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Mitral heart valve design

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https://www.readbyqxmd.com/read/29747965/mitral-annuloplasty-ring-flexibility-preferentially-reduces-posterior-suture-forces
#1
Eric L Pierce, Charles H Bloodworth, Akito Imai, Keitaro Okamoto, Yoshiaki Saito, Robert C Gorman, Joseph H Gorman, Ajit P Yoganathan
Annuloplasty ring repair is a common procedure for the correction of mitral valve regurgitation. Commercially available rings vary in dimensions and material properties. Annuloplasty ring suture dehiscence from the native annulus is a catastrophic yet poorly understood phenomenon that has been reported across ring types. Recognizing that sutures typically dehisce from the structurally weaker posterior annulus, our group is conducting a multi-part study in search of ring design parameters that influence forces acting on posterior annular sutures in the beating heart...
May 3, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29676043/mitral-valve-interventions-in-heart-failure
#2
REVIEW
Daniel Lavall, Andreas Hagendorff, Stephan H Schirmer, Michael Böhm, Michael A Borger, Ulrich Laufs
Secondary mitral regurgitation (MR) results from left ventricular dilatation and dysfunction. Quantification of secondary MR is challenging because of the underlying myocardial disease. Clinical and echocardiographic evaluation requires a multi-parametric approach. Severe secondary MR occurs in up to one-fourth of patients with heart failure with reduced ejection fraction, which is associated with a mortality rate of 40% to 50% in 3 years. Percutaneous edge-to-edge mitral valve repair (MitraClip) has emerged as an alternative to surgical valve repair to improve symptoms, functional capacity, heart failure hospitalizations, and cardiac haemodynamics...
April 19, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29619932/mortality-and-morbidity-in-patients-with-osteogenesis-imperfecta-in-denmark
#3
Lars Folkestad
Ostegenesis imperfecta (OI) is a hereditary disease of the connective tissue caused by mutations to, mainly, the genes that are involved in the biosynthesis of collagen type 1. Patients are grouped according to clinical severity and mode of inheritance according to Sillence's classification (originally 1979, updated 2014). According to our data, the population prevalence of OI in Denmark was 10.3 per 100,000, with 575 patients registered with an OI diagnosis in the National Patient Register and alive at the end of 2012 out of a total population of 5,602,628 persons...
April 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29574918/ginsenoside-rb1-inhibits-autophagy-through-regulation-of-rho-rock-and-pi3k-mtor-pathways-in-a-pressure-overload-heart-failure-rat-model
#4
Tianrui Yang, Yunbo Miao, Tong Zhang, Ninghui Mu, Libo Ruan, Jinlan Duan, Ying Zhu, Rongping Zhang
OBJECTIVE: This study was designed to explore the relationship between ginsenoside Rb1 (Grb1) and high-load heart failure (HF) in rats. METHODS: The parameters of cardiac systolic function (left ventricular posterior wall thickness (LVPWT), left ventricular internal diastolic diameter (LVID), fraction shortening (FS) and mitral valves (MVs)) of rat hearts in each group were inspected by echocardiogram. The expressions of rat myocardial contractile proteins, autophagy-related proteins and the activation of Rho/ROCK and PI3K/mTOR pathways were detected by Western blot...
June 2018: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/29361168/novel-stent-design-for-transcatheter-mitral-valve-implantation
#5
Klaas Loger, Saskia Pokorny, Tim Schaller, Irma Haben, Derk Frank, Georg Lutter
OBJECTIVES: In this study, results of a functional in vitro study of 2 newly developed valved stents for transcatheter mitral valve implantation are presented. METHODS: Two novel stent designs, an oval-shaped and a D-shaped stent with a strut fixation system were developed. The fixation force of the novel stents were tested in vitro in porcine hearts with a tensile test set-up. In further experiments, the stents were equipped with a circular valved stent, and the valve performances were investigated in a pulsatile heart valve tester...
