Anterior leaflet augmentation for ischemic mitral regurgitation

Kincaid, Edward H.; Riley, Robert D.; Hines, Michael H.; Hammon, John W.; Kon, Neal D.

doi:10.1016/j.athoracsur.2004.02.040

Cited by 84 publications

(42 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Such changes result from and cause large forces in the surrounding tissue both on the myocardial side and on the leaflet side. Suture lines placed close to highly strained mitral annular segments, for example, during anterior leaflet augmentation, 29 are therefore likely to experience large stresses. Increased stresses in the mitral valve leaflets maybe associated with a higher risk of suture rupture that has been discussed as a potential causes for mitral valve repair failure.…”

Section: Clinical Significancementioning

confidence: 99%

Characterization of Mitral Valve Annular Dynamics in the Beating Heart

et al. 2011

View full text Add to dashboard Cite

The objective of this study is to establish a mathematical characterization of the mitral valve annulus that allows a precise qualitative and quantitative assessment of annular dynamics in the beating heart. We define annular geometry through 16 miniature markers sewn onto the annuli of 55 sheep. Using biplane videofluoroscopy, we record marker coordinates in vivo. By approximating these 16 marker coordinates through piecewise cubic splines, we generate a smooth mathematical representation of the 55 mitral annuli. We time-align these 55 annulus representations with respect to characteristic hemodynamic time points to generate an averaged baseline annulus representation. To characterize annular physiology, we extract classical clinical metrics of annular form and function throughout the cardiac cycle. To characterize annular dynamics, we calculate displacements, strains, and curvature from the discrete mathematical representations. To illustrate potential future applications of this approach, we create rapid prototypes of the averaged mitral annulus at characteristic hemodynamic time points. In summary, this study introduces a novel mathematical model that allows us to identify temporal, regional, and inter-subject variations of clinical and mechanical metrics that characterize mitral annular form and function. Ultimately, this model can serve as a valuable tool to optimize both surgical and interventional approaches that aim at restoring mitral valve competence.

show abstract

Section: Clinical Significancementioning

confidence: 99%

Characterization of Mitral Valve Annular Dynamics in the Beating Heart

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Kincaid et al introduced anterior leaflet augmentation with a pericardial patch combined with annuloplasty and CABG to address the problem of tethered leaflets in chronic ischemic mitral regurgitation. 18 Others have advocated patch enlargement of the posterior leaflet (Figure 7). 19 Another group has recently published on the monocuspidalization of the mitral valve by implantation of a novel bioposterior leaflet, which device imitates a closed posterior mitral leaflet.…”

Section: Novel Approaches To Repair Of the Ischemic Mitral Valvementioning

confidence: 99%

Ischemic Mitral Regurgitation

Boyd

2013

Circ J

View full text Add to dashboard Cite

Chronic ischemic mitral regurgitation (IMR) is still a significant clinical problem. It is present in 10-20% of patients with coronary artery disease and is associated with a worse prognosis after myocardial infarction and subsequent revascularization. Currently, coronary artery bypass grafting combined with restrictive annuloplasty is the most commonly performed surgical procedure, although novel approaches have been used in limited numbers with varying degrees of success. The purpose of this review is to clarify the rationale for the surgical techniques applicable to IMR. In order to do so, the condition will be defined and the evolution of classic or traditional surgical approaches to repairing or replacing the mitral valve in the setting of IMR will be described. Finally, novel approaches to the repair of the ischemic mitral valve will be considered. (Circ J 2013; 77: 1952 -1956

show abstract

“…Also, relative mitral stenosis after reduction annuloplasty has been reported. 27 Enhancement of Coaptation Zone To further enhance the coaptation zone, surgical interventions, including chordal cutting, 28 pericardial patch enlargement of the mitral leaflet, 29 and the use of a remodeling ring specifically designed to treat asymmetric leaflet tethering, 30 have been reported as adjuncts to MAP, with promising long-term results for some methods. Cutting the anterior leaflet second-order "strut" chordae in the chordal cutting procedure is, however, reported to alter LV geometry and impair LV systolic function.…”

Section: Procedures For Fmrmentioning

confidence: 99%

Overlapping Left Ventricular Restoration

Matsui

2009

Circ J

View full text Add to dashboard Cite

Anterior leaflet augmentation for ischemic mitral regurgitation

Cited by 84 publications

References 6 publications

Characterization of Mitral Valve Annular Dynamics in the Beating Heart

Characterization of Mitral Valve Annular Dynamics in the Beating Heart

Ischemic Mitral Regurgitation

Overlapping Left Ventricular Restoration

Contact Info

Product

Resources

About