Key result
Decellularized tendon-based mitral rings reduce regurgitation to ~16%, matching commercial rings in preclinical testing.
Why the study?
Conventional mitral annuloplasty rings made of metal or synthetic polymers may increase infection risk, prompting development of a ring using decellularised tissue.
Does a decellularised tendon-based annuloplasty ring reduce regurgitation comparably to commercial rings in an in vitro degenerative mitral regurgitation model?
Does a decellularised tendon-based annuloplasty ring reduce regurgitation comparably to commercial rings in an in vitro degenerative mitral regurgitation model?
A novel decellularised tendon-based mitral annuloplasty ring demonstrated comparable regurgitation suppression and effective mitral valve area to commercial rings in an in vitro degenerative mitral regurgitation model.
Supports biological ring development in preclinical MR models; leaves open clinical translation pending in vivo validation.
OBJECTIVES Conventional annuloplasty rings used in mitral valve repair (MVr) are made of metal or synthetic polymers, which may increase infection risk. This study aimed to develop a mitral annuloplasty ring using decellularised tissue and evaluate its ability to suppress regurgitation in a degenerative mitral regurgitation (DMR) model. METHODS A 4 mm diameter annuloplasty ring was created using decellularized bovine tendon. Porcine mitral valve complexes (including the annulus, leaflets, chordae tendineae, and papillary muscles) were obtained from a slaughterhouse. The annulus was enlarged by 4 mm, and the two chordae tendineae of the posterior leaflet (P2) were severed. The DMR model, integrated into a pulsatile flow simulator, was repaired using a commercial—Physio II, Colvin-Galloway (CG) Future, Tailor band, and a decellularised tendon-based ring. Regurgitation control and effective mitral valve area (MVA) were compared (n = 6 for each group). RESULTS The regurgitation rate of the DMR model was 52.3 ± 3.4%, consistent with severe MR. Post-MVr with each ring, the regurgitation rates were 14.9 ± 3.1% (Physio II), 14.5 ± 1.1% (CG Future), 16.4 ± 1.7% (Tailor band), and 15.5 ± 3.0% (decellularised tendon-based biological ring). All of these rates were significantly reduced, with no significant differences among them. Effective MVA was comparable across groups: 2.46 ± 0.28 cm2 (Physio II), 2.33 ± 0.54 cm2 (CG Future), 2.28 ± 0.12 cm2 (Tailor band), and 2.27 ± 0.53 cm2 (decellularised tendon-based biological ring). CONCLUSIONS The decellularised tendon-based annuloplasty ring demonstrated functional performance comparable to that of current mitral annuloplasty devices.
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Katayama et al. (2026) studied this question. Decellularised tendon-based mitral annuloplasty ring reduced regurgitation to 15.5%±3.0%, comparable to commercial rings, and maintained effective MVA around 2.27 cm².
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