In-Vivo Dynamic Strains of the Ovine Anterior Mitral Valve Leaflet

2011 ◽  
Author(s):  
Manuel Rausch ◽  
Wolfgang Bothe ◽  
John-Peder Escobar-Kvitting ◽  
Serdar Goktepe ◽  
Craig Miller ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Surgical Repair ◽  
High Morbidity ◽  
Valve Leaflet ◽  
Mitral Valve Leaflet ◽  
Excellent Research ◽  
Valve Function ◽  
Repair Techniques

Throughout the cardiac cycle the Mitral Valve (MV) experiences complex mechanical and hemodynamic loading [1]. Dysfunction of the MV may have devastating consequences and has been associated with high morbidity and mortality. Surgical repair techniques are available to treat malfunctioning MVs [2]. However, it is likely that interventions such as surgical repair may cause alterations in the loading conditions and associated deformations of the MV. In consequence such alterations could result in detrimental remodeling and disturb normal valve function. It is therefore essential to characterize the MV under in-vivo conditions as accurately as possible and thereby establish a baseline of the normal valve. Even though excellent research has been conducted in-vivo [3], in-vitro [4], as well as in-silico [5], the Anterior Mitral Valve Leaflet (AMVL) has never been characterized from a mechanical perspective across its entire surface. The goal of this study is, hence, to provide a more complete picture of the deformations across the entire AMVL in the beating heart.

In Vivo Dynamic Strains of the Mitral Valve Annulus

2007 ◽  
Author(s):  
Brett Zubiate ◽  
Michael Sacks ◽  
Robert C. Gorman ◽  
Joseph H. Gorman
Keyword(s):  
Mitral Valve ◽  
Cardiac Cycle ◽  
Dimensional Space ◽  
Complex Structure ◽  
Three Dimensional ◽  
Mitral Annulus ◽  
Mitral Valve Leaflet ◽  
Valve Function ◽  
Integrated Operation

The mitral valve apparatus is a complex structure with multiple components that require seamless, integrated operation for normal valve function. One of these components is the annulus, a fibrous ring of tissue that defines the boundary between the mitral valve leaflets and the surrounding superstructure of the heart. During the cardiac cycle the annulus undergoes large deformations and dramatic shape changes. Moreover, the annulus motion represents a key boundary condition for mitral valve leaflet deformation. Yet, to date our knowledge of the subtle deformations this structure undergoes during the cardiac cycle remains very limited. In the present study, an array of 1 mm diameter piezoelectric sonocrystals was implanted in 5 sheep to quantify annular deformation over the complete cardiac cycle. These crystals act as fiducial markers for the mitral annulus with a temporal resolution of ∼1ms and a special resolution of .01mm in a calibrated three dimensional space. A quintic order generalized 3D spline was developed to reconstruct the annular geometry.

scholarly journals In vivo dynamic strains of the ovine anterior mitral valve leaflet

2011 ◽  
Vol 44 (6) ◽  
pp. 1149-1157 ◽  
Author(s):  
Manuel K. Rausch ◽  
Wolfgang Bothe ◽  
John-Peder Escobar Kvitting ◽  
Serdar Göktepe ◽  
D. Craig Miller ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Leaflet ◽  
Mitral Valve Leaflet ◽  
Dynamic Strains

Tension Measurement of Artificial Chordae Tendinae Implanted between the Anterior Mitral Valve Leaflet and the Left Ventricular Apex

2008 ◽  
Vol 3 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Pietro Bajona ◽  
Kenton J. Zehr ◽  
Jun Liao ◽  
Giovanni Speziali
Keyword(s):  
Mitral Valve ◽  
Free Edge ◽  
Left Ventricular ◽  
Tension Stress ◽  
Valve Leaflet ◽  
Mitral Leaflet ◽  
Mitral Valve Leaflet ◽  
Off Pump ◽  
Artificial Chordae

