Background: The three-dimensional saddle shape of the mitral annulus is well characterized in animals and humans, but the impact of annular nonplanarity on valve function or mechanics is poorly understood. In this study, we investigated the impact of the saddle shaped mitral annulus on the mechanics of the P2 segment of the posterior mitral leaflet.
Methods: Eight porcine mitral valves (n = 8) were studied in an in-vitro left heart simulator with an adjustable annulus that could be changed from flat to different degrees of saddle. Miniature markers were placed on the atrial face of the posterior leaflet, and leaflet strains at 0%, 10%, and 20% saddle were measured using dual-camera stereophotogrammetry. Averaged areal strain and the principal strain components are reported.
Results: Peak areal strain magnitude decreased significantly from flat to 20% saddle annulus, with a 78% reduction in the measured strain over the entire P2 region. In the radial direction (annulus free edge), a 44.4% reduction in strain was measured, whereas in the circumferential direction (commissure-commissure), a 34% reduction was measured from flat to 20% saddle.
Conclusions: Nonplanar shape of the mitral annulus significantly reduced the mechanical strains on the posterior leaflet during systolic valve closure. Reduction in strain in both the radial and circumferential directions may reduce loading on the suture lines and potentially improve repair durability, and also inhibit progression of valve degeneration in patients with myxomatous valve disease.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021783 | PMC |
| http://dx.doi.org/10.1016/j.athoracsur.2009.06.042 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Redo mitral valve replacement with annular reconstruction of left atrial dissection following mitral valve replacement for infective endocarditis: a case report.
Gen Thorac Cardiovasc Surg Cases
January 2025
Department of Cardiovascular Surgery, Osaka General Medical Center, Osaka, 558-8558, Japan.
Background: Left atrial dissection is a rare and occasionally fatal complication of cardiac surgery and is defined as the creation of a false chamber through a tear in the mitral valve annulus extending into the left atrial wall. Some patients are asymptomatic, while others present with various symptoms, such as chest pain, dyspnea, and even cardiac arrest. Although there is no established management for left atrial dissection, surgery should be considered in patients with hemodynamic disruption.
View Article and Find Full Text PDFInterobserver and intraobserver variability among different vendors for mitral valve assessment: implications for transcatheter mitral valve repair.
Radiol Med
January 2025
Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Purpose: Pre-procedural imaging is critical for transcatheter mitral valve repair planning in patients with mitral valve disease. As differences among various measurement techniques for valve evaluation are still poorly understood, we sought to assess the intra- and interobserver agreement of complex measurements derived from a prototype mitral evaluation tool (Siemens) and a commercially available tool (CVI42) using both saddle- and D-shaped mitral annulus techniques.
Materials And Methods: Multiphasic cardiac computed tomography angiography data were loaded into each software.
"A Bridge-over-the Bar": A Novel Strategy to Prevent Paravalvular Regurgitation during Mitral Valve Replacement for Severe Mitral Annular Calcifications.
Ann Thorac Cardiovasc Surg
January 2025
Division of Pediatric and Adult Congenital Cardiac Surgery, Maria Fareri Children's Hospital, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
Mitral annular calcifications have been known to increase complexity during mitral valve replacement (MVR). Standard procedure requires decalcification followed by reconstruction of the mitral annulus prior to placing the prosthesis. While this is the ideal technique, it is not feasible in every patient due to the associated risks.
View Article and Find Full Text PDFImpact of Exercise on Atrial Functional Mitral Regurgitation and its Ddeterminants. An Exercise Echocardiographic Study.
Am J Cardiol
January 2025
Research group Cardiovascular Diseases, Department GENCOR, University of Antwerp, Antwerp, Belgium; Department of Cardiology, Antwerp University Hospital, Edegem, Belgium. Electronic address:
Atrial functional mitral regurgitation (AFMR) is a distinct form of MR in patients with atrial fibrillation and heart failure with preserved ejection fraction (HFpEF). Its pathophysiology remains elusive, and data on exercise-related AFMR are scarce. We sought to investigate the impact of acute exercise on AFMR severity and to identify its determinants.
View Article and Find Full Text PDFPercutaneous Mitral Valve-in-Ring Procedure in a Case of Severe Mitral Regurgitation Repaired with a Surgical Flexible Ring: A Step-by-Step Description.
Turk Kardiyol Dern Ars
January 2025
Department of Cardiology, Gülhane Faculty of Medicine, University of Health Sciences, Ankara, Türkiye.
Severe mitral regurgitation (MR) following surgical repair of the mitral valve poses a significant clinical challenge. Patients who have undergone surgery are typically at high risk for a second operation. This report details the case of a 54-year-old male who underwent aortic valve replacement and mitral valve repair using a 34-ring, 14 years prior.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!