Biomechanical engineering analysis of an acute papillary muscle rupture disease model using an innovative 3D-printed left heart simulator.
Ex vivo model
Mitral regurgitation
Papillary muscle rupture
Journal
Interactive cardiovascular and thoracic surgery
ISSN: 1569-9285
Titre abrégé: Interact Cardiovasc Thorac Surg
Pays: England
ID NLM: 101158399
Informations de publication
Date de publication:
02 05 2022
02 05 2022
Historique:
received:
15
11
2021
accepted:
08
12
2021
pubmed:
14
1
2022
medline:
10
5
2022
entrez:
13
1
2022
Statut:
ppublish
Résumé
The severity of acute papillary muscle (PM) rupture varies according to the extent and site of the rupture. However, the haemodynamic effects of different rupture variations are still poorly understood. Using a novel ex vivo model, we sought to study acute PM rupture to improve clinical management. Using porcine mitral valves (n = 32) mounted within an ex vivo left heart simulator, PM rupture was simulated. The mitral valve was divided into quadrants for analysis according to the PM heads. Acute PM rupture was simulated by incrementally cutting from 1/3 to the total number of chordae arising from 1 PM head of interest. Haemodynamic parameters were measured. Rupture >2/3 of the chordae from 1 given PM head or regurgitation fraction >60% led to markedly deteriorated haemodynamics. Rupture at the anterolateral PM had a stronger negative effect on haemodynamics than rupture at the posteromedial PM. Rupture occurring at the anterior head of the anterolateral PM led to more marked haemodynamic instability than rupture occurring at the other PM heads. The haemodynamic effects of acute PM rupture vary considerably according to the site and extent of the rupture. Rupture of ≤2/3 of chordae from 1 PM head or rupture at the posteromedial PM lead to less marked haemodynamics effects, suggesting a higher likelihood of tolerating surgery. Rupture at the anterolateral PM, specifically the anterior head, rupture of >2/3 of chordae from 1 PM head or regurgitation fraction >60% led to marked haemodynamic instability, suggesting the potential benefit from bridging strategies prior to surgery.
Identifiants
pubmed: 35022737
pii: 6504773
doi: 10.1093/icvts/ivab373
pmc: PMC9153378
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
822-830Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL089315
Pays : United States
Organisme : Thoracic Surgery Foundation Resident Research Fellowship
Organisme : National Science Foundation Graduate Research Fellowship Program
ID : DGE-1656518
Organisme : Stanford Graduate Fellowship (Annabel M. Imbrie-Moore)
Organisme : NHLBI NIH HHS
ID : R01 HL152155
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.
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