Why the study?
Transcatheter repair and replacement devices, such as intravalvular spacers, are emerging for patients with mitral regurgitation who are not candidates for conventional surgery, requiring evaluation of spacer efficacy.
Does an intra-valvular spacer reduce mitral regurgitation severity in a subject-specific computational model?
Does an intra-valvular spacer reduce mitral regurgitation severity in a subject-specific computational model?
Computational modeling demonstrates that precise anchoring of an intra-valvular spacer at the regurgitant orifice is critical for optimally reducing mitral regurgitation.
Hypothesis-generating for intra-valvular spacers; prospective human studies needed before clinical adoption.
Mitral regurgitation imposes a significant symptomatic burden on patients who are not candidates for conventional surgery. For these patients, transcatheter repair and replacement devices are emerging as alternative options. One such device is an intravalvular balloon or spacer that is inserted between the mitral valve leaflets to fill the gap that gives rise to mitral regurgitation. In this study, we apply a large-deformation fluid-structure interaction analysis to a fully 3D subject-specific mitral valve model to assess the efficacy of the intra-valvular spacer for reducing mitral regurgitation severity. The model includes a topologically 3D subvalvular apparatus with unprecedented detail. Results show that device fixation and anchoring at the location of the subject’s regurgitant orifice is imperative for optimal reduction of mitral regurgitation.
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Toma et al. (2020) studied this question.
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