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Research Papers

In Vitro Stretches of the Mitral Valve Anterior Leaflet Under Edge-to-Edge Repair Condition

[+] Author and Article Information
Zhaoming He1

Department of Mechanical Engineering, Texas Tech University, Lubbock, TX 79409-1021zhaoming.he@ttu.edu

Bo Gao, Shamik Bhattacharya, Tyler Harrist, Sibi Mathew

Department of Mechanical Engineering, Texas Tech University, Lubbock, TX 79409-1021

Wei Sun

Department of Mechanical Engineering, and Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269-3139

1

Corresponding author.

J Biomech Eng 131(11), 111012 (Oct 26, 2009) (5 pages) doi:10.1115/1.4000111 History: Received November 05, 2008; Revised June 03, 2009; Posted September 01, 2009; Published October 26, 2009

Mitral valve edge-to-edge repair (ETER) alters valve mechanics, which may impact efficacy and durability of the repair. The objective of this paper was to quantify stretches in the central region of the anterior leaflet of the mitral valve after ETER with a single suture and 6 mm suture. Sixteen markers, forming a 4×4 array, were attached onto the central region of the mitral valve anterior leaflet. The mitral valve was subjected to ETER with a single suture and 6 mm suture, and mounted in an in vitro flow loop simulating physiological conditions. Images of the marker array were used to calculate marker displacement and stretch. A total of 9 mitral valves were tested. Two peak stretches were observed during a cardiac cycle, one in systole and the other in diastole under mitral valve edge-to-edge repair condition. The major principal (radial) stretch during systole was significantly greater than that during diastole. However, there was no significant difference between the minor principal (circumferential) stretch during diastole and that during systole. In addition, there were no significant differences in the radial and circumferential, or areal stretches and stretch rates during diastole between the single suture and 6 mm suture. The ETER subjects the mitral valve leaflets to double frequency of loading and unloading. Minor change in suture length may not result in a significant load difference in the central region of the anterior leaflet during diastole.

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Copyright © 2009 by American Society of Mechanical Engineers
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Figures

Grahic Jump Location
Figure 3

Peak principal stretches of the central region of the anterior leaflet during systole and diastole under MV ETER with (a) single suture and (b) 6 mm suture. The error bars are in the format of ± 1 standard deviation centered on the averaged principal stretches.

Grahic Jump Location
Figure 4

Loading (a) and unloading (b) rates of the peak principal stretches on the central region of the anterior leaflet under MV ETER with the single suture and 6 mm suture. The error bars are in the format of ± 1 standard deviation centered on the averaged principal stretches.

Grahic Jump Location
Figure 1

A schematic of the left heart simulator and flow loop. A 4×4 marker array in the central area of the anterior leaflet between the annulus and the coaptation line is shown in the lower-right corner. Two high speed cameras were positioned at an angle in the ventricular side of the mitral valve to record three-dimensional marker array spatial positions.

Grahic Jump Location
Figure 2

(a) An example of transmitral pressure and mitral flow rate. (b) An example of the major and minor principal stretches during valve closure and opening.

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