Mechanics Of The Mitral Valve After Surgical Repair An In Vitro Study
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Mechanics Of The Mitral Valve After Surgical Repair An In Vitro Study
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Author : Sai Muralidhar Padala
language : en
Publisher:
Release Date : 2010
Mechanics Of The Mitral Valve After Surgical Repair An In Vitro Study written by Sai Muralidhar Padala and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010 with Biomechanics categories.
Mitral valve disease is widely prevalent among pediatric and adult population across the world, and it encompasses a spectrum of lesions which include congenital valve defects, degenerative valve lesions, and valve dysfunction due to secondary pathologies. Though replacement of the diseased mitral valves with artificial heart valves has been the standard of care until early 1990's, current trends have veered towards complete surgical repair. These trends are encouraging, but current repair techniques are plagued with lack of durability and high rates of failure within 10 years after repair. With increasing number of patients receiving mitral valve repair, there is now an immediate need to understand the mechanisms of repair failure, and assess the role of several clinical risk factors on valve repair. In this thesis, an in vitro pulsatile left heart simulator was developed to mimic the congenital and adult mitral valve pathological morphologies in normal porcine valves, and simulate the pathological valve hemodynamics and mechanics. Different surgical repair techniques were used to correct the valve lesions, and the post repair valve hemodynamics, mechanics and geometry were assessed using quantitative measurement techniques. The extent to which each repair restores physiological valve function and mechanics was assessed, and the impact of different pathological risk factors on repair failure mechanisms was investigated. It is expected that the knowledge from this thesis would play an important role in the evolution of mitral valve surgical repair, and guide the development of more effective and long-lasting heart valve repair technologies.
The Loading And Function Of The Mitral Valve Under Normal Pathological And Repair Conditions
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Author : Jorge Hernan Jimenez-Mejia
language : en
Publisher:
Release Date : 2006
The Loading And Function Of The Mitral Valve Under Normal Pathological And Repair Conditions written by Jorge Hernan Jimenez-Mejia and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2006 with Cardiology, Experimental categories.
Currently, mitral valve repair techniques have shown substandard mid-term and long term results. In order to improve the efficacy of these repair techniques, detailed knowledge of normal mitral valve function and the alterations to the valvular and subvalvular apparatus which occur under pathological conditions is required. Furthermore, current techniques may be optimized through a better understanding of the function and mechanics of the mitral valve after a particular repair. The experiments which comprise this study were designed using an in vitro approach since this technique has the clear advantage of isolating and independently controlling specific parameters that are of importance to valvular mechanics and function. The experiments were conducted in the Georgia Tech Left Heart Simulator using native porcine and human mitral valves. The first set of experiments measured the chordal force distribution and anterior leaflet strain of the mitral valve in its normal geometrical configuration. Subsequent experiments measure mitral regurgitation volume and chordal force distribution in conditions associated with ventricular dilation. The last set of experiments simulated two commonly used mitral repair techniques. For the Alfieri stitch experiments, the effects of mitral flow rate, transmitral pressure, and mitral annular area on valve stenosis, mitral regurgitation and Alfieri stitch force were evaluated. For annuloplasty, the effect of annular saddle curvature on anterior leaflet strain was quantified. In Conclusion, the normal geometry of the native mitral valve optimized its function and mechanics. Under pathological conditions associated with ventricular dilation, significant alterations to mitral valve function and mechanics were present. Although the studied repair techniques may have significantly restored valve function, severe alterations to the mechanics of the valve still persisted.
Mechanics Of The Mitral Valve An In Vivo In Silico Approach
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Author : Manuel K. Rausch
language : en
Publisher:
Release Date : 2013
Mechanics Of The Mitral Valve An In Vivo In Silico Approach written by Manuel K. Rausch and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013 with categories.
