Selectively Compliant Annuloplasty Ring to Enable Annular Dynamics in Mitral Valve Repair Evaluated by In-Vitro Stereovision

Samuel Frishman, Annabel M. Imbrie-Moore, M. Cutkosky, Ali Kight, I. Pirozzi, Michael J Paulsen, J. Woo
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Abstract

Mitral valve (MV) annular dynamics are critical to the long term efficacy of MV repair. Today’s annuloplasty rings, used to restore MV function, impose significant constraints on the motion profile of the MV annulus. We present a selectively compliant ring that provides sufficient stiffness to stabilize a diseased annulus while allowing physiological annular dynamics. Ring design is informed by a finite element analysis and experimentally evaluated with in-vitro stereophotogrammetry. We compare the ring dynamics to commercially available semi-rigid rings as well as values found in literature for healthy annuli. The results demonstrate that motion of the selectively compliant ring is significantly closer to that of a healthy annulus based on standard metrics that define MV annular movement. Specifically, the metrics for the new ring compare to those in literature as follows: change in orifice area 12.5 ± 3% vs.10 ± 2%; change in anterior-posterior diam. 5.4 ± 0.3% vs. 7 ± 1%; change in inter-commissural diam. 6.6 ± 1.3% vs. 5 ± 1%.
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体外立体视觉评估选择性顺应环成形术使二尖瓣修复中的环动力学成为可能
二尖瓣环动力学对二尖瓣修复的长期疗效至关重要。目前用于恢复中压功能的环成形术对中压环的运动轮廓有很大的限制。我们提出了一种选择性柔顺环,提供足够的刚度来稳定患病环空,同时允许生理环空动力学。环形设计是由有限元分析和实验评估与体外立体摄影测量。我们将环动力学与商业上可用的半刚性环以及健康环空文献中发现的值进行比较。结果表明,基于定义MV环空运动的标准指标,选择性柔顺环的运动明显接近健康环空的运动。具体而言,新环与文献中的指标进行了比较:孔口面积变化12.5±3% vs.10±2%;前后直径变化:5.4±0.3% vs. 7±1%;关节间直径变化:6.6±1.3% vs. 5±1%。
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