Beating-heart, off-pump mitral valve repair by implantation of artificial chordae tendineae

An acute in vivo animal study

Pietro Bajona, William E. Katz, Richard C. Daly, Kenton J. Zehr, Giovanni Speziali

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Objective: To evaluate the effectiveness of a new off-pump mitral valve repair technology in restoring valve competency in a porcine model of acute mitral regurgitation. Methods: Acute mitral regurgitation was induced in 6 anesthetized pigs by cutting anterior leaflet chordae. Artificial chordae were then transapically implanted on the prolapsing segment under epicardial echocardiographic guidance and secured outside the left ventricular apex. All intracardiac manipulations were performed off-pump, through a stab wound incision on the left ventricular apex. Results: Cutting the anterior leaflet chordae caused an eccentric, posteriorly directed jet of mitral regurgitation that could be visualized by color Doppler sonography. Implantation of chordae through the left ventricular apex completely eliminated valve regurgitation in 4 animals and reduced regurgitation in 2. Intraoperative measurement of artificial chordal tensions gave similar values to those reported for native chordae. Conclusions: Off-pump, transapical implantation of artificial chordae between a prolapsing anterior mitral valve leaflet and the left ventricular apex was effective in reducing acutely induced mitral regurgitation. Long-term studies are planned to assess the stability in this animal model.

Original languageEnglish (US)
Pages (from-to)188-193
Number of pages6
JournalJournal of Thoracic and Cardiovascular Surgery
Volume137
Issue number1
DOIs
StatePublished - Jan 2009

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Chordae Tendineae
Mitral Valve Insufficiency
Mitral Valve
Swine
Stab Wounds
Doppler Color Ultrasonography
Animal Models
Technology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Beating-heart, off-pump mitral valve repair by implantation of artificial chordae tendineae : An acute in vivo animal study. / Bajona, Pietro; Katz, William E.; Daly, Richard C.; Zehr, Kenton J.; Speziali, Giovanni.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 137, No. 1, 01.2009, p. 188-193.

Research output: Contribution to journalArticle

Bajona, Pietro ; Katz, William E. ; Daly, Richard C. ; Zehr, Kenton J. ; Speziali, Giovanni. / Beating-heart, off-pump mitral valve repair by implantation of artificial chordae tendineae : An acute in vivo animal study. In: Journal of Thoracic and Cardiovascular Surgery. 2009 ; Vol. 137, No. 1. pp. 188-193.
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