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Novel Transcatheter Mitral Prosthesis Designed to Preserve Physiological Ventricular Flow Dynamics
Marcio Scorsin1, Martin Andreas2, Silvia Corona3
1Department of Cardiac Surgery, Jilin Heart Hospital, Changchun, China.
The Annals of Thoracic Surgery
|April 10, 2021
Summary
A novel mitral bioprosthesis preserves left ventricular (LV) vortex and physiological intraventricular flow dynamics (IFD). This innovative design shows promising hemodynamic performance in preclinical studies, warranting further clinical investigation.
Area of Science:
- Cardiovascular Surgery
- Biomedical Engineering
- Medical Devices
Background:
- Current mitral bioprostheses do not replicate the native valve's function, disrupting left ventricular (LV) physiological vortex.
- This leads to altered intraventricular flow dynamics (IFD).
Purpose of the Study:
- To evaluate the hemodynamic performance of a novel mitral bioprosthesis designed to mimic native valve function.
- To assess the impact of this new bioprosthesis on intraventricular flow dynamics (IFD).
Main Methods:
- A D-shaped, self-expandable, monoleaflet valve made of bovine pericardium was implanted in 12 juvenile sheep via transapical approach.
- Hemodynamic performance and IFD were assessed using Doppler echocardiography and echo particle imaging velocimetry immediately post-implantation and at 3 months.
Main Results:
- The novel bioprosthesis demonstrated favorable hemodynamics with low transvalvular gradients and good effective orifice area.
- Preservation of LV vortex dimension, orientation, and physiological anticlockwise rotation was observed.
- No significant complications like LV outflow tract obstruction, thrombosis, or hemolysis were noted; mild paravalvular leaks occurred in some cases.
Conclusions:
- Preclinical in vivo results indicate good hemodynamic performance and preservation of physiological IFD with the new transcatheter mitral bioprosthesis.
- Further clinical studies are required to determine if these benefits translate to improved LV recovery and patient outcomes in mitral regurgitation.
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