Acute in vivo evaluation of a new stentless mitral valve

Jose L. Navia, Kazuyoshi Doi, Fernando A. Atik, Kiyotaka Fukamachi, Michael W. Kopcak, Raymond Dessoffy, Pablo Ruda-Vega, Mario J. Garcia, Penny L. Houghtaling, Maureen Martin, Eugene H. Blackstone, Patrick M. McCarthy, Bruce W. Lytle

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives: We have developed a stentless pericardial mitral valve prosthesis in 2 configurations; the purposes of this acute study in sheep were to assess (1) valve design and implant technique; (2) valve performance; and (3) acute effects on postimplant left ventricular function. Methods: A stentless bovine pericardial bileaflet valve was developed with the intent to preserve annular-papillary muscle continuity. This valve, in 2 configurations-with (n = 5) and without (n = 5) flap chordae-was implanted in 10 sheep (mean weight 73 ± 9 kg). Epicardial echocardiography was performed to assess valve performance. Load-independent left ventricular function was also estimated before implantation (baseline), 1 hour after discontinuing cardiopulmonary bypass (rest), and during dobutamine stimulation using conductance technology. Results: Implantation was easily accomplished for both configurations. Both configurations had low transvalvular pressure (mean 2.1 ± 1.2 mm Hg at rest; 2.2 ± 1.0 mm Hg with dobutamine stimulation with flap chordae; 1.7 ± 0.5 mm Hg and 1.6 ± 0.3 mm Hg without flap chordae). No mitral regurgitation was observed in 8 sheep, and mild regurgitation was seen in 2 sheep. Compared with baseline, slope of maximum rate of change of left ventricular pressure-end-diastolic volume relation increased with stimulation both with flap chordae (+52 ± 41 mm Hg · s-1 · mL-1, P = .0005) and without (+20 ± 12 mm Hg · s-1 · mL-1, P = .003). Conclusions: Both configurations of this newly designed stentless mitral bioprosthesis, which preserves annular-papillary muscle continuity using different novel surgical implantation techniques, demonstrated reliable valve performance, with low transvalvular pressure gradients, minimal regurgitation, and acutely preserved postimplant left ventricular function. Further chronic study is needed to verify these results and evaluate reliability of implantation procedures, biocompatibility, and durability.

Original languageEnglish (US)
JournalJournal of Thoracic and Cardiovascular Surgery
Volume133
Issue number4
DOIs
StatePublished - Apr 2007
Externally publishedYes

Fingerprint

Mitral Valve
Sheep
Left Ventricular Function
Dobutamine
Papillary Muscles
Bioprosthesis
Pressure
Mitral Valve Insufficiency
Ventricular Pressure
Cardiopulmonary Bypass
Reproducibility of Results
Stroke Volume
Prostheses and Implants
Echocardiography
Technology
Weights and Measures

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Navia, J. L., Doi, K., Atik, F. A., Fukamachi, K., Kopcak, M. W., Dessoffy, R., ... Lytle, B. W. (2007). Acute in vivo evaluation of a new stentless mitral valve. Journal of Thoracic and Cardiovascular Surgery, 133(4). https://doi.org/10.1016/j.jtcvs.2006.11.044

Acute in vivo evaluation of a new stentless mitral valve. / Navia, Jose L.; Doi, Kazuyoshi; Atik, Fernando A.; Fukamachi, Kiyotaka; Kopcak, Michael W.; Dessoffy, Raymond; Ruda-Vega, Pablo; Garcia, Mario J.; Houghtaling, Penny L.; Martin, Maureen; Blackstone, Eugene H.; McCarthy, Patrick M.; Lytle, Bruce W.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 133, No. 4, 04.2007.

