Cardiovascular engineering and technology · 2024
A Novel Transcatheter Posterior Ventricular Anchoring Neochordoplasty Mitral Valve Repair Device.
СтатьяСравнительное исследованиеПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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Park Matthew H, Imbrie-Moore Annabel M, Paulsen Michael J, Zhu Yuanjia, MacArthur John W, Woo Y Joseph
Аннотация
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.
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.