Abstract

Optimal translocation patch width for functional mitral regurgitation (FMR) treatment was evaluated in an air-filled ex vivo system. FMR was created in 19 isolated swine hearts by annular dilation and papillary muscle displacement. Frustum-shaped pericardial patches of varying widths (Group 1 = 0.5 cm; Group 2 = 1.0 cm; Group 3 = 1.5 cm) were implanted and imaged via a 3D-structured light scanner. Median leaflet coaptation decreased (P < 0.001) from 5.5 ± 2.0 mm at baseline to 2.4 ± 1.3 mm following FMR creation. Translocation repair increased coaptation length over FMR levels by 2.2 mm in Group 1 (P < 0.001), 4.6 mm in Group 2 (P < 0.001), and 4.7 mm in Group 3 (P < 0.001). After repair, no significant differences were found between groups for annular height, circularity index, tenting height, tenting area, and non-coapting surface area. The supranormal coaptation and minimal valve geometric changes support using a 1.0- or 1.5-cm translocation patch for FMR treatment.

Graphical abstract

Implantation of a 1.0-cm or 1.5-cm circumferential pericardial patch (mitral valve translocation) increases leaflet coaptation length without significantly altering valve geometry.

中文翻译：

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二尖瓣易位：继发性二尖瓣反流体外模型中斑块几何形状的优化

摘要

在充满空气的离体系统中评估了功能性二尖瓣反流 (FMR) 治疗的最佳易位补片宽度。FMR 是通过环状扩张和乳头肌移位在 19 只孤立的猪心脏中产生的。通过 3D 结构光扫描仪植入和成像不同宽度的截锥体形心包贴片（第 1 组 = 0.5 厘米；第 2 组 = 1.0 厘米；第 3 组 = 1.5 厘米）。在 FMR 创建后，中位小叶接合减少 ( P  < 0.001) 从基线的 5.5 ± 2.0 mm 到 2.4 ± 1.3 mm。易位修复使第 1 组的接合长度在 FMR 水平上增加了 2.2 毫米（P  < 0.001），第 2 组增加了 4.6 毫米（P  < 0.001），第 3 组增加了 4.7 毫米（P < 0.001)。修复后，环高、圆度指数、隆起高度、隆起面积和非接合表面积组间无显着差异。超常接合和最小的瓣膜几何变化支持使用 1.0 或 1.5 厘米易位贴片进行 FMR 治疗。

图形概要

植入 1.0 厘米或 1.5 厘米的环形心包补片（二尖瓣易位）可增加小叶接合长度，而不会显着改变瓣膜几何形状。