Objective: The development of a novel surgical tool or technique for mitral valve repair can be hampered by cost, complexity, and time associated with performing animal trials. A dynamically pressurized model was developed to control pressure and flowrate profiles in intact porcine hearts in order to quantify mitral regurgitation and evaluate the quality of mitral valve repair. Methods: A pulse duplication system was designed to replicate physiological conditions in explanted hearts. To test the capabilities of this system in measuring varying degrees of mitral regurgitation, the output of eight porcine hearts was measured for two different pressure waveforms before and after induced mitral valve failure. Four hearts were further repaired and tested. Measurements were compared with echocardiographic images. Results: For all trials, cardiac output decreased as left ventricular pressure was increased. After induction of mitral valve insufficiencies, cardiac output decreased, with a peak regurgitant fraction of 71.8%. Echocardiography clearly showed increases in regurgitant severity from post-valve failure and with increased pressure. Conclusions: The dynamic heart model consistently and reliably quantifies mitral regurgitation across a range of severities. Advantages include low experimental cost and time associated with each trial, while still allowing for surgical evaluations in an intact heart.
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This work was funded by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH), Grant Number 1 R01 HL075489-03A1. The authors would like to thank Dr. Teresa DeFrancesco for her expertise in acquiring echocardiographic images, William Griffin for his assistance with the design of the system, and Molly Purser for her aid in experimental trials.
Author information Authors and AffiliationsDepartment of Biomedical Engineering, North Carolina State University, Raleigh, NC, 27695, USA
Andrew L. Richards
Division of Cardiovascular Surgery, University of British Columbia, Vancouver, BC, V6Z 1H5, Canada
Richard C. Cook
Department of Cardiac Surgery, Rambam Medical Center, Haifa, 31096, Israel
Gil Bolotin
Department of Mechanical and Aerospace Engineering, North Carolina State University, 2601 Stinson Dr., Raleigh, NC, 27695, USA
Gregory D. Buckner
Correspondence to Gregory D. Buckner.
About this article Cite this articleRichards, A.L., Cook, R.C., Bolotin, G. et al. A Dynamic Heart System to Facilitate the Development of Mitral Valve Repair Techniques. Ann Biomed Eng 37, 651–660 (2009). https://doi.org/10.1007/s10439-009-9653-x
Received: 15 July 2008
Accepted: 06 February 2009
Published: 18 February 2009
Issue Date: April 2009
DOI: https://doi.org/10.1007/s10439-009-9653-x
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