A Computational Study of the Hemodynamics After “Edge-to-Edge” Mitral Valve Repair

2001 ◽  
Vol 123 (6) ◽  
pp. 565-570 ◽  
Author(s):  
A. Redaelli ◽  
G. Guadagni ◽  
R. Fumero ◽  
F. Maisano ◽  
O. Alfieri
Keyword(s):  
Mitral Valve ◽  
Pressure Drop ◽  
Mitral Valve Repair ◽  
Computational Study ◽  
Free Edge ◽  
Parametric Model ◽  
Left Heart ◽  
Valve Repair ◽  
Double Orifice ◽  
Orifice Valve

Edge-to-edge mitral valve repair consists in suturing the free edge of the leaflets to re-establish coaptation in prolapsing valves. The leaflets are frequently sutured at the middle and a double orifice valve is created. In order to study the hemodynamic implications, a parametric model of the left heart has been developed. Different valve areas and shapes have been investigated. Results show that the simplified Bernoulli formula provides a good estimation of the pressure drop and that the pressure drop may be predicted on the basis of the pre-operative geometric and hemodynamics data by means of customized models.

Percutaneous edge-to-edge mitral valve repair: beyond the left heart

2021 ◽  
Author(s):  
Leonardo Italia ◽  
Marianna Adamo ◽  
Laura Lupi ◽  
Marta Scodro ◽  
Salvatore Curello ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Left Heart ◽  
Valve Repair

Mitral Valve Repair for Isolated Double-Orifice Mitral Valve With Torn Chordae

1997 ◽  
Vol 64 (6) ◽  
pp. 1831-1834 ◽  
Author(s):  
Yukihiro Tomita ◽  
Hisataka Yasui ◽  
Ryuji Tominaga
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Valve Repair ◽  
Double Orifice

Mitral Valve Repair for Double-orifice Mitral Valve

2014 ◽  
Vol 23 (12) ◽  
pp. e267-e269 ◽  
Author(s):  
Qun-Jun Duan ◽  
Zhan Gao
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Valve Repair ◽  
Double Orifice

scholarly journals Preliminary observations on haemodynamics during physiological stress conditions following ‘double-orifice’ mitral valve repair

2001 ◽  
Vol 20 (2) ◽  
pp. 262-269 ◽  
Author(s):  
Valentino Borghetti ◽  
Marco Campana ◽  
Carla Scotti ◽  
Giovanni Parrinello ◽  
Roberto Lorusso
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Physiological Stress ◽  
Stress Conditions ◽  
Valve Repair ◽  
Double Orifice

scholarly journals The double-orifice technique in mitral valve repair: A simple solution for complex problems

2001 ◽  
Vol 122 (4) ◽  
pp. 674-681 ◽  
Author(s):  
Ottavio Alfieri ◽  
Francesco Maisano ◽  
Michele De Bonis ◽  
Pier Luigi Stefano ◽  
Lucia Torracca ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Simple Solution ◽  
Valve Repair ◽  
Complex Problems ◽  
Double Orifice

scholarly journals P951 Intraprocedural echocardiographic technique to locate the insertion points of artificial chordae during transventricular beating heart mitral valve repair: ultrasound ""starry sky""

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Vairo ◽  
M Marro ◽  
G Speziali ◽  
M Rinaldi ◽  
S Salizzoni
Keyword(s):  
Mitral Valve ◽  
Real Time ◽  
Mitral Valve Repair ◽  
Three Dimensional ◽  
Free Edge ◽  
Beating Heart ◽  
Valve Repair ◽  
Native Valve ◽  
Intense Signal ◽  
Echocardiographic Technique

Abstract BACKGROUND Mitral valve repair is the preferred surgical treatment for severe mitral regurgitation due to degenerative leaflet prolapse. Within the growing era of transcatheter treatments for valvular heart disease, an innovative micro-invasive trans-ventricular beating-heart procedure was developed. Three-dimensional transoesophageal echocardiographic guidance is crucial to assist the operator in instrument navigation and chords positioning. Indeed, it is important an equidistant chords placement on the leaflet to ensure a uniform force distribution on the prolapsing segment and to avoid damaging of the previously inserted chords. PURPOSE To propose an intraoperative three-dimensional echocardiographic technique that allows operators to see the exact location of the polytetrafluoroethylene (ePTFE) chords used for the mitral repair. METHODS The procedure is performed using a device that is introduced through a posterolateral ventriculotomy and it is advanced towards the mitral valve under real-time 3D transoesophageal guidance. The prolapsing segments are grasped with the jaw of the instrument and the chords are implanted to achieve the proper distribution of forces and then tensioned and secured outside the ventricle. The proposed technique exploits the greater echogenicity of the artificial chord loop compared to native chords and leaflets. By lowering of the gains, remaining in the three-dimensional mitral valve surgical view, the signals of the native structures are attenuated, the underlying ventricular cavity appears black and the insertion points are visible as an intense signal on the virtual free edge of the leaflet treated. Figure 1 shows the intraoperative sequence of images of a case performed at our centre. The images were acquired using real time single beat three-dimensional reconstruction. Figure 1A shows the surgical view of the native valve with prolapse of the P2-P3 scallops. Image 1B reveals the prolapsing leaflet grasping and device location. After gain lowering, it’s possible to see the intense signal of the positioned artificial chord (Figure 1C). It can also be noted how this position matches with the position of the device at the time of grasping. Image 1D shows the partial disappearance of the prolapse during the tensioning test after the positioning of a second chord in a more medial position. Figure 1E shows the correct position of the ePTFE chords. We can notice the second chord placed in a medial position from the first one. This view, with dark ventricular chamber and intense signals of chordae loops, looks like a "STARRY SKY". RESULTS This technique allows to locate the correct insertion points of the artificial chords during the procedure. CONCLUSIONS This is a simple technique to guide operators during trans-ventricular beating heart mitral valve repair with ePTFE chords. Abstract P951 Figure 1

scholarly journals A simple approach to mitral valve repair: Posterior leaflet height adjustment using a partial fold of the free edge

2014 ◽  
Vol 148 (6) ◽  
pp. 2780-2786 ◽  
Author(s):  
Travis O. Abicht ◽  
Adin-Cristian Andrei ◽  
Jane Kruse ◽  
Eileen McDonald ◽  
Zhi Li ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Free Edge ◽  
Simple Approach ◽  
Posterior Leaflet ◽  
Valve Repair

scholarly journals Successful mitral valve repair involving division of bridging tissue in a patient with double orifice mitral valve

2019 ◽  
Vol 157 (5) ◽  
pp. e293-e295 ◽  
Author(s):  
Masashi Takeshita ◽  
Hirokuni Arai ◽  
Tomohiro Mizuno ◽  
Masahumi Yashima
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Valve Repair ◽  
Double Orifice
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