Research output: Contribution to journalArticle

Navia, JL, Doi, K, Atik, FA, Fukamachi, K, Kopcak, MW, Dessoffy, R, Ruda-Vega, P, Garcia, MJ, Houghtaling, PL, Martin, M, Blackstone, EH, McCarthy, PM & Lytle, BW 2007, 'Acute in vivo evaluation of a new stentless mitral valve', Journal of Thoracic and Cardiovascular Surgery, vol. 133, no. 4. https://doi.org/10.1016/j.jtcvs.2006.11.044
Navia, Jose L. ; Doi, Kazuyoshi ; Atik, Fernando A. ; Fukamachi, Kiyotaka ; Kopcak, Michael W. ; Dessoffy, Raymond ; Ruda-Vega, Pablo ; Garcia, Mario J. ; Houghtaling, Penny L. ; Martin, Maureen ; Blackstone, Eugene H. ; McCarthy, Patrick M. ; Lytle, Bruce W. / Acute in vivo evaluation of a new stentless mitral valve. In: Journal of Thoracic and Cardiovascular Surgery. 2007 ; Vol. 133, No. 4.
@article{20dd3d3aa84f4aaea03f37747c4ee6f7,
title = "Acute in vivo evaluation of a new stentless mitral valve",
abstract = "Objectives: We have developed a stentless pericardial mitral valve prosthesis in 2 configurations; the purposes of this acute study in sheep were to assess (1) valve design and implant technique; (2) valve performance; and (3) acute effects on postimplant left ventricular function. Methods: A stentless bovine pericardial bileaflet valve was developed with the intent to preserve annular-papillary muscle continuity. This valve, in 2 configurations-with (n = 5) and without (n = 5) flap chordae-was implanted in 10 sheep (mean weight 73 ± 9 kg). Epicardial echocardiography was performed to assess valve performance. Load-independent left ventricular function was also estimated before implantation (baseline), 1 hour after discontinuing cardiopulmonary bypass (rest), and during dobutamine stimulation using conductance technology. Results: Implantation was easily accomplished for both configurations. Both configurations had low transvalvular pressure (mean 2.1 ± 1.2 mm Hg at rest; 2.2 ± 1.0 mm Hg with dobutamine stimulation with flap chordae; 1.7 ± 0.5 mm Hg and 1.6 ± 0.3 mm Hg without flap chordae). No mitral regurgitation was observed in 8 sheep, and mild regurgitation was seen in 2 sheep. Compared with baseline, slope of maximum rate of change of left ventricular pressure-end-diastolic volume relation increased with stimulation both with flap chordae (+52 ± 41 mm Hg · s-1 · mL-1, P = .0005) and without (+20 ± 12 mm Hg · s-1 · mL-1, P = .003). Conclusions: Both configurations of this newly designed stentless mitral bioprosthesis, which preserves annular-papillary muscle continuity using different novel surgical implantation techniques, demonstrated reliable valve performance, with low transvalvular pressure gradients, minimal regurgitation, and acutely preserved postimplant left ventricular function. Further chronic study is needed to verify these results and evaluate reliability of implantation procedures, biocompatibility, and durability.",
author = "Navia, {Jose L.} and Kazuyoshi Doi and Atik, {Fernando A.} and Kiyotaka Fukamachi and Kopcak, {Michael W.} and Raymond Dessoffy and Pablo Ruda-Vega and Garcia, {Mario J.} and Houghtaling, {Penny L.} and Maureen Martin and Blackstone, {Eugene H.} and McCarthy, {Patrick M.} and Lytle, {Bruce W.}",
year = "2007",
month = "4",
doi = "10.1016/j.jtcvs.2006.11.044",
language = "English (US)",
volume = "133",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "4",

}

TY - JOUR

T1 - Acute in vivo evaluation of a new stentless mitral valve

AU - Navia, Jose L.

AU - Doi, Kazuyoshi

AU - Atik, Fernando A.

AU - Fukamachi, Kiyotaka

AU - Kopcak, Michael W.

AU - Dessoffy, Raymond

AU - Ruda-Vega, Pablo

AU - Garcia, Mario J.

AU - Houghtaling, Penny L.

AU - Martin, Maureen

AU - Blackstone, Eugene H.

AU - McCarthy, Patrick M.

AU - Lytle, Bruce W.

