVEDD exceeds 65 mm, outcome is poor and a ventricular approach should be considered.
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Large Animal Models of Heart Failure A Critical Link in the Translation of Basic Science to Clinical Practice
TL;DR: Large animal models recapitulating the clinical HF phenotype in large animal models can allow for the translation of basic science discoveries into clinical therapies and translate basic science to clinical applications have successfully traveled the journey from bench to bedside.
Development of Therapeutics for Heart Failure Large Animal Models of Heart Failure A Critical Link in the Translation of Basic Science to Clinical Practice
TL;DR: In this paper, the authors used large animal models of congestive heart failure (HF) for the elucidation of biological pathways involved in HF and the development and refinement of HF therapies.