Impact of Anchor Location on Mitral Neochordae Forces: An In Vitro Study.

PURPOSE

This study examined changes in force distribution between the neochordae corresponding to different ventricular anchor locations.

DESCRIPTION

Seven porcine mitral valves were mounted in a left heart simulator. Neochordae (expanded polytetrafluoroethylene) originated from either a simulated left ventricular apex, papillary muscle base, or papillary muscle tip location. The neochordae were attached at three sites along the P leaflet segment: P; P, and P. Mitral regurgitation was induced by cutting posterior leaflet P marginal chordae. The forces on each neochord required to restore normal mitral valve coaptation were quantified for different ventricular anchoring origins and leaflet insertion sites.

EVALUATION

The results showed that under both normotensive and hypertensive conditions, the force exerted was much higher at P than either P or P, independent of ventricular anchor location. Also, forces on both P and P were not statistically different.

CONCLUSIONS

Artificial neochordae treatment for all anchoring locations was effective in correcting induced mitral regurgitation. The P central neochordae had a significantly higher force than both lateral neochords under all conditions.