Development of an Ex Vivo Mitral Valve Evaluation Model Using a Pulsatile Flow Simulator

Area of Science:

• Biomedical Engineering
• Cardiovascular Research
• Surgical Simulation

Background:

• Surgical mitral valve repair is complex, with limited data on the hemodynamic effects of different techniques.
• Existing pulse duplicator systems struggle to accommodate the unique structure of biological mitral valves.
• Standardized methods for mounting ex vivo lamb mitral valves in experimental setups are lacking.

Purpose of the Study:

• To develop and validate a novel mitral valve holder for use with pulse duplicator systems.
• To enable reliable hemodynamic assessment of ex vivo lamb mitral valves for surgical technique evaluation.
• To simulate physiological conditions for testing mitral valve function.

Main Methods:

• A custom mitral valve holder was created using 3D printing and silicone molding.
• Ex vivo lamb mitral valves, including annulus and subvalvar apparatus, were excised and mounted.
• Papillary muscle tension was simulated using sutures, and hemodynamic parameters were measured.
• Valve competence was tested using electromagnetic flowmeters and validated with echocardiography.

Main Results:

• The novel holder successfully facilitated the implantation of lamb mitral valves into the pulse duplicator system.
• Baseline hemodynamic testing showed consistent valve function across five experiments.
• Mean regurgitation fraction was 21.1%, with transmitral gradients ranging from 5.15 to 8.13 mmHg.
• Physiological variability in stroke volumes and peak flow rates was observed.

Conclusions:

• The developed mitral valve holder effectively enables ex vivo hemodynamic testing of lamb mitral valves.
• This method provides a reliable platform for comparing the hemodynamic effects of surgical mitral valve repair techniques.
• The findings support the use of this system for advancing research in mitral valve surgery.