Entire mitral reconstruction with porcine extracellular matrix in an acute porcine model

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Entire mitral reconstruction with porcine extracellular matrix in an acute porcine model. / Tjørnild, Marcell J; Carlson Hanse, Lisa; Skov, Søren N; Poulsen, Karen B; Sharghbin, Mona; Benhassen, Leila L; Waziri, Farhad; Røpcke, Diana M; Nielsen, Sten L; Hasenkam, J Michael.

I: The Journal of Thoracic and Cardiovascular Surgery, Bind 160, Nr. 1, 07.2020, s. 102-112.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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@article{a96a9567bb4f4008a996ce6971d24b1f,
title = "Entire mitral reconstruction with porcine extracellular matrix in an acute porcine model",
abstract = "OBJECTIVE: The objective of our study was to investigate the feasibility of reconstructing the entire mitral valvular and subvalvular apparatus in pigs using a modified tube graft design made of 2-ply small intestinal submucosa extracellular matrix.METHODS: The reconstructions were performed in an acute 80-kg porcine model with 8 pigs, each acting as its own control. A modified tube graft was designed from a sheet of 2-ply small intestinal submucosa extracellular matrix. Before and after mitral valve reconstruction, echocardiography was used to assess mitral regurgitation, left ventricular outflow tract obstruction due to systolic anterior motion, mitral stenosis, leaflet mobility, and leaflet geometry.RESULTS: The reconstructed mitral valves were fully functional without any observable echocardiographic signs of regurgitation. We did not observe any left ventricular outflow tract obstruction due to systolic anterior motion nor any mitral valve stenosis, despite a diminished septal-lateral distance after reconstruction. The reconstruction had a reduced tenting area, a reduced coaptation length (9.6 ± 1.7 mm vs 7.9 ± 1.0 mm, P = .010, diff = -1.7 mm, 95% confidence interval, -3.1 to -0.4 mm), and atrial bending of both leaflets.CONCLUSIONS: In this acute porcine study, entire mitral valvular and subvalvular apparatus reconstruction using a modified tube graft design made from 2-ply small intestinal submucosal extracellular matrix was feasible. The 2-ply small intestinal submucosa extracellular matrix could withstand the pressure exerted by the left ventricle without any signs of tearing or rupture. These promising results warrant further assessment of both the annular geometry and the long-term durability.",
keywords = "2-ply small intestinal submucosa extracellular matrix, Cormatrix Tyke, mitral valve, mitral valve reconstruction, mitral valve repair, mitral valve replacement",
author = "Tj{\o}rnild, {Marcell J} and {Carlson Hanse}, Lisa and Skov, {S{\o}ren N} and Poulsen, {Karen B} and Mona Sharghbin and Benhassen, {Leila L} and Farhad Waziri and R{\o}pcke, {Diana M} and Nielsen, {Sten L} and Hasenkam, {J Michael}",
note = "Copyright {\textcopyright} 2019 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.",
year = "2020",
month = jul,
doi = "10.1016/j.jtcvs.2019.07.085",
language = "English",
volume = "160",
pages = "102--112",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby, Inc",
number = "1",

}

RIS

TY - JOUR

T1 - Entire mitral reconstruction with porcine extracellular matrix in an acute porcine model

AU - Tjørnild, Marcell J

AU - Carlson Hanse, Lisa

AU - Skov, Søren N

AU - Poulsen, Karen B

AU - Sharghbin, Mona

AU - Benhassen, Leila L

AU - Waziri, Farhad

AU - Røpcke, Diana M

AU - Nielsen, Sten L

AU - Hasenkam, J Michael

N1 - Copyright © 2019 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

PY - 2020/7

Y1 - 2020/7

N2 - OBJECTIVE: The objective of our study was to investigate the feasibility of reconstructing the entire mitral valvular and subvalvular apparatus in pigs using a modified tube graft design made of 2-ply small intestinal submucosa extracellular matrix.METHODS: The reconstructions were performed in an acute 80-kg porcine model with 8 pigs, each acting as its own control. A modified tube graft was designed from a sheet of 2-ply small intestinal submucosa extracellular matrix. Before and after mitral valve reconstruction, echocardiography was used to assess mitral regurgitation, left ventricular outflow tract obstruction due to systolic anterior motion, mitral stenosis, leaflet mobility, and leaflet geometry.RESULTS: The reconstructed mitral valves were fully functional without any observable echocardiographic signs of regurgitation. We did not observe any left ventricular outflow tract obstruction due to systolic anterior motion nor any mitral valve stenosis, despite a diminished septal-lateral distance after reconstruction. The reconstruction had a reduced tenting area, a reduced coaptation length (9.6 ± 1.7 mm vs 7.9 ± 1.0 mm, P = .010, diff = -1.7 mm, 95% confidence interval, -3.1 to -0.4 mm), and atrial bending of both leaflets.CONCLUSIONS: In this acute porcine study, entire mitral valvular and subvalvular apparatus reconstruction using a modified tube graft design made from 2-ply small intestinal submucosal extracellular matrix was feasible. The 2-ply small intestinal submucosa extracellular matrix could withstand the pressure exerted by the left ventricle without any signs of tearing or rupture. These promising results warrant further assessment of both the annular geometry and the long-term durability.

AB - OBJECTIVE: The objective of our study was to investigate the feasibility of reconstructing the entire mitral valvular and subvalvular apparatus in pigs using a modified tube graft design made of 2-ply small intestinal submucosa extracellular matrix.METHODS: The reconstructions were performed in an acute 80-kg porcine model with 8 pigs, each acting as its own control. A modified tube graft was designed from a sheet of 2-ply small intestinal submucosa extracellular matrix. Before and after mitral valve reconstruction, echocardiography was used to assess mitral regurgitation, left ventricular outflow tract obstruction due to systolic anterior motion, mitral stenosis, leaflet mobility, and leaflet geometry.RESULTS: The reconstructed mitral valves were fully functional without any observable echocardiographic signs of regurgitation. We did not observe any left ventricular outflow tract obstruction due to systolic anterior motion nor any mitral valve stenosis, despite a diminished septal-lateral distance after reconstruction. The reconstruction had a reduced tenting area, a reduced coaptation length (9.6 ± 1.7 mm vs 7.9 ± 1.0 mm, P = .010, diff = -1.7 mm, 95% confidence interval, -3.1 to -0.4 mm), and atrial bending of both leaflets.CONCLUSIONS: In this acute porcine study, entire mitral valvular and subvalvular apparatus reconstruction using a modified tube graft design made from 2-ply small intestinal submucosal extracellular matrix was feasible. The 2-ply small intestinal submucosa extracellular matrix could withstand the pressure exerted by the left ventricle without any signs of tearing or rupture. These promising results warrant further assessment of both the annular geometry and the long-term durability.

KW - 2-ply small intestinal submucosa extracellular matrix

KW - Cormatrix Tyke

KW - mitral valve

KW - mitral valve reconstruction

KW - mitral valve repair

KW - mitral valve replacement

U2 - 10.1016/j.jtcvs.2019.07.085

DO - 10.1016/j.jtcvs.2019.07.085

M3 - Journal article

C2 - 31548077

VL - 160

SP - 102

EP - 112

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 1

ER -