Objective A newly developed surgical technique allows implantation of artificial chordae tendinae between a mitral valve leaflet and the left ventricular (LV) apex in a closed-chest, off-pump mitral valve repair operation. However, this orientation causes tension vectors on the mitral valve leaflet in a different direction than those of native chordae. The purpose of this study was to investigate the relationship between systolic LV pressure and the tension of artificial chordae secured at the ventricular apex to assess if the altered tension vectors on the mitral leaflet resulted in excessive stress on the chordae/leaflet system. Methods Freshly harvested porcine mitral valves were suspended in a mechanical LV simulator. Two 5-0 Gore-Tex sutures were secured to the free edge of the middle scallop of the anterior leaflet adjacent to the insertion point of two major native chordae. The native chordae were then cut. A simulator pump was activated at different pressure levels, and the tension of the artificial chordae was measured with a digital tensiometer during several cardiac cycles. Results The numerical relationship between chordal tension (in Newtons, N) and LV pressure (in mm Hg/100) averaged at 0.8 (range 0.6–1.05). This tension/pressure relationship was similar in order of magnitude and range to that measured in native chordae in previously published studies. Conclusions In this in vitro model, orienting artificial chordae in a direction mimicking implantation between the valve and the LV apex does not result in excessive tension stress on either the chordae or the mitral leaflet.

Role of in vivo and in vitro Tests in the Diagnosis of Severe Cutaneous Adverse Reactions (SCAR) to Drug

2019 ◽  
Vol 25 (36) ◽  
pp. 3872-3880 ◽  
Author(s):  
Marcel M. Bergmann ◽  
Jean-Christoph Caubet
Keyword(s):  
Adverse Reactions ◽  
Lymphocyte Transformation ◽  
Stevens Johnson Syndrome ◽  
In Vitro Tests ◽  
High Morbidity ◽  
Patch Tests ◽  
Severe Cutaneous Adverse Reactions ◽  
Cutaneous Adverse Reactions

Severe cutaneous adverse reactions (SCAR) are life-threatening conditions including acute generalized exanthematous pustulosis (AGEP), Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN) and drug reaction with eosinophilia and systemic symptoms (DRESS). Diagnosis of causative underlying drug hypersensitivity (DH) is mandatory due to the high morbidity and mortality upon re-exposure with the incriminated drug. If an underlying DH is suspected, in vivo test, including patch tests (PTs), delayed-reading intradermal tests (IDTs) and in vitro tests can be performed in selected patients for which the suspected culprit drug is mandatory, or in order to find a safe alternative treatment. Positivity of in vivo and in vitro tests in SCAR to drug varies depending on the type of reaction and the incriminated drugs. Due to the severe nature of these reactions, drug provocation test (DPT) is highly contraindicated in patients who experienced SCAR. Thus, sensitivity is based on positive test results in patients with a suggestive clinical history. Patch tests still remain the first-line diagnostic tests in the majority of patients with SCAR, followed, in case of negative results, by delayed-reading IDTs, with the exception of patients with bullous diseases where IDTs are still contra-indicated. In vitro tests have shown promising results in the diagnosis of SCAR to drug. Positivity is particularly high when the lymphocyte transformation test (LTT) is combined with cytokines and cytotoxic markers measurement (cyto-LTT), but this still has to be confirmed with larger studies. Due to the rarity of SCAR, large multi-center collaborative studies are needed to better study the sensitivity and specificity of in vivo and in vitro tests.

The variable spectrum of anterior mitral valve leaflet restriction in rheumatic heart disease screening

2021 ◽  
Author(s):  
Luke David Hunter ◽  
Anton F. Doubell ◽  
Alfonso J. K. Pecoraro ◽  
Mark Monaghan ◽  
Guy Lloyd ◽  
...  
Keyword(s):  
Heart Disease ◽  
Mitral Valve ◽  
Rheumatic Heart Disease ◽  
Disease Screening ◽  
Valve Leaflet ◽  
Mitral Valve Leaflet ◽  
Rheumatic Heart

scholarly journals Erratum to: Pre and Post Operative 3D Echocardiographic Appearance of Isolated Cleft of the Anterior Mitral Valve Leaflet

2010 ◽  
Vol 31 (5) ◽  
pp. 744-744
Author(s):  
Meive Furtado ◽  
Jose Andrade ◽  
Edmar Atik ◽  
Roberto Kalil-Filho
Keyword(s):  
Mitral Valve ◽  
Valve Leaflet ◽  
Mitral Valve Leaflet
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