Ghavidel Alireza Alizadeh, Samiei Niloofar, Javadikasgari Hoda, Bashirpour Kamiar
From the *Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran; and †Mechanical Engineering Department, Amirkabir University of Technology, Tehran, Iran.
Innovations (Phila). 2013 Nov-Dec;8(6):443-9. doi: 10.1097/IMI.0000000000000030.
The exact length of neochordae loops plays the major role in the success of mitral valve repair. The Neochordae Loop Maker is a novel device that models the left ventricular structure in an individual patient. Preoperative transthoracic echocardiography is used to identify the geometry of each papillary muscle and set up the device for the patient. All required neochordae loops are made in the operating room before initiating the cardiopulmonary bypass. In the calibration phase, seven consecutive patients who were candidates for mitral valve replacement underwent transthoracic echocardiography. The device was set up for each patient, and the length of their normal chordae and their respective neochordae was compared by the Bland-Altman analysis. From seven excised mitral valves, 21 chordae were considered normal (gold standard). The length of these gold standards (1.92 ± 0.67 cm) and their respective neochordae (1.93 ± 0.69 cm) showed agreement by the Bland-Altman analysis. The proposed technology showed satisfactory preliminary results in creating the premeasured neochorda loops inasmuch as it reduced the complexity of minimally invasive surgeries.
新腱索环的确切长度对二尖瓣修复的成功起着主要作用。新腱索环制作器是一种能模拟个体患者左心室结构的新型装置。术前经胸超声心动图用于确定每个乳头肌的几何形状，并为患者设置该装置。在启动体外循环之前，所有所需的新腱索环均在手术室制作。在校准阶段，对七名二尖瓣置换术候选患者进行了经胸超声心动图检查。为每位患者设置该装置，并通过布兰德-奥特曼分析比较其正常腱索和各自新腱索的长度。从七个切除的二尖瓣中，21条腱索被视为正常（金标准）。通过布兰德-奥特曼分析，这些金标准腱索的长度（1.92±0.67厘米）与其各自新腱索的长度（1.93±0.69厘米）显示出一致性。所提出的技术在制作预先测量的新腱索环方面显示出令人满意的初步结果，因为它降低了微创手术的复杂性。
