scholarly journals Feasibility of a Mitral Annuloplasty With the Capability for Peri- and Postoperative Adjustment

2020 ◽  
Vol 14 (2) ◽  
Author(s):  
Jacob Brubert ◽  
Steven Tsui ◽  
Paul De Sciscio ◽  
Geoff D. Moggridge
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Gold Standard ◽  
Standard Treatment ◽  
Surgical Repair ◽  
Traction Force ◽  
Heart Model ◽  
Mitral Annuloplasty ◽  
Valve Annulus ◽  
Postoperative Adjustment

Abstract Surgical repair with implantation of a mitral annuloplasty ring is the gold standard treatment for mitral regurgitation. However, outcomes are variable and recurrent mitral regurgitation is not uncommon. A REshapeable Mitral Annuloplasty DevIce (REMADI) is proposed, which consists of a fully encapsulated low melting temperature alloy. The alloy is solid and rigid at body temperature and provides traction force to shape the annulus. When heated using a noncontact method, the alloy melts and the REMADI becomes malleable. The REMADI is engaged with the mitral valve annulus using anchors which automatically deploy upon contact. A passive beating porcine heart model was used to demonstrate the feasibility of the REMADI device, which was deployed, engaged, and used to reduce the diameter of the mitral valve annulus.

scholarly journals In Vivo Validation of Restored Chordal Biomechanics After Mitral Ring Annuloplasty in a Rare Ovine Case of Natural Chronic Functional Mitral Regurgitation

2020 ◽  
Vol 7 (2) ◽  
pp. 17 ◽  
Author(s):  
Hanjay Wang ◽  
Michael Paulsen ◽  
Annabel Imbrie-Moore ◽  
Yuko Tada ◽  
Hunter Bergamasco ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Fiber Bragg Grating ◽  
Surgical Repair ◽  
Functional Mitral Regurgitation ◽  
Force Sensing ◽  
Chordae Tendineae ◽  
Mitral Annuloplasty ◽  
Ring Annuloplasty

Mitral valve chordae tendineae forces are elevated in the setting of mitral regurgitation (MR). Ring annuloplasty is an essential component of surgical repair for MR, but whether chordal forces are reduced after mitral annuloplasty has never been validated in vivo. Here, we present an extremely rare ovine case of natural, severe chronic functional MR, in which we used force-sensing fiber Bragg grating neochordae to directly measure chordal forces in the baseline setting of severe MR, as well as after successful mitral ring annuloplasty repair. Overall, our report is the first to confirm in vivo that mitral ring annuloplasty reduces elevated chordae tendineae forces associated with chronic functional MR.

Single-Center Experience with Adjustable Annuloplasty Ring in Degenerative Mitral Regurgitation

2015 ◽  
Vol 10 (4) ◽  
pp. 248-251 ◽  
Author(s):  
Markus Czesla ◽  
Julia Götte ◽  
Vladimir Voth ◽  
Nicolas Doll
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Surgical Repair ◽  
Fine Tuning ◽  
Single Center ◽  
Annuloplasty Ring ◽  
Single Center Experience ◽  
Complex Anatomy ◽  
Repair Procedure ◽  
Systolic Anterior Movement

Objective Owing to the complex anatomy of the mitral valve, successful surgical repair of degenerative regurgitation remains a challenging procedure in cardiac surgery. Methods This paper aimed to report on our single-center experience with 20 patients who received an adjustable annuloplasty ring (Cardinal ring, ValtechCardio Ltd, Or Yehuda, Israel) as part of their mitral valve repair procedure. The device allows for intraoperative echocardiography-guided ring size adjustments under beating-heart conditions. Results All of the 20 patients left the operating room without any residual mitral regurgitation. There was no risk of systolic anterior movement (SAM) because of image-guided fine tuning of the ring before weaning the patient from bypass. Conclusions Further multicenter data are required to prove the concept of adjustable annuloplasty devices.

