Novel Direct Annuloplasty Fastener System for Minimally Invasive Mitral Valve Repair
| العنوان: | Novel Direct Annuloplasty Fastener System for Minimally Invasive Mitral Valve Repair |
|---|---|
| المؤلفون: | Dumitru Mazilu, Joshua L. Chan, Justin G. Miller, Andrada C. Diaconescu, Keith A. Horvath, Ming Li |
| المصدر: | Cardiovascular Engineering and Technology. 9:53-59 |
| بيانات النشر: | Springer Science and Business Media LLC, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | medicine.medical_specialty, Mitral Valve Annuloplasty, business.product_category, Computer science, medicine.medical_treatment, Sus scrofa, Biomedical Engineering, 030204 cardiovascular system & hematology, Prosthesis Design, Fastener, 03 medical and health sciences, Fixation (surgical), 0302 clinical medicine, Internal medicine, Mitral valve annuloplasty, Mitral valve, Materials Testing, medicine, Animals, Humans, In patient, 030212 general & internal medicine, Heart Valve Prosthesis Implantation, Mitral valve repair, Mitral Valve Insufficiency, Cardiac surgery, medicine.anatomical_structure, Echocardiography, Heart Valve Prosthesis, Models, Animal, cardiovascular system, Cardiology, Feasibility Studies, Mitral Valve, Cardiology and Cardiovascular Medicine, Cadaveric spasm, business, Biomedical engineering |
| الوصف: | The development of less invasive approaches for mitral valve repair remains an important objective, particularly in patients with multiple comorbidities. We describe a novel method to affix a mitral valve annuloplasty ring in a minimally invasive manner. A delivery apparatus for an annuloplasty fastener system was designed. Two channels were created, one for advancing the annuloplasty ring, and another to accommodate the fastener applicator. Custom designed fasteners, either with a helical-shaped screw or a strap-shaped tack structure, were tested. Fasteners were primed within an application device and automatic alignment of fasteners was achieved to allow accurate firing of the fixators securing the ring. The delivery apparatus was constructed to be deployed within a 10 mm trocar through a left atrial approach. Using a cadaveric swine heart model, access to the mitral valve from the left atrium was obtained with insertion of a trocar. The delivery apparatus was accurately directed to the mitral annulus under echocardiographic guidance. Fasteners were placed along the annular plane to secure the annuloplasty ring. Both fastener designs achieved considerable fixation force; the helical-shaped screw was found to have significantly greater fixation force compared to the strap-shaped tack design. The annuloplasty ring remained intact and did not experience any structural deformity during the fixation process. The use of a novel fastener system was successful in deploying and securing a mitral valve annuloplasty ring. These promising results may have further application for minimally invasive mitral valve repairs. Additional evaluation of this procedure with pre-clinical in vivo animal studies is necessary. |
| تدمد: | 1869-4098 1869-408X |
| DOI: | 10.1007/s13239-017-0337-7 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0a1ce4d964ba6d4e883b68fdf5c7d3cb https://doi.org/10.1007/s13239-017-0337-7 |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....0a1ce4d964ba6d4e883b68fdf5c7d3cb |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 18694098 1869408X |
|---|---|
| DOI: | 10.1007/s13239-017-0337-7 |