Key result
MIMVS and TEER reduce mitral regurgitation fraction by ~17% in a dynamic simulator.
Why the study?
MIMVS and TEER are complex procedures with limited training opportunities, requiring a realistic hemodynamic environment to enable training.
Does the developed dynamic simulator realistically replicate physiological and pathological hemodynamics for MIMVS and TEER training?
Does the developed dynamic simulator realistically replicate physiological and pathological hemodynamics for MIMVS and TEER training?
The developed dynamic simulator realistically replicates physiological and pathological mitral valve hemodynamics, demonstrating feasibility for MIMVS and TEER training and patient-specific planning.
Supports simulator feasibility for MIMVS/TEER training; leaves open clinical translation pending human validation.
PURPOSE: Minimally invasive mitral valve surgery (MIMVS) and transcatheter edge-to-edge repair (TEER) are complex procedures used to treat mitral valve (MV) pathologies, but with limited training opportunities available. To enable training, a realistic hemodynamic environment is needed. In this work we aimed to develop and validate a simulator that enables investigation of MV pathologies and their repair by MIMVS and TEER in a hemodynamic setting. METHODS: Different MVs were installed in the simulator, and pressure, flow, and transesophageal echocardiographic measurements were obtained. To confirm the simulator's physiological range, we first installed a biological prosthetic, a mechanical prosthetic, and a competent excised porcine MV. Subsequently, we inserted two porcine MVs-one with induced chordae tendineae rupture and the other with a dilated annulus, along with a patient-specific silicone valve extracted from echocardiography with bi-leaflet prolapse. Finally, TEER and MIMVS procedures were conducted by experts to repair the MVs. RESULTS: , and 5 ± 3 ml respectively, and thus within the physiological range. In contrast, the pathological MVs displayed increased RVols. MIMVS and TEER resulted in a decrease in RVols and mitigated the severity of mitral regurgitation. CONCLUSION: Ex-vivo modelling of MV pathologies and repair procedures using the described simulator realistically replicated physiological in-vivo conditions. Furthermore, we showed the feasibility of performing MIMVS and TEER at the simulator, also at patient-specific level, thus providing new clinical perspectives in terms of training modalities and personalized planning.
No takes yet. Share an insight, caveat, or question.
Karl et al. (2023) studied Mitral regurgitation (n=5). Minimally invasive mitral valve surgery (MIMVS) and transcatheter edge-to-edge repair (TEER) vs. Pathological mitral valves (pre-repair) was evaluated on Reduction in regurgitation volume and regurgitation fraction. MIMVS and TEER successfully repaired pathological mitral valves in a dynamic simulator, reducing regurgitation volume by an average of 12 ± 3 ml and regurgitation fraction by 17 ± 4%.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: