Large Animal Translational Validation of 3 Mitral Valve Repair Operations for Mitral Regurgitation Using a Mitral...

Area of Science:

• Cardiovascular Surgery
• Biomedical Engineering
• Translational Research

Background:

• Limited quantitative biomechanical data exist for various mitral valve repair techniques.
• A lack of standardized, translatable in vivo studies hinders validation of these techniques.
• Translational large animal models are needed to evaluate and optimize mitral repair.

Purpose of the Study:

• To evaluate and validate biomechanical differences among various mitral repair techniques.
• To optimize mitral valve repair operations using a large animal model of mitral valve prolapse.

Main Methods:

• A mitral valve prolapse model was created in 20 male Dorset sheep by severing P2 chordae.
• Fiber Bragg grating force sensors measured chordal forces in vivo.
• Sheep underwent neochord repair, leaflet remodeling, or triangular resection, with subsequent biomechanical analysis.

Main Results:

• All repair techniques eliminated regurgitation; neochord and remodeling repairs reduced secondary chordal forces.
• Neochord repair normalized primary chordal forces and resulted in lower forces compared to remodeling and resection.
• Using 4-6 neochordae significantly reduced primary chordal forces and forces on the neochordae compared to 2 neochordae.

Conclusions:

• Significant biomechanical differences exist between mitral repair techniques in a large animal model.
• Neochord repair, particularly with at least 4 neochordae, demonstrated superior biomechanical outcomes.
• Findings offer insights for optimizing mitral valve repair and enhancing repair durability.