Mitral valve repair based on intraoperative objective measurement

Figures

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  Figure 1. Principal scheme of chordae tension measuring device. The four force sensors are identifiable (top view) with the clamp to connect the chordae on the right side. All sensors are fixed on independent linear stage (bottom view) allowing micrometric traction of each chorda independently. Chordae can also be pulled synchronously thanks to another linear stage (bottom and left part of the device).

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  Figure 2. Surgical setup during the measuring phase. During this step of the protocol, the chordae were fixed to the measurement device that was brought close to the patient. While puling on the first chordae a pressure curve can be observed on the display (yellow curve).

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  Figure 3. Implementation of chordae to mitral valve. In this example, four chordae are attached to the posterior leaflet of the mitral valve. Chordae are exteriorized through the apex and attached to the tension measuring device via crocodile clips.

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  Figure 4. Real-time tension measurements during surgery procedure. The first phase consists of the traction of the chorda implanted in the best location (yellow) until plateau value (Testing step 3B). The tension of the first chorda reaches a plateau value of 0.8N (minute 1). Then all chordae are set in tension one after the other, until tension is homogenously spread to each chorda (Testing step 3C).

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  Figure 5. Traction on four chordae. When a first chordae is pulled the tension measured on this single chorda was find between 0.8 and 1N. This tension was then divided by the number of chordae set in tension. Thus, on the right insight we observe that when 4 chordae are set in tension, the tension applied in each chorda was homogeneous and low.