Key result
A 5 mm papillary muscle helix anchor matches standard PTFE suture durability ex vivo.
Why the study?
Various percutaneous mitral valve repair approaches struggle with durable results, necessitating investigation of durability of different left ventricular anchoring points and types.
Do different anchoring points and anchoring types in the left ventricle provide comparable durability to standard PTFE sutures in the papillary muscle in an ex vivo porcine model?
Do different anchoring points and anchoring types in the left ventricle provide comparable durability to standard PTFE sutures in the papillary muscle in an ex vivo porcine model?
In an ex vivo porcine model, a 5 mm helix anchored in the papillary muscle demonstrated durability most comparable to standard PTFE sutures, informing the development of future percutaneous mitral valve repair devices.
Supports papillary helix anchoring for percutaneous mitral repair device development; leaves open in vivo human durability validation.
Objective Surgical mitral valve repair, including anchoring in different parts of the mitral apparatus, is the standard of care for severe mitral regurgitation. Various percutaneous approaches have been developed and are currently under development, but are struggling with durable results. This study investigates the durability of different anatomic anchoring points and anchoring types in the left ventricle. Material and Methods Anchoring was tested with PTFE sutures or a 5 mm helix at three locations: the head of the papillary muscle, the lateral wall of the ventricle, and the apex of the ventricle. An accelerated life test was performed with 300 cycles at 3 N for each anchoring. Durability was assessed by measuring compliance (strain in mm until 3 N is reached), migration (change in strain from the first to the last cycle), and the occurrence of dehiscence. Results The lowest numerical strain/compliance in the first cycle was observed at the head of the papillary muscle anchoring (both surgical and helix). Migration of strain limits over 300 cycles was seen for all locations. The lowest migration was numerically for helix in the papillary muscle. Conclusion PTFE in the head of the papillary muscle is standard practice in mitral valve repair and was used as a reference in the present study. The anchoring that yielded the most similar results was a helix in the papillary muscle, whereas other anchoring points showed greater compliance and/or migration.
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Bjursten et al. (2026) studied Severe mitral regurgitation. Anchoring with PTFE sutures or a 5 mm helix at different locations vs. PTFE in the head of the papillary muscle (reference) was evaluated on Durability assessed by compliance, migration, and dehiscence over 300 cycles at 3 N. A 5 mm helix anchored in the head of the papillary muscle yielded durability results most similar to the standard practice of PTFE sutures in an ex vivo porcine model.
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