A study of the mechanical properties of ePTFE suture used as artificial mitral chordae

Caimmi, Philippe Primo; Sabbatini, Maurizio; Fusaro, Luca; Borrone, Alessia; Cannas, M.

doi:10.1111/jocs.12799

Cited by 24 publications

(27 citation statements)

References 15 publications

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“…In general, it has been found that ePTFE chordae do not have similar mechanical properties to native chordae. In particular, Caimmi et al [68] found that ePTFE chordae were of higher compliance than their native counterparts, and that the stiffness of ePTFE chordae increases with the length of the implant. These findings would be beneficial to the refinement of therapeutics to better emulate native structures.…”

Section: Mechanics Of Artificial Chordaementioning

confidence: 99%

Mechanics and Microstructure of the Atrioventricular Heart Valve Chordae Tendineae: A Review

Ross

Zheng

et al. 2020

Bioengineering

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The atrioventricular heart valves (AHVs) are responsible for directing unidirectional blood flow through the heart by properly opening and closing the valve leaflets, which are supported in their function by the chordae tendineae and the papillary muscles. Specifically, the chordae tendineae are critical to distributing forces during systolic closure from the leaflets to the papillary muscles, preventing leaflet prolapse and consequent regurgitation. Current therapies for chordae failure have issues of disease recurrence or suboptimal treatment outcomes. To improve those therapies, researchers have sought to better understand the mechanics and microstructure of the chordae tendineae of the AHVs. The intricate structures of the chordae tendineae have become of increasing interest in recent literature, and there are several key findings that have not been comprehensively summarized in one review. Therefore, in this review paper, we will provide a summary of the current state of biomechanical and microstructural characterizations of the chordae tendineae, and also discuss perspectives for future studies that will aid in a better understanding of the tissue mechanics–microstructure linking of the AHVs’ chordae tendineae, and thereby improve the therapeutics for heart valve diseases caused by chordae failures.

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Section: Mechanics Of Artificial Chordaementioning

confidence: 99%

Mechanics and Microstructure of the Atrioventricular Heart Valve Chordae Tendineae: A Review

Ross

Zheng

et al. 2020

Bioengineering

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“…Mechanical properties derived from uniaxial tensile tests were obtained from literature. 27,28 In this study, virtual transapical neochordae repair was modeled under optimal implantation conditions, that is, following the manufacturer's recommendations 29 and the clinical step-by-step guide. 26,30 Clinically, three or four neochordae are implanted on average in order to balance the tension per neochorda, provide structural support, and avoid excessive mechanical stress on the leaflets.…”

Section: Transapical Neochordae Modelingmentioning

confidence: 99%

Transapical mitral valve repair with neochordae implantation: FSI analysis of neochordae number and complexity of leaflet prolapse

Caballero

Mao

McKay

et al. 2019

Numer Methods Biomed Eng

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Transapical mitral valve repair with neochordae implantation is a relatively new minimally invasive technique to treat primary mitral regurgitation. Quantifying the complex biomechanical interaction and interdependence between the left heart structures and the neochordae during this procedure is technically challenging. The aim of this parametric computational study is to investigate the immediate effects of neochordae number and complexity of leaflet prolapse on restoring physiologic left heart dynamics after optimal transapical neochordae repair procedures. Neochordae implantation using three and four sutures was modeled under three clinically relevant prolapse conditions: isolated P2, multi‐scallop P2/P3, and multi‐scallop P2/P1. A fluid‐structure interaction (FSI) modeling framework was used to evaluate the left heart dynamics under baseline, prerepair, and postrepair states. Despite immediate restoration of leaflet coaptation and no residual mitral regurgitation in all postrepair models, the average and peak stresses in the repaired scallop(s) increased >40% and >100%, respectively, compared with the baseline state. Additionally, anterior mitral leaflet marginal chordae tension increased >30%, while posterior mitral leaflet chordae tension decreased at least 30%. No marked differences in hemodynamic performance, in native and neochordae forces, and in leaflet stress were found when implanting three or four sutures. We report, to our knowledge, the first set of time‐dependent in silico FSI human neochordae tension measurements during transapical neochordae repair. This work represents a further step towards an improved understanding of the biomechanical outcomes of minimally invasive mitral valve repair procedures.

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“…Moreover, different lengths of ePTFE materials showed different mechanical properties and could alter the performance of the material. 31 Based on the mechanical experiments in our study, both the membranes (15×30 mm) had moderate cellulose crystallinity and mechanical strength. The elastic modulus of the BC+Exos membrane and BC membrane was 11.02±0.76 and 10.98±1.26 MPa ( Figure 3E), which was close to the elastic modulus of articular cartilage.…”

Section: Properties Of the Bc+exos Membranementioning

confidence: 67%

A novel bacterial cellulose membrane immobilized with human umbilical cord mesenchymal stem cells-derived exosome prevents epidural fibrosis

Wang

Shangguan

et al. 2018

IJN

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IntroductionFailed back surgery syndrome is a situation where there is failure after lumbar surgery aimed at correcting lumbar disease that is characterized by continuous back and/or leg pain. Epidural fibrosis and adhesions are among the major causes of failed back surgery syndrome. In recent years, several biomaterials have been applied as barriers or deterrents to prevent the compression of neural structures by postsurgical fibrosis.MethodsIn this study, a new bacterial cellulose (BC) anti-adhesion membrane, composed of exosomes from human umbilical cord mesenchymal stem cells, was developed. Its structure and morphology, water content, thickness, and mechanical properties of elasticity were analyzed and characterized. The degradation of the BC+exosomes (BC+Exos) membrane in vitro was evaluated, and its in vitro cytotoxicity and in vivo biocompatibility were tested. The prevention effect of BC+Exos membrane on epidural fibrosis post-laminectomy in a rabbit model was investigated.ResultsThe BC+Exos membrane showed a three-dimensional network structure constituted of high-purity cellulose and moderate mechanical properties. No degeneration was observed. The BC+Exos membrane showed no cytotoxicity and displayed biocompatibility in vivo. The BC+Exos film was able to inhibit epidural fibrosis and peridural adhesions.ConclusionBased on the current findings, the BC+Exos membrane is a promising material to prevent postoperative epidural fibrosis and adhesion.

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A study of the mechanical properties of ePTFE suture used as artificial mitral chordae

Cited by 24 publications

References 15 publications

Mechanics and Microstructure of the Atrioventricular Heart Valve Chordae Tendineae: A Review

Mechanics and Microstructure of the Atrioventricular Heart Valve Chordae Tendineae: A Review

Transapical mitral valve repair with neochordae implantation: FSI analysis of neochordae number and complexity of leaflet prolapse

A novel bacterial cellulose membrane immobilized with human umbilical cord mesenchymal stem cells-derived exosome prevents epidural fibrosis

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