The mitral valve is one of four heart valves that ensure unidirectional blood flow through the heart. Due to mitral valve failure approximately 44,000 people in the US alone undergo open heart surgery every year. Current treatment options include mitral valve replacement and mitral valve repair, neither of which have shown satisfying long-term success. A deepened understanding of mitral valve mechanics may help in improving current medical device designs and treatment options for mitral valve regurgitation. Here I provide an in depth analysis of the in vivo mechanics of the mitral valve using the theory of finite kinematics and based on this data develop non-linear in silico models of the mitral valve employing the finite element method. Using mechanical metrics such as strain and curvature I reveal the in vivo deformation of the mitral annulus and the mitral leaflet in the healthy, diseased, and repaired mitral valve. Furthermore, in silico I explore the effects of prestrain as well as growth and remodeling on the mechanics of the mitral valve. The results of my in vivo studies extend our current understanding of the healthy mitral valve, reveal new insight into disease characteristics and progressions, and evaluate the efficacy of current device designs. Furthermore, results from the in silico studies provide improved means to simulate mitral valve mechanics and predict long term adaptation for basic science research and medical device design. In conclusion, with the current work I take a large step toward a deepened understanding of mitral valve mechanics that may help to optimize medical device designs and treatment options.
Mitral Valve Surgery
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Author : Robert S. Bonser
language : en
Publisher: Springer Science & Business Media
Release Date : 2010-12-25
Mitral Valve Surgery written by Robert S. Bonser and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010-12-25 with Medical categories.
Part of the Monographs in Cardiac Surgery Series – Introducing ‘basic science into the cardiac operating room’. Fast systematic review of small areas of cardiac surgery including up-to-date information. This will allow more rapid publication than the alternative cardiac surgery ‘tomes’. This entry into the series will provide readers with a complete review of the current understanding in mitral valve surgery and include extensive details on the diagnosis and surgical management of patients with mitral valve disease.
Atlas Of Mitral Valve Repair
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Author : Edward B. Savage
language : en
Publisher: Lippincott Williams & Wilkins
Release Date : 2012-10-09
Atlas Of Mitral Valve Repair written by Edward B. Savage and has been published by Lippincott Williams & Wilkins this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-10-09 with Medical categories.
This full-color atlas with accompanying video DVD provides a complete and practical "how-to" guide to planning and performing mitral valve repair surgery for mitral regurgitation. The book reviews the natural history of mitral regurgitation, the functional anatomy of the mitral valve, and the use of echocardiography in preoperative evaluation and surgical planning. Chapters describe and illustrate all techniques currently used for mitral valve repair and discuss results. A bound-in DVD presents narrated video clips of six cases that show the application of specific techniques. Each case begins with preoperative echocardiograms demonstrating the mitral valve defect and proceeds through key surgical maneuvers.
Percutaneous Mitral Valve Interventions Repair Current Indications And Future Perspectives
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Author : Alfonso Ielasi
language : en
Publisher: Frontiers Media SA
Release Date : 2020-12-31
Percutaneous Mitral Valve Interventions Repair Current Indications And Future Perspectives written by Alfonso Ielasi and has been published by Frontiers Media SA this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-12-31 with Medical categories.
This eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contact.
Fluid Mechanics Of The Mitral Valve
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Author : Ajit Prithiviraj Yoganathan
language : en
Publisher:
Release Date : 2001
Fluid Mechanics Of The Mitral Valve written by Ajit Prithiviraj Yoganathan and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2001 with categories.
The Effect Of Mechanical Stimuli On The Mitral Valve Interstitial Cell
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Author : Salma Ayoub
language : en
Publisher:
Release Date : 2018
The Effect Of Mechanical Stimuli On The Mitral Valve Interstitial Cell written by Salma Ayoub and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018 with categories.
