title: Mitral web--a new concept for mitral valve repair: improved engineering design and in-vitro studies.
abstract: OBJECTIVE
  A new mitral valve repair concept to treat mitral regurgitation (MR) due to valve prolapse was recently proposed. In this study, an improved design of this concept is presented, and the results of preliminary hemodynamic studies conducted in an in-vitro prolapse model are reported.
  
  
  METHODS
  The new repair approach is based on using a web/net attached to a standard annuloplasty ring spanning the annulus of the mitral valve. Experiments were conducted in a left ventricular simulator, using native porcine mitral valves. Severe MR was created by transecting the marginal chordae to induce P2 prolapse, and also by displacing the papillary muscles basally to induce bileaflet prolapse.
  
  
  RESULTS
  Implantation of the mitral web prevented leaflet prolapse and restored leaflet coaptation with trace mitral insufficiency, in both posterior and bileaflet prolapse. In posterior leaflet prolapse, implantation of the mitral web reduced the regurgitation volume from 10.43 +/- 3.76 ml to 2.13 +/- 1.83 ml per beat (p < 0.05). No visual damage was observed on the mitral valve leaflets after 4 h of continuous operation.
  
  
  CONCLUSIONS
  Based on the study results, the mitral web may represent a feasible option to repair different types of mitral valve prolapse. The mitral web may also significantly simplify mitral valve repair for complex lesions.
authors: Department of Cardiovascular Surgery, Acibadem Hospital, Istanbul, Turkey.
authors: Ersin
authors: E
authors: Erek
authors: Muralidhar
authors: M
authors: Padala
authors: Kerem
authors: K
authors: Pekkan
authors: Jorge
authors: J
authors: Jimenez
authors: Yusuf K
authors: YK
authors: Yalçinba
authors: Ece
authors: E
authors: Salihoğlu
authors: Tayyar
authors: T
authors: Sarioğlu
authors: Ajit P
authors: AP
authors: Yoganathan
mesh_terms: D000818:Animals; D006348:Cardiac Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D004867:Equipment Design / Q000639:trends*; D004864:Equipment and Supplies; D006439:Hemodynamics / Q000502:physiology; D066298:In Vitro Techniques; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D008945:Mitral Valve Prolapse / Q000150:complications / Q000601:surgery*; D008953:Models, Anatomic; D013552:Swine