Document Detail


The Geoform disease-specific annuloplasty system: a finite element study.
MedLine Citation:
PMID:  17588392     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Functional mitral regurgitation (FMR) is the inability of mitral leaflets to coapt due to a combination of functional and geometrical factors. Valve competence is commonly restored by undersized annuloplasty, reducing the native annulus anteroposterior dimension. In case of severe FMR, this solution may be inadequate. The use of rings specific for the correction of FMR may lead to better results. METHODS: The performance of the Geoform ring, a recently designed FMR-specific prosthesis, was compared with that of a standard Physio annuloplasty ring. Finite element modeling was used to simulate dilated cardiomyopathy-related FMR and compare, at the systolic peak, the valve's pathologic condition with the postoperative scenario corresponding to both devices. Three degrees of the pathology were simulated by progressively displacing papillary muscles apically, up to 5 mm. Three ring sizes were modeled. RESULTS: Regurgitant area, coaptation length, and stresses acting on valve structures were assessed. When the use of the Geoform was modeled, coaptation length was always longer than 7 mm. In the most unfavorable case, the regurgitant area reduction was 74% with respect to baseline, and leaflets stresses were reduced by 20% when undersizing was simulated. When Physio ring implantation was simulated, coaptation length maximum extent was equal to 4.3 mm, the maximum regurgitant area reduction was equal to 60%, and leaflet stress reduction was observed. CONCLUSIONS: Disease-specific prostheses may allow for restoration of valve competence even for significant degrees of leaflets tethering and avoid the need for aggressive undersizing, thus leading to more durable results.
Authors:
Emiliano Votta; Francesco Maisano; Steven F Bolling; Ottavio Alfieri; Franco M Montevecchi; Alberto Redaelli
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  84     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-25     Completed Date:  2007-07-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  92-101     Citation Subset:  AIM; IM    
Affiliation:
Politecnico di Milano, Bioengineering Department, Cardiac Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy. emiliano.votta@polimi.it
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MeSH Terms
Descriptor/Qualifier:
Finite Element Analysis*
Heart Valve Prosthesis Implantation / methods*
Humans
Mitral Valve / surgery*
Mitral Valve Insufficiency / surgery*
Papillary Muscles / surgery
Stress, Mechanical
Comments/Corrections
Comment In:
Ann Thorac Surg. 2007 Jul;84(1):101-2   [PMID:  17588393 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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