Document Detail


Effects of hemodynamic alterations on anterior mitral leaflet curvature during systole.
MedLine Citation:
PMID:  17140969     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The application of repair techniques to treat mitral valve incompetence has increased progressively during the past 20 years. Unfortunately, recent reports have demonstrated the longevity of these repairs to be less than previously believed. Most repair failures are stress related. Computational models to optimize valve repair are in development, but to be brought to fruition, a better understanding of dynamic leaflet geometry is necessary. In this study, sonomicrometry was used in an ovine model to compute systolic leaflet curvature at varying afterloads and states of contractility.
METHODS: The anterior leaflet of 12 sheep was instrumented with 5 piezoelectric transducers in a cruciate array. Systolic blood pressure ranged from 90 to 200 mm Hg with increasing phenylephrine hydrochloride infusion. Epinephrine was used to vary contractile state. Leaflet curvature was calculated continuously (200 Hz) during systole.
RESULTS: Anterior leaflet curvature in the septolateral direction was double that in the intercommisural direction. There were also significant changes in leaflet curvature during systole. Curvature in neither direction was affected by afterload. Epinephrine augmented intercommisural curvature in a dose-independent fashion, whereas it had no effect on curvature in the septolateral direction.
CONCLUSIONS: Dynamic mitral anterior leaflet geometry was found to be amazingly constant over a wide range of hemodynamic conditions. These data provide information about leaflet geometry that will aid in the construction of realistic computational models. Such models may facilitate the design of annuloplasty rings and surgical techniques that minimize leaflet stress and increase mitral valve repair longevity.
Authors:
Hiroaki Sakamoto; Landi M Parish; Hirotsugu Hamamoto; Yoshiharu Enomoto; Ahmad Zeeshan; Theodore Plappert; Benjamin M Jackson; Martin G St John-Sutton; Robert C Gorman; Joseph H Gorman
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  132     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-04     Completed Date:  2007-01-25     Revised Date:  2013-09-09    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1414-9     Citation Subset:  AIM; IM    
Affiliation:
Harrison Department of Surgical Research, School of Medicine, University of Pennsylvania, Philadelphia, Pa 19104, USA.
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MeSH Terms
Descriptor/Qualifier:
Animals
Mitral Valve / anatomy & histology*,  physiology*
Sheep
Systole*
Grant Support
ID/Acronym/Agency:
HL63954/HL/NHLBI NIH HHS; HL71137/HL/NHLBI NIH HHS; HL73021/HL/NHLBI NIH HHS; R01 HL063954/HL/NHLBI NIH HHS; R01 HL071137/HL/NHLBI NIH HHS

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