二尖瓣脱垂瓣环张力通过瓣对瓣修复得以矫正。

Annulus tension of the prolapsed mitral valve corrected by edge-to-edge repair.

机构信息

Department of Mechanical Engineering, Texas Tech University, Lubbock, TX 79409, USA.

出版信息

J Biomech. 2012 Feb 2;45(3):562-8. doi: 10.1016/j.jbiomech.2011.11.005. Epub 2011 Dec 5.

DOI:10.1016/j.jbiomech.2011.11.005

PMID:22153221

Abstract

BACKGROUND

Mitral valve (MV) performance after edge-to-edge repair (ETER) without ring annuloplasty is suboptimal. ETER efficacy needs to be evaluated from annulus tension (AT) of a prolapsed MV corrected by ETER to understand annular dilatation.

METHODS

Ten porcine MVs were harvested and mounted on a MV closure test rig. The MV annulus tissue rested on top of a saddle-shaped plastic ring on which the annulus could slide freely. The annulus was held by strings in the periphery during MV closure under a hydrostatic trans-mitral pressure. String tensions were measured and further divided by string spacing to obtain AT. The MVs were then prolapsed by shifting split papillary muscles to simulate mono-leaflet prolapse due to elongation of chords, which insert into a single leaflet. Last, MV prolapse was corrected by ETER applied in the central leaflet region and AT was measured.

RESULTS

AT in both anterior and posterior leaflet prolapse corrected by ETER was less than that of normal MVs. AT in the anterior leaflet prolapse corrected by ETER was less than that in the posterior leaflet prolapse corrected by ETER.

CONCLUSION

ETER does not restore the normal AT and therefore leads potential of annular dilatation. The anterior leaflet prolapse has a greater potential of annular dilatation than the posterior leaflet prolapse after ETER. Annuloplasty is recommended to maintain long-term ETER efficacy.

摘要

背景

二尖瓣（MV）在不进行瓣环成形术的情况下进行缘对缘修复（ETER）后的性能并不理想。需要通过评估通过 ETER 纠正脱垂 MV 的瓣环张力（AT）来评估 ETER 的疗效，以了解瓣环扩张。

方法

采集 10 个猪 MV 并将其安装在 MV 闭合测试装置上。MV 瓣环组织位于马鞍形塑料环的顶部，瓣环可以在其上自由滑动。在静水压跨 MV 压力下，瓣环在闭合过程中通过周围的线固定。测量线张力，并进一步除以线间距以获得 AT。然后通过移位分裂乳头肌模拟由于腱延长而导致的单叶瓣脱垂，将 MV 脱垂，腱插入单个瓣叶。最后，通过在中央瓣叶区域应用 ETER 来纠正 MV 脱垂并测量 AT。