TY - JOUR
T1 - Mechanics of mitral valve edge-to-edge-repair and mitraclip procedure
AU - Bhattachary, Shamik
AU - He, Zhaoming
N1 - Publisher Copyright:
© 2015 by Begell House, Inc.
PY - 2015
Y1 - 2015
N2 - The edge-to-edge repair (ETER) technique has been used as a stand-alone procedure, or as a secondary procedure with ring annuloplasty for degenerative, functional mitral regurgitation, or for mitral regurgitation of other kinds of valvular etiologies. The percutaneous MitraClip technique based on ETER has been used in patients who are inoperable or at high surgical risk. However, adverse events such as residual mitral regurgitation, and clip detachment or fracture indicate that the mechanics underlying these procedures is not well understood. Therefore, current studies on mitral valve functionality and mechanics related to the ETER and MitraClip procedures are reviewed to improve the efficacy and safety of both procedures. Extensive in vivo, in vitro, and in silico studies related to ETER and MitraClip procedures along with MitraClip clinical trial results are presented and discussed herein. The ETER suture force and the mitral valve tissue mechanics and hemodynamics of each procedure are discussed. A quantitative understanding of the interplay of mitral valve components and as to biological response to the procedures remains challenging. Based on mitral valve mechanics, ETER or MitraClip therapy can be optimized to enhance repair efficacy and durability.
AB - The edge-to-edge repair (ETER) technique has been used as a stand-alone procedure, or as a secondary procedure with ring annuloplasty for degenerative, functional mitral regurgitation, or for mitral regurgitation of other kinds of valvular etiologies. The percutaneous MitraClip technique based on ETER has been used in patients who are inoperable or at high surgical risk. However, adverse events such as residual mitral regurgitation, and clip detachment or fracture indicate that the mechanics underlying these procedures is not well understood. Therefore, current studies on mitral valve functionality and mechanics related to the ETER and MitraClip procedures are reviewed to improve the efficacy and safety of both procedures. Extensive in vivo, in vitro, and in silico studies related to ETER and MitraClip procedures along with MitraClip clinical trial results are presented and discussed herein. The ETER suture force and the mitral valve tissue mechanics and hemodynamics of each procedure are discussed. A quantitative understanding of the interplay of mitral valve components and as to biological response to the procedures remains challenging. Based on mitral valve mechanics, ETER or MitraClip therapy can be optimized to enhance repair efficacy and durability.
KW - Mechanics
KW - Medical device
KW - Mitral valve
KW - Percutaneous repair
UR - http://www.scopus.com/inward/record.url?scp=84932137154&partnerID=8YFLogxK
U2 - 10.1615/jlongtermeffmedimplants.2015011729
DO - 10.1615/jlongtermeffmedimplants.2015011729
M3 - Article
C2 - 25955011
AN - SCOPUS:84932137154
SN - 1050-6934
VL - 25
SP - 135
EP - 145
JO - Journal of Long-Term Effects of Medical Implants
JF - Journal of Long-Term Effects of Medical Implants
IS - 1-2
ER -