Mitral valve force balance: a quantitative assessment of annular and subvalvular forces
Siefert, Andrew William
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In vitro and in vivo models were proposed to evaluate the effects of ischemic mitral regurgitation and surgical repair on the function and mechanics of the heart’s mitral valve. In specific aim 1, a novel transducer was developed to measure the radially directed forces that may act on devices implanted to the mitral annulus. In an ovine model, radial forces were found to statistically increase with left ventricular pressure and were reduced in the setting of ischemic mitral regurgitation. In specific aim 2, the suture forces required to constrain true-sized and undersized annuloplasty rings to the mitral annulus of ovine animals was evaluated. Suture forces were observed to be larger on the anterior aspect of the rings and were elevated with annular undersizing. In specific aim 3, an in vitro simulator’s ability to mimic healthy and ischemic mitral regurgitation ovine mitral valve function was evaluated. After understanding the accuracy of the model, the in vitro ischemic mitral regurgitation model was used to evaluate the progressive effects of annuloplasty on strut and intermediary chordal tethering. The generated data and knowledge will contribute to the development of more durable devices and techniques to assess the significant clinical burden known as ischemic mitral regurgitation.