In the diseases of the mitral valve (MV), such as mitral regurgitation (MR) and degenerative myxomatous MV disease (MMVD), several pathological factors have been shown to affect tissue structure and composition that ultimately lead to valve failure. Current clinical treatments for both functional and degenerative MR include repair by ring annuloplasty (AP). Though beneficial in the short-term, AP has been shown to be less promising long term with repair failure as high as 60%. Mechanical stress is a strong etiological factor: alterations in mechanical loading caused by surgical repair lead to stress-induced changes in mitral valve interstitial cell (MVIC) function that affect both tissue structure and composition, ultimately leading to repair failure. A common thread needed to address these issues is the link between tissue-level stresses and cellular homeostatic responses. MVIC deformation is a major driver for cellular mechanoregulation. As such, a quantitative understanding of MVIC responses to mechanical stimulation in vivo is necessary. We thus hypothesize that abnormal mechanical stimuli lead to non-physiological MVIC deformations that result in phenotypic activation and altered biosynthetic activity. Exploiting this knowledge can lead to improved surgical repair techniques for both functional and degenerative MR. We address our hypothesis in four parts. First, we evaluate the remodeling of the MV anterior leaflet after ischemic MR using an in vivo ovine model, laying out an essential prerequisite for the rest of the dissertation. Second, we characterize the three-dimensional microenvironment of the MVIC under physiological loading, allowing us to develop more structurally accurate computational models that incorporate the heterogeneities of the cellular microenvironment. Third, we use an integrated experimental-computational approach to elucidate the link between MVIC deformation and biosynthetic response in an intact tissue system under simplified deformations. And finally, we design and develop a more physiologically-relevant bioreactor and use it investigate the response of MVICs to a range of simulated physiological and non-physiological loading conditions. Our integrated approaches allowed us to identify MVIC deformation as a key player in leaflet tissue homeostatic regulation and use it as a metric that makes the critical link between in vitro responses to equivalent in vivo behavior.
Diagnosis And Treatment Of Mitral Valve Disease
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Author : Scott Goldman
language : en
Publisher: Elsevier Health Sciences
Release Date : 2022-07-22
Diagnosis And Treatment Of Mitral Valve Disease written by Scott Goldman and has been published by Elsevier Health Sciences this book supported file pdf, txt, epub, kindle and other format this book has been release on 2022-07-22 with Medical categories.
The only reference wholly dedicated to this complex topic, Diagnosis and Treatment of Mitral Valve Disease: A Multidisciplinary Approach provides authoritative, must-have information on the disease processes affecting the mitral valve, interpretation of diagnostic studies, and medical, transcatheter, and surgical treatments needed for mitral valve repair. Using a multidisciplinary approach, Drs. Scott Goldman and William Gray oversee a “who’s who team of contributing authors who offer a holistic view of the modern treatment of mitral valve disease for today’s cardiac surgeons, cardiologists, and other cardiac team members. Includes foundational chapters on anatomy and pathophysiology of the mitral valve—critically important topics when treating multiple complex and highly dynamic structures that function as a single unit. Covers diagnostic tools, medical treatments, surgical therapies, and transcatheter therapies, and provides tips for developing a successful mitral valve program (with baseline thresholds, common pitfalls, and a checklist for hospitals). Uses an accessible, quick-reference format that features takeaway chapter openers, bulleted key points, end-of-chapter summaries, a common nomenclature and glossary of terms, key references, and ample line drawings, photographs, tables, charts, and graphs throughout. Incorporates the essential role of imaging in structural transcatheter interventions, including echocardiography and transcatheter edge-to-edge repair (TEER), and their uses in diagnostic work-up, procedural planning, intra-procedural guidance, and follow-up. Features dozens of procedural videos, including transthoracic echocardiogram; cardiac MRI for mitral regurgitation; transcatheter mitral valve repair; transcatheter valvuloplasty; percutaneous mitral valve interventions; MitraClipTM positioning; and many more.
Mitral Valve Surgery
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Author :
language : en
Publisher:
Release Date : 2011-07-11
Mitral Valve Surgery written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011-07-11 with categories.