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In Vitro System for Measuring Chordal Force Changes Following Mitral Valve Patch Repair
B Ostli1, J Vester-Petersen1, J B Askov2
1Dept. of Biomedical Engineering, Engineering College of Aarhus, Aarhus, Denmark.
Cardiovascular Engineering and Technology
|August 15, 2015
Summary
This study developed a novel system to measure chordae tendineae forces in mitral valve repairs. The system accurately reflects how patch augmentation affects stress distribution in the mitral valve leaflet.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Biomechanical Analysis
Background:
- Mitral valve repair techniques are continually being optimized.
- Patch augmentation is a key strategy for complex mitral valve repairs, addressing issues like functional mitral regurgitation and systolic anterior motion.
- Understanding stress redistribution in valve leaflets after patch augmentation is crucial.
Purpose of the Study:
- To describe a novel system for investigating chordae tendineae tension redistribution after mitral valve patch augmentation.
- To assess how patch augmentation alters stress distribution within the mitral valve leaflet.
- To establish a method for measuring secondary chordae tendineae forces in relation to applied pressure.
Main Methods:
- An in vitro test setup was created using native porcine mitral valves, including an annulus and papillary muscle positioning system.
- The system allowed for visualization of patch augmentation effects from both atrial and ventricular perspectives.
- Chordae tendineae forces were measured under regulated ventricular pressure (0-150 mmHg) after applying a pericardial patch to the anterior mitral leaflet.
Main Results:
- The test setup successfully accommodated native porcine mitral valves and simulated clinical patch repairs.
- A strong correlation (R² = 0.95) was observed between secondary chordae tendineae forces and applied transvalvular pressure.
- The system demonstrated the ability to maintain normal mid-systolic mitral valve function and visual access.
Conclusions:
- The developed test setup is effective for measuring secondary chordae forces and the pressure-force relationship in mitral valve repairs.
- This system allows for the identification of shifts in secondary chordae insertion points on the anterior leaflet relative to the coaptation zone.
- The findings support the use of this system to better understand the biomechanical consequences of patch augmentation in mitral valve repair.