February 1, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29302279/prior-oral-conditions-in-patients-undergoing-heart-valve-surgery
#6
Francisco-Javier Silvestre, Irene Gil-Raga, Mayte Martinez-Herrera, Dorina Lauritano, Javier Silvestre-Rangil
Background: Patients scheduled for heart valve surgery should be free of any oral infectious disorders that might pose a risk in the postoperative period. Few studies have been made on the dental conditions of such patients prior to surgery. The present study describes the most frequent prior oral diseases in this population group. Material and Methods: A prospective, observational case-control study was designed involving 60 patients (30 with heart valve disease and 30 controls, with a mean age of 71 years in both groups)...
November 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/29232300/three-dimensional-printing-of-life-like-models-for-simulation-and-training-of-minimally-invasive-cardiac-surgery
#7
Toshiyuki Yamada, Motohiko Osako, Tomoya Uchimuro, Ryogen Yoon, Toshiaki Morikawa, Maki Sugimoto, Hisao Suda, Hideyuki Shimizu
OBJECTIVE: As the use of minimally invasive surgery in cardiothoracic surgery increases, so does the need for simulation and training. We developed a heart model for simulation and training of minimally invasive cardiac surgery, particularly minimally invasive mitral valve repair using our new three-dimensional printing system. METHODS: Digital imaging and communication in medicine data from patient computed tomography, three-dimensional computer-aided design, and three-dimensional printing helped create replicas of the heart and thoracic cavity...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29232298/use-of-a-new-expanded-polytetrafluoroethylene-multichordal-mitral-apparatus-mitrapatch-to-repair-complex-mitral-valve-lesions
#8
Surendra K Chawla, Muralidhar Padala, W Randolph Chitwood, Robert W M Frater
OBJECTIVE: We report a new expanded polytetrafluoroethylene multichordal mitral apparatus (MitraPatch) to simplify mitral repairs involving multiple cusps and sought to describe the surgical technique and demonstrate the efficacy of the device. METHODS: MitraPatch was laser cut from a single sheet of expanded polytetrafluoroethylene and mounted on a custom-designed handle. Surgical technique to deploy the apparatus on the native mitral valve was developed in ex vivo porcine hearts...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29168146/novel-direct-annuloplasty-fastener-system-for-minimally-invasive-mitral-valve-repair
#9
Joshua L Chan, Ming Li, Dumitru Mazilu, Justin G Miller, Andrada C Diaconescu, Keith A Horvath
The development of less invasive approaches for mitral valve repair remains an important objective, particularly in patients with multiple comorbidities. We describe a novel method to affix a mitral valve annuloplasty ring in a minimally invasive manner. A delivery apparatus for an annuloplasty fastener system was designed. Two channels were created, one for advancing the annuloplasty ring, and another to accommodate the fastener applicator. Custom designed fasteners, either with a helical-shaped screw or a strap-shaped tack structure, were tested...
March 2018: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/29103675/heart-valve-surgery-performed-by-trainee-surgeons-meta-analysis-of-clinical-outcomes
#10
REVIEW
Akshat Saxena, Sohaib A Virk, Sebastian R A Bowman, Richmond Jeremy, Paul G Bannon
BACKGROUND: Cardiac surgical units must balance trainee education with the duty to provide optimal patient care. This is particularly challenging with valvular surgery, given the lower volume and increased complexity of these procedures. The present meta-analysis was conducted to assess the impact of trainee operator status on clinical outcomes following valvular surgery. METHODS: Medline, Embase and CENTRAL databases were systematically searched for studies reporting clinical outcomes according to the training status of the primary operator (consultant or trainee)...
April 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29102689/early-experience-with-new-transcatheter-mitral-valve-replacement
#11
Vinayak Bapat, Vivek Rajagopal, Christopher Meduri, R Saeid Farivar, Antony Walton, Stephen J Duffy, Robert Gooley, Aubrey Almeida, Michael J Reardon, Neal S Kleiman, Konstantinos Spargias, Stratis Pattakos, Martin K Ng, Michael Wilson, David H Adams, Martin Leon, Michael J Mack, Sharla Chenoweth, Paul Sorajja
BACKGROUND: Transcatheter mitral valve replacement (TMVR) is a potential therapy for patients with symptomatic, severe mitral regurgitation (MR). The feasibility of this therapy remains to be defined. OBJECTIVES: The authors report their early experience with TMVR using a new valve system. METHODS: The valve is a self-expanding, nitinol valve with bovine pericardial leaflets that is placed using a transapical delivery system. Patients with symptomatic MR who were deemed high or extreme risk by the local heart teams were enrolled in a global pilot study at 14 sites (United States, Australia, and Europe)...
