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An ex-vivo and in-vitro dynamic simulator for surgical and transcatheter mitral valve interventions
- Source :
- International Journal of Computer Assisted Radiology and Surgery; March 2024, Vol. 19 Issue: 3 p411-421, 11p
- Publication Year :
- 2024
-
Abstract
- 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: Systolic pressures, cardiac outputs, and regurgitations volumes (RVol) with competent MVs were 119 ± 1 mmHg, 4.78 ± 0.16 l min<superscript>−1</superscript>, 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.
Details
- Language :
- English
- ISSN :
- 18616410 and 18616429
- Volume :
- 19
- Issue :
- 3
- Database :
- Supplemental Index
- Journal :
- International Journal of Computer Assisted Radiology and Surgery
- Publication Type :
- Periodical
- Accession number :
- ejs64829032
- Full Text :
- https://doi.org/10.1007/s11548-023-03036-4