A Novel Transcatheter Posterior Ventricular Anchoring Neochordoplasty Mitral Valve Repair Device.

IF 1.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Engineering and Technology Pub Date : 2024-12-26 DOI:10.1007/s13239-024-00764-9

Matthew H Park, Annabel M Imbrie-Moore, Michael J Paulsen, Yuanjia Zhu, John W MacArthur, Y Joseph Woo

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引用次数: 0

Abstract

Purpose: Advancements in minimally invasive technologies to decrease postoperative morbidity and recovery times represent a large opportunity for mitral valve repair operations. However, current technologies are unable to replicate gold standard surgical neochord implantation.

Methods: We developed a novel neochordal repair device, Minimally Invasive Ventricular Anchoring Neochordoplasty (MIVAN), which operates via transcatheter, trans-septal anchoring to the posterior ventricular wall. We evaluated MIVAN in an ex vivo heart simulator and compared it with surgical neochordal repair and MitraClip using a prolapse model.

Results: Upon MIVAN repair of the model (n = 5), regurgitant fraction was reduced from 19.46 ± 1.77% to 7.30 ± 0.99% (p = 0.01). Surgical neochordal repair reduced regurgitant fraction to 5.65 ± 0.66%, but there was no significant difference between MIVAN and surgical repair (p = 0.22). Unpaired MitraClip repair had significantly higher regurgitant fraction of 11.9 ± 1.40%, compared with those of neochord (p < 0.01) and MIVAN (p = 0.03) repairs.

Conclusions: MIVAN represents a high-value opportunity for minimally invasive mitral valve repair. The benefits of the percutaneous, trans-septal approach for implantation on the posterior ventricular wall necessitate the expanded exploration of this device as a treatment alternative.

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一种新型经导管后心室锚定新脊索成形术二尖瓣修复装置。

目的：微创技术的进步减少了术后发病率和恢复时间，为二尖瓣修复手术提供了巨大的机会。然而，目前的技术还无法复制金标准的手术新脐带植入。方法：我们开发了一种新型的新脊索修复装置，微创心室锚定新脊索成形术（MIVAN），它通过经导管，经间隔锚定到后心室壁。我们在离体心脏模拟器中评估了MIVAN，并将其与外科新索索修复和使用脱垂模型的MitraClip进行了比较。结果：经MIVAN修复模型（n = 5）后，返流分数由19.46±1.77%降至7.30±0.99% （p = 0.01）。手术新索修复使返流分数降低至5.65±0.66%，但MIVAN与手术修复无显著差异（p = 0.22）。未配对MitraClip修复的返流率为11.9±1.40%，明显高于新索修复(p)。结论：MIVAN是微创二尖瓣修复的高价值机会。由于经皮、经间隔入路植入后心室壁的优点，有必要扩大对这种装置的探索，作为一种治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Engineering and Technology Engineering-Biomedical Engineering

CiteScore

4.00

自引率

0.00%

发文量

期刊介绍： Cardiovascular Engineering and Technology is a journal publishing the spectrum of basic to translational research in all aspects of cardiovascular physiology and medical treatment. It is the forum for academic and industrial investigators to disseminate research that utilizes engineering principles and methods to advance fundamental knowledge and technological solutions related to the cardiovascular system. Manuscripts spanning from subcellular to systems level topics are invited, including but not limited to implantable medical devices, hemodynamics and tissue biomechanics, functional imaging, surgical devices, electrophysiology, tissue engineering and regenerative medicine, diagnostic instruments, transport and delivery of biologics, and sensors. In addition to manuscripts describing the original publication of research, manuscripts reviewing developments in these topics or their state-of-art are also invited.