January 2, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29102688/beating-heart-mitral-valve-repair-using-a-novel-eptfe-cordal-implantation-device-a-prospective-trial
#12
James S Gammie, Krzysztof Bartus, Andrzej Gackowski, Michael N D'Ambra, Piotr Szymanski, Agata Bilewska, Mariusz Kusmierczyk, Boguslaw Kapelak, Jolanta Rzucidlo-Resil, Neil Moat, Alison Duncan, Rashmi Yadev, Steve Livesey, Paul Diprose, Gino Gerosa, Augusto D'Onofrio, Demetrio Pitterello, Paolo Denti, Giovanni La Canna, Michele De Bonis, Ottavio Alfieri, Judy Hung, Piotr Kolsut
BACKGROUND: Conventional mitral valve (MV) operations allow direct anatomic assessment and repair on an arrested heart, but require cardiopulmonary bypass, aortic cross-clamping, sternotomy or thoracotomy, and cardioplegic cardiac arrest, and are associated with significant perioperative disability, and risks of morbidity and mortality. OBJECTIVES: This study evaluated safety and performance of a transesophageal echocardiographic-guided device designed to implant artificial expanded polytetrafluoroethylene (ePTFE) cords on mitral leaflets in the beating heart...
January 2, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29029949/mitral-valve-replacement-using-carpentier-edwards-pericardial-bioprosthesis-in-patients-with-rheumatic-heart-disease-aged-below-40-years-17-year-results
#13
Ujjwal Kumar Chowdhury, Adil Rizvi, Rajeev Narang, Sandeep Seth, Mani Kalaivani, Suruchi Hasija, Lakshmi Kumari
BACKGROUND: This study was designed to evaluate patients aged less than 40 years implanted with tissue heart valves with respect to survival, thromboembolism, structural degeneration and quality of life. METHODS: Between January, 2000 and December, 2016, 132 patients (51 males) with rheumatic heart disease underwent mitral valve replacement using Carpentier-Edwards, perimount, pericardial bioprostheses. The patients' ages ranged between 12 and 39 years (mean±SD 30...
August 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28944175/long-term-outcome-of-simultaneous-septal-myectomy-and-anterior-mitral-leaflet-retention-plasty-in-hypertrophic-obstructive-cardiomyopathy-the-berlin-experience
#14
Eva Maria Delmo Walter, Mariano Francisco Javier, Roland Hetzer
BACKGROUND: Various surgical strategies designed to relieve left ventricular outflow tract obstruction (LVOTO) and correct mitral regurgitation (MR) in hypertrophic obstructive cardiomyopathy (HOCM) have evolved, yet reports on the long-term outcomes of each technique are scarce. We provide an update on over 20 years' experience at our institution in the standardized surgical treatment of HOCM. METHODS: Between April 1986 and April 2014, 320 cases of endomyocardial resection and 305 septal myectomies were performed at our institution...
July 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28942384/transcatheter-mitral-valve-replacement-device-landscape-and-early-results
#15
Amisha Patel, Vinayak Bapat
Mitral regurgitation (MR) is the second most common valvular heart disease in the western world with a prevalence in the USA alone of two to four million people. MR is age-dependent and hence the MR burden is expected to increase with the increase in life expectancy observed in Europe and the USA. Medical and surgical treatment has been the cornerstone of the treatment as untreated MR results in poor prognosis. However, only a fraction of patients are offered surgical treatment due to high risk. With the success of transcatheter aortic valve implantation (TAVI), many transcatheter options have emerged to provide a less invasive option for these patients...
