Pre-clinical Experience with a Multi-Chordal Patch for Mitral Valve Repair

Journal of Cardiovascular Translational Research
Surendra K ChawlaMuralidhar Padala

Abstract

Surgical repair of flail mitral valve leaflets with neochordoplasty has good outcomes, but implementing it in anterior and bi-leaflet leaflet repair is challenging. Placing and sizing individual neochordae is time consuming and error prone, with persistent localized flail if performed incorrectly. In this study, we report our pre-clinical experience with a novel multi-chordal patch for mitral valve repair. The device was designed based on human cadaver hearts, and laser cut from expanded polytetrafluoroethylene. The prototypes were tested in: (stage 1) ex vivo hearts with leaflet flail (N = 6), (stage 2) acute swine induced with flail (N = 6), and (stage 3) two chronic swine survived to 23 and 120 days (N = 2). A2 and P2 prolapse were successfully repaired with coaptation length restored to 8.1 ± 2.2mm after posterior repair and to 10.2 ± 1.3mm after anterior repair in ex vivo hearts. In vivo, trace regurgitation was seen after repair with excellent patch durability, healing, and endothelialization at euthanasia. A new device for easier mitral repair is reported, with good early pre-clinical outcomes.

References

Jun 1, 1975·Canadian Journal of Physiology and Pharmacology·K O Lim, D R Boughner
Apr 26, 2008·Journal of Cardiac Surgery·Antonio M CalafiorePaolo Bosco
Jun 12, 2008·The Journal of Thoracic and Cardiovascular Surgery·Loris SalvadorCarlo Valfrè
Jul 14, 2010·European Heart Journal·David H AdamsVolkmar Falk
Jul 31, 2010·Journal of Biomechanical Engineering·Muralidhar PadalaAjit P Yoganathan
Jul 25, 2012·Journal of the Mechanical Behavior of Biomedical Materials·J A CasadoF Gutiérrez-Solana
Jan 24, 2014·Journal of Cardiovascular Translational Research·Paolo DentiOttavio Alfieri
Apr 11, 2014·Journal of Cardiovascular Translational Research·Daniel H SteinbergEric R Powers

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Citations

May 29, 2016·Annals of Biomedical Engineering·Daniella EspirituMuralidhar Padala
Dec 13, 2017·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Surendra K ChawlaRobert W M Frater
Oct 28, 2018·The Journal of Thoracic and Cardiovascular Surgery·Surendra K ChawlaMuralidhar Padala

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