Prevalence of Calcification of the Mitral Valve Annulus in Patients Undergoing Surgical Repair of Mitral Valve Prolapse

2014 ◽  
Vol 113 (11) ◽  
pp. 1867-1873 ◽  
Author(s):  
Laura Fusini ◽  
Sarah Ghulam Ali ◽  
Gloria Tamborini ◽  
Manuela Muratori ◽  
Paola Gripari ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Surgical Repair ◽  
Valve Annulus

Surgical Repair of the Mitral Valve in Children With Dilated Cardiomyopathy and Mitral Regurgitation

2008 ◽  
Vol 85 (6) ◽  
pp. 2085-2088 ◽  
Author(s):  
Mark A. Walsh ◽  
Lee N. Benson ◽  
Anne I. Dipchand ◽  
Andrew N. Redington ◽  
Christopher A. Caldarone ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Dilated Cardiomyopathy ◽  
Surgical Repair

scholarly journals Successful mitral valve-in-ring repair of mitral annuloplasty ring dehiscence causing severe mitral regurgitation—a case report

2021 ◽  
Author(s):  
Harish Sharma ◽  
Adnan Nadir ◽  
Richard P Steeds ◽  
Sagar N Doshi
Keyword(s):  
Case Report ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Transesophageal Echocardiography ◽  
Severe Mitral Regurgitation ◽  
Annuloplasty Ring ◽  
Mitral Annuloplasty ◽  
Case Summary ◽  
Valve Implantation ◽  
Two Jets

Abstract Background Annuloplasty failure caused by ring dehiscence can lead to trans-ring and para-ring mitral regurgitation. Transcatheter treatments are available for patients at prohibitive risk of surgery. In patients unsuitable for edge-to-edge repair, valve-in-ring transcatheter mitral valve implantation has been described to treat trans-ring or para-ring jets but not both concurrently. Case summary A 78-year-old male presented with severe mitral regurgitation due to dehiscence of a 34 mm Edwards Physio II mitral annuloplasty ring. Transesophageal echocardiography showed two jets of regurgitation; trans-ring and para- ring. Repair was successfully undertaken with a valve-in-ring procedure (29 mm S3 Edwards Lifesciences). Discussion Patients with failure of mitral valve annuloplasty with trans-ring and para-ring regurgitation can be safely and effectively treated by valve-in-ring transcatheter mitral valve implantation.

scholarly journals Outcomes and dynamic changes of the mitral valve after surgical repair of mitral regurgitation in patients with an atrial septal defect

2019 ◽  
Vol 3 (4) ◽  
pp. 158-164
Author(s):  
Ok Jeong Lee ◽  
Jinyoung Song ◽  
June Huh ◽  
I-Seok Kang ◽  
Ji-Hyuk Yang ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Surgical Repair ◽  
Dynamic Changes

Management of Isolated, Congenital Anterior Mitral Valve Cleft

2021 ◽  
Vol 13 (1) ◽  
pp. 60-64
Author(s):  
J. Blade Hargiss ◽  
Joseph A. Dearani ◽  
Elizabeth H. Stephens ◽  
Nathaniel W. Taggart
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Surgical Repair ◽  
Nyha Class ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Postoperative Result ◽  
Ventricular Ejection Fraction ◽  
Class 1

Background: Isolated anterior mitral valve clefts (MVC) are rare congenital heart defects, and data are limited regarding the natural history and surgical outcomes for such isolated MVCs. Methods: We conducted a retrospective review of patients with congenital MVC who were evaluated at Mayo Clinic in Rochester, Minnesota between 1993 and 2020. Patients were separated into two cohorts: those who underwent surgical repair of the MVC and those who had not yet undergone repair. Baseline and postoperative clinical and echocardiographic data were analyzed. Results: Fourteen patients were included in the nonsurgical cohort and eight patients in the surgical cohort. Surgical repair was via primary median sternotomy (n = 6) or robot-assisted, minimally invasive (n = 2). All cleft repairs were performed by simple suture closure. Intraoperative evaluation of the clefts did not reveal additional structural factors that could account for the mitral regurgitation (MR). At latest follow-up of the surgical cohort, the median grade of MR was 1 (range 0-1), and median left ventricular ejection fraction was 65% (IQR 59%-67%), both similar to the immediate postoperative result. At latest follow-up, all patients in the nonsurgical cohort were NYHA Class 1, and median MR grade was 1. All patients were asymptomatic (NYHA Class 1). Conclusions: Our findings corroborate prior reports that MVC repair is safe and successful and is followed by a low rate of recurrent mitral valve dysfunction. Durable surgical repair of isolated, congenital MVC can be performed safely in select patients. The decision to intervene should be based on the severity of mitral regurgitation and patient symptoms rather than the presence of the MVC alone.

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