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二尖瓣蝶形装置：一种使用人工乳头肌的新型腱索修复装置的临床前经验。

Mitral Butterfly: Preclinical Experience of a Novel Chordal Repair Device Using an Artificial Papillary Muscle.

作者信息

Ticar Johanna M, Gaidulis Gediminas, Veith Kenzie, Rath Claus, Jarman Jeremy, Mohl Werner

机构信息

AVVie GmbH, Vienna, Austria.

Department of Biomechanical Engineering, Vilnius Gediminas Technical University, Vilnius, Lithuania.

出版信息

JACC Basic Transl Sci. 2020 Oct 7;5(10):1002-1014. doi: 10.1016/j.jacbts.2020.08.007. eCollection 2020 Oct.

DOI:10.1016/j.jacbts.2020.08.007
PMID:33145463
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7591935/
Abstract

Transcatheter mitral repair is based on the principle of artificial monochordal repair. In this paper, the authors show an alternative, based on the realization of an artificial papillary muscle concept that avoids multiple chordal replacements and fixation in the myocardium. Unlike the interposition of artificial chordae between the free edge of the leaflet and the myocardium, the so-called Mitral Butterfly device collects a multitude of chordae in a matrix connected to a swing arm, stabilizing prolapsing forces with a broad atrial support. Device testing in chronic animal models and in silico substantiated the underlying device concept and performance after 90 days.

摘要

经导管二尖瓣修复术基于人工单弦修复的原理。在本文中，作者展示了一种替代方法，该方法基于人工乳头肌概念的实现，避免了多条弦的置换以及在心肌中的固定。与在瓣叶游离缘和心肌之间插入人工腱索不同，所谓的二尖瓣蝴蝶装置在连接到摆动臂的基质中收集大量腱索，通过广泛的心房支撑来稳定脱垂力。在慢性动物模型和计算机模拟中的装置测试证实了90天后该装置的基本概念和性能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/287effddf703/gr11.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/cfa2bf87a288/gr3.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/dff237730766/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/e80a1a4e3c60/gr7.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/2524b931f488/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/e17f4458ce6c/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/287effddf703/gr11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/8f35d1d481d3/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/177937401f7d/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/dfdf7e453e1b/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/cfa2bf87a288/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/1bfee298fbfe/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/e1d3e3692bfd/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/dff237730766/gr6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/e80a1a4e3c60/gr7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/9f85ca6ff5b1/gr8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/2524b931f488/gr9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/e17f4458ce6c/gr10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/402e/7591935/287effddf703/gr11.jpg

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本文引用的文献

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Int J Numer Method Biomed Eng. 2020 Mar;36(3):e3297. doi: 10.1002/cnm.3297. Epub 2019 Dec 20.
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Artificial mitral chordae: When length matters.人工二尖瓣腱索：长度的重要性。
J Thorac Cardiovasc Surg. 2019 Feb;157(2):e23-e25. doi: 10.1016/j.jtcvs.2018.09.015. Epub 2018 Sep 29.
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Numerical simulation of transapical off-pump mitral valve repair with neochordae implantation.
JACC Basic Transl Sci. 2020 Oct 26;5(10):1015-1016. doi: 10.1016/j.jacbts.2020.09.006. eCollection 2020 Oct.
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The Specialty of Mitral Valve Repair.二尖瓣修复专科
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Degenerative mitral valve disease-contemporary surgical approaches and repair techniques.退行性二尖瓣疾病——当代手术方法与修复技术
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Biomechanical drawbacks of different techniques of mitral neochordal implantation: When an apparently optimal repair can fail.不同二尖瓣腱索植入技术的生物力学缺陷：看似完美的修复也可能失败。
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Is it possible to assess the best mitral valve repair in the individual patient? Preliminary results of a finite element study from magnetic resonance imaging data.是否有可能评估个体患者的最佳二尖瓣修复？基于磁共振成像数据的有限元研究的初步结果。
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