September 24, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28876686/management-of-failed-mitral-valve-replacement-the-durban-experience
#16
D Kistan, M Booysen, G Alexander, T E Madiba
BACKGROUND: Mitral valve replacement is the procedure of choice in patients with severe mitral valve disease. However, these patients are surviving longer and are thus at an increased risk of prosthesis failure or valve-related complications. METHOD: Study setting: Inkosi Albert Luthuli Central Hospital, a tertiary referral Hospital in Durban. Study population: All patients undergoing redo mechanical mitral valve replacement surgery between January 2005 and December 2014...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28854273/high-resolution-imaging-of-the-mitral-valve-in-the-natural-state-with-7-tesla-mri
#17
Sam E Stephens, Serguei Liachenko, Neil B Ingels, Jonathan F Wenk, Morten O Jensen
Imaging techniques of the mitral valve have improved tremendously during the last decade, but challenges persist. The delicate changes in annulus shape and papillary muscle position throughout the cardiac cycle have significant impact on the stress distribution in the leaflets and chords, thus preservation of anatomically accurate positioning is critical. The aim of this study was to develop an in vitro method and apparatus for obtaining high-resolution 3D MRI images of porcine mitral valves in both the diastolic and systolic configurations with physiologically appropriate annular shape, papillary muscle positions and orientations, specific to the heart from which the valve was harvested...
2017: PloS One
https://www.readbyqxmd.com/read/28847146/on-x-versus-st-jude-medical-mechanical-prosthesis-in-mitral-position-are-we-moving-forward-in-design-technology
#18
Ezzeldin A Mostafa, Ashraf A El Midany, Ahmed S Taha, Saeed R El Aasy, Ayman A Doghish, Ahmed Helmy, Sherif A Mansour, Ramy Khorshid, Hosam E Ashor, Yaser Elnahas, Mohammed Saffan
BACKGROUND: Continuous effort is still provided in designing optimal artificial heart valves with better hemodynamic function and reduced thromboembolic potential. The question is do we have moved forward toward this goal or not. METHODS: A prospective, randomized comparative study was done on 360 patients scheduled for elective mitral valve replacement. Patients were grouped into On-X group (n=180) who received On-X mechanical valve and SJM (n=180) who received St Jude mechanical valve...
July 28, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28741245/the-last-frontier-transcatheter-devices-for-percutaneous-or-minimally-invasive-treatment-of-chronic-heart-failure
#19
REVIEW
V J Nijenhuis, L Sanchis, J A S van der Heyden, P Klein, B J W M Rensing, A Latib, F Maisano, J M Ten Berg, P Agostoni, M J Swaans
Heart failure has a high prevalence in the general population. Morbidity and mortality of heart failure patients remain high, despite improvements in drug therapy, implantable cardioverter-defibrillators and cardiac resynchronisation therapy. New transcatheter implantable devices have been developed to improve the treatment of heart failure. There has been a rapid development of minimally invasive or transcatheter devices used in the treatment of heart failure associated with aortic and mitral valve disease and these devices are being incorporated into routine clinical practice at a fast rate...
October 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28721493/modelling-of-lesions-associated-with-functional-mitral-regurgitation-in-an-ex-vivo-platform
#20
Michal Jaworek, Federico Lucherini, Claudia Romagnoni, Guido Gelpi, Monica Contino, Paolo Romitelli, Carlo Antona, Gianfranco B Fiore, Riccardo Vismara
Functional mitral regurgitation (FMR) is a complex pathology involving valvular and subvalvular structures reconfiguration, and its treatment is considered challenging. There is a lack of experimental models allowing for reliable preclinical FMR treatments' evaluation in a realistic setting. A novel approach to simulate FMR was developed and incorporated into an ex vivo passive beating heart platform. FMR was obtained by dilating the mitral annulus (MA) mainly in the antero-posterior direction and displacing the papillary muscles (PMs) apically and laterally by ad hoc designed and 3D printed dilation and displacing devices...
October 2017: Annals of Biomedical Engineering
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