PY - 2007/4

Y1 - 2007/4

N2 - Objectives: We have developed a stentless pericardial mitral valve prosthesis in 2 configurations; the purposes of this acute study in sheep were to assess (1) valve design and implant technique; (2) valve performance; and (3) acute effects on postimplant left ventricular function. Methods: A stentless bovine pericardial bileaflet valve was developed with the intent to preserve annular-papillary muscle continuity. This valve, in 2 configurations-with (n = 5) and without (n = 5) flap chordae-was implanted in 10 sheep (mean weight 73 ± 9 kg). Epicardial echocardiography was performed to assess valve performance. Load-independent left ventricular function was also estimated before implantation (baseline), 1 hour after discontinuing cardiopulmonary bypass (rest), and during dobutamine stimulation using conductance technology. Results: Implantation was easily accomplished for both configurations. Both configurations had low transvalvular pressure (mean 2.1 ± 1.2 mm Hg at rest; 2.2 ± 1.0 mm Hg with dobutamine stimulation with flap chordae; 1.7 ± 0.5 mm Hg and 1.6 ± 0.3 mm Hg without flap chordae). No mitral regurgitation was observed in 8 sheep, and mild regurgitation was seen in 2 sheep. Compared with baseline, slope of maximum rate of change of left ventricular pressure-end-diastolic volume relation increased with stimulation both with flap chordae (+52 ± 41 mm Hg · s-1 · mL-1, P = .0005) and without (+20 ± 12 mm Hg · s-1 · mL-1, P = .003). Conclusions: Both configurations of this newly designed stentless mitral bioprosthesis, which preserves annular-papillary muscle continuity using different novel surgical implantation techniques, demonstrated reliable valve performance, with low transvalvular pressure gradients, minimal regurgitation, and acutely preserved postimplant left ventricular function. Further chronic study is needed to verify these results and evaluate reliability of implantation procedures, biocompatibility, and durability.

AB - Objectives: We have developed a stentless pericardial mitral valve prosthesis in 2 configurations; the purposes of this acute study in sheep were to assess (1) valve design and implant technique; (2) valve performance; and (3) acute effects on postimplant left ventricular function. Methods: A stentless bovine pericardial bileaflet valve was developed with the intent to preserve annular-papillary muscle continuity. This valve, in 2 configurations-with (n = 5) and without (n = 5) flap chordae-was implanted in 10 sheep (mean weight 73 ± 9 kg). Epicardial echocardiography was performed to assess valve performance. Load-independent left ventricular function was also estimated before implantation (baseline), 1 hour after discontinuing cardiopulmonary bypass (rest), and during dobutamine stimulation using conductance technology. Results: Implantation was easily accomplished for both configurations. Both configurations had low transvalvular pressure (mean 2.1 ± 1.2 mm Hg at rest; 2.2 ± 1.0 mm Hg with dobutamine stimulation with flap chordae; 1.7 ± 0.5 mm Hg and 1.6 ± 0.3 mm Hg without flap chordae). No mitral regurgitation was observed in 8 sheep, and mild regurgitation was seen in 2 sheep. Compared with baseline, slope of maximum rate of change of left ventricular pressure-end-diastolic volume relation increased with stimulation both with flap chordae (+52 ± 41 mm Hg · s-1 · mL-1, P = .0005) and without (+20 ± 12 mm Hg · s-1 · mL-1, P = .003). Conclusions: Both configurations of this newly designed stentless mitral bioprosthesis, which preserves annular-papillary muscle continuity using different novel surgical implantation techniques, demonstrated reliable valve performance, with low transvalvular pressure gradients, minimal regurgitation, and acutely preserved postimplant left ventricular function. Further chronic study is needed to verify these results and evaluate reliability of implantation procedures, biocompatibility, and durability.

UR - http://www.scopus.com/inward/record.url?scp=33947213333&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33947213333&partnerID=8YFLogxK

U2 - 10.1016/j.jtcvs.2006.11.044

DO - 10.1016/j.jtcvs.2006.11.044

M3 - Article

C2 - 17382639

AN - SCOPUS:33947213333

VL - 133

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 4

ER -