JTCVS open · 2021
Biomechanical engineering analysis of commonly utilized mitral neochordae.
СтатьяНазвание и аннотация: Перевод в очереди
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Marin-Cuartas Mateo, Imbrie-Moore Annabel M, Zhu Yuanjia, Park Matthew H, Wilkerson Robert, Leipzig Matthew, Borger Michael A, Woo Y Joseph
Аннотация
OBJECTIVE: To evaluate the suture rupture forces of commonly clinically utilized neochord repair techniques to identify the most biomechanically resistant most biomechanically resistant technique.
METHODS: Several types of neochord techniques (standard interrupted neochordae, continuous running neochordae, and loop technique), numbers of neochordae, and suture calibers (polytetrafluoroethylene CV-3 to CV-6) were compared. To perform the tests, both ends of the neochordae were loaded in a tensile force analysis machine. During the test, the machine applied tension to the neochord until rupture was achieved. The tests were performed 3 times for each variation, and the rupture forces were averaged for statistical analysis.
RESULTS: Rupture force was significantly higher for running neochordae relative to interrupted neochordae (P < .01). However, a single rupture in the running technique resulted in failure of the complete neochord system. For both running and interrupted neochordae, a greater number of neochordae as well as a thicker suture caliber significantly increased the neochord rupture force (P < .01). The loop technique ruptured at significantly lower forces compared with the other 2 techniques (P < .01). A greater number of loops did not significantly increase the rupture force of loop neochordae. Observed rupture forces for all techniques were higher than those normally observed in physiologic conditions.
CONCLUSIONS: Under experimental conditions, the running neochord technique has the best mechanical performance due to an increased rupture force. If using running neochordae, more than 1 independent set of multiple running neochordae are advised (ie, >2 independent sets of multiple running neochordae in each set).
METHODS: Several types of neochord techniques (standard interrupted neochordae, continuous running neochordae, and loop technique), numbers of neochordae, and suture calibers (polytetrafluoroethylene CV-3 to CV-6) were compared. To perform the tests, both ends of the neochordae were loaded in a tensile force analysis machine. During the test, the machine applied tension to the neochord until rupture was achieved. The tests were performed 3 times for each variation, and the rupture forces were averaged for statistical analysis.
RESULTS: Rupture force was significantly higher for running neochordae relative to interrupted neochordae (P < .01). However, a single rupture in the running technique resulted in failure of the complete neochord system. For both running and interrupted neochordae, a greater number of neochordae as well as a thicker suture caliber significantly increased the neochord rupture force (P < .01). The loop technique ruptured at significantly lower forces compared with the other 2 techniques (P < .01). A greater number of loops did not significantly increase the rupture force of loop neochordae. Observed rupture forces for all techniques were higher than those normally observed in physiologic conditions.
CONCLUSIONS: Under experimental conditions, the running neochord technique has the best mechanical performance due to an increased rupture force. If using running neochordae, more than 1 independent set of multiple running neochordae are advised (ie, >2 independent sets of multiple running neochordae in each set).