Do annuloplasty rings designed to treat ischemic/functional mitral regurgitation alter left-ventricular dimensions in the acutely ischemic ovine heart?

被引:10
作者
Bothe, Wolfgang [1 ,2 ]
Kvitting, John-Peder Escobar [2 ,4 ]
Rausch, Manuel K. [5 ]
Timek, Tomasz A. [2 ,6 ]
Swanson, Julia C. [2 ,7 ]
Liang, David H. [3 ]
Walther, Mario [8 ]
Kuhl, Ellen [2 ,9 ]
Ingels, Neil B., Jr. [2 ,10 ]
Miller, D. Craig [2 ]
机构
[1] Univ Freiburg, Dept Cardiovasc Surg, Heart Ctr Freiburg, Fac Med, Freiburg, Germany
[2] Stanford Univ, Dept Cardiothorac Surg, Sch Med, Stanford, CA USA
[3] Stanford Univ, Dept Cardiol, Sch Med, Stanford, CA USA
[4] Natl Hosp Norway, Oslo Univ Hosp, Dept Cardiothorac Surg, Oslo, Norway
[5] Univ Texas Austin, Aerosp Engn & Engn Mech, Austin, TX 78712 USA
[6] Spectrum Hlth, Div Cardiothorac Surg, Grand Rapids, MI USA
[7] Providence St Vincent Hosp, Providence Heart & Vasc Inst, Portland, OR USA
[8] Univ Appl Sci, Dept Math & Appl Stat, Jena, Germany
[9] Stanford Univ, Sch Engn, Dept Mech Engn, Stanford, CA USA
[10] Palo Alto Med Fdn, Res Inst, Lab Cardiovasc Physiol & Biophys, Palo Alto, CA 94301 USA
基金
美国国家卫生研究院;
关键词
mitral valve; mitral regurgitation; mitral valve repair; cardiomyopathy; heart failure; pathophysiology; surgery techniques; cardiac intervention; IMR ETLOGIX(R) RING; VALVE REPAIR; OUTCOMES; COMPLEX;
D O I
10.1016/j.jtcvs.2018.12.077
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To quantify the effects of annuloplasty rings designed to treat ischemic/functional mitral regurgitation on left ventricular septal-lateral (S-L) and commissure-commissure (C-C) dimensions. Methods: Radiopaque markers were placed as opposing pairs on the S-L and C-C aspects of the mitral annulus and the basal, equatorial, and apical level of the left ventricle (LV) in 30 sheep. Ten true-sized Carpentier-Edwards Physio (PHY), Edwards IMR ETlogix (ETL), and GeoForm (GEO; all from Edwards Lifesciences, Irvine, Calif) annuloplasty rings were inserted in a releasable fashion. After 90 seconds of left circumflex artery occlusion with the ring implanted (RING), 4-dimensional marker coordinates were obtained using biplane videofluoroscopy. After ring release, another data set was acquired after another 90 seconds of left circumflex artery occlusion (NO RING). S-L and C-C diameters were computed as the distances between the respective marker pairs at end-diastole. Percent change in diameters was calculated between RING versus NO RING as 100 x (diameter in centimeters [RING] - diameter in centimeters [NO RING])/diameter in centimeters [NO RING]). Results: Compared with NO RING, all ring types (PHY, ETL, and GEO) reduced mitral annular S-L dimensions by -20.7 +/- 5.6%, -26.8 +/- 3.9%, and -34.5 +/- 3.8%, respectively. GEO reduced the S-L dimensions of the LV at the basal level only by -2.3 +/- 2.4%, whereas all other S-L dimensions of the LV remained unchanged with all 3 rings implanted. PHY, ETL, and GEO reduced mitral annular C-C dimensions by -17.5 +/- 4.8%, -19.6 +/- 2.5, and -8.3 +/- 4.9%, respectively, but none of the rings altered the C-C dimensions of the LV. Conclusions: Despite radical reduction of mitral annular size, disease-specific ischemic/functional mitral regurgitation annuloplasty rings do not induce relevant changes of left ventricular dimensions in the acutely ischemic ovine heart.
引用
收藏
页码:1058 / 1068
页数:11
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