Key result
DynaRing outperforms a commercial semirigid ring in ex-vivo testing by closely matching healthy annular motion.
Why the study?
Annuloplasty ring choice and design are critical to long-term MV repair efficacy, motivating a selectively compliant ring that stabilizes a diseased annulus while preserving physiological dynamics.
Does the DynaRing patient-specific mitral annuloplasty ring provide physiological annular dynamics and allow tuning of key mitral valve metrics?
Does the DynaRing patient-specific mitral annuloplasty ring provide physiological annular dynamics and allow tuning of key mitral valve metrics?
DynaRing demonstrates physiological annular dynamics ex-vivo and allows for patient-specific tuning of key mitral valve metrics in computational models, suggesting potential for customized mitral valve repair.
Answers are grounded in this paper and cite their sources.
Suggests potential for physiological mitral repair; leaves open clinical translation pending human studies.
Annuloplasty ring choice and design are critical to the long-term efficacy of mitral valve (MV) repair. DynaRing is a selectively compliant annuloplasty ring composed of varying stiffness elastomer segments, a shape-set nitinol core, and a cross diameter filament. The ring provides sufficient stiffness to stabilize a diseased annulus while allowing physiological annular dynamics. Moreover, adjusting elastomer properties provides a mechanism for effectively tuning key MV metrics to specific patients. We evaluate the ring embedded in porcine valves with an ex-vivo left heart simulator and perform a 150 million cycle fatigue test via a custom oscillatory system. We present a patient-specific design approach for determining ring parameters using a finite element model optimization and patient MRI data. Ex-vivo experiment results demonstrate that motion of DynaRing closely matches literature values for healthy annuli. Findings from the patient-specific optimization establish DynaRing's ability to adjust the anterior-posterior and intercommissural diameters and saddle height by up to 8.8%, 5.6%, 19.8%, respectively, and match a wide range of patient data.
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Frishman et al. (2022) studied Mitral regurgitation. DynaRing vs. Physio-II ring was evaluated on Annular dynamic motion (AP diameter, IC diameter, orifice area, saddle height) (p=<0.001). DynaRing, a selectively compliant annuloplasty ring, closely matched healthy annular motion and outperformed a commercial semirigid ring in ex-vivo testing.
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