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Thorac Cardiovasc Surg 2022; 70(02): 126-132
DOI: 10.1055/s-0041-1722976
Original Basic Science

Transcatheter Mitral Valve Replacement: A Novel Anchor Technology

Yazhou Liu
1   Department of Experimental Cardiac Surgery and Heart Valve Replacement, Christian-Albrechts-University of Kiel, School of Medicine, UKSH, Kiel, Germany
2   Department of Cardiothoracic Surgery, The First People's Hospital of Jingmen, Hubei Minzu University, Jingmen, Hubei, China
,
Georg Lutter
1   Department of Experimental Cardiac Surgery and Heart Valve Replacement, Christian-Albrechts-University of Kiel, School of Medicine, UKSH, Kiel, Germany
3   Department of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, UKSH, Kiel, Germany
,
Philipp Knueppel
1   Department of Experimental Cardiac Surgery and Heart Valve Replacement, Christian-Albrechts-University of Kiel, School of Medicine, UKSH, Kiel, Germany
3   Department of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, UKSH, Kiel, Germany
,
Derk Frank
4   Department of Cardiology and Angiology, Christian-Albrechts-University of Kiel, School of Medicine, UKSH, Kiel, Germany
,
Lucian Lozonschi
5   Department of Cardiothoracic Surgery, Tampa University, Tampa, Florida, United States
,
Rouven Berndt
1   Department of Experimental Cardiac Surgery and Heart Valve Replacement, Christian-Albrechts-University of Kiel, School of Medicine, UKSH, Kiel, Germany
3   Department of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, UKSH, Kiel, Germany
,
Tim Attmann
1   Department of Experimental Cardiac Surgery and Heart Valve Replacement, Christian-Albrechts-University of Kiel, School of Medicine, UKSH, Kiel, Germany
3   Department of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, UKSH, Kiel, Germany
,
Thomas Puehler 
1   Department of Experimental Cardiac Surgery and Heart Valve Replacement, Christian-Albrechts-University of Kiel, School of Medicine, UKSH, Kiel, Germany
3   Department of Cardiovascular Surgery, Christian-Albrechts-University of Kiel, School of Medicine, UKSH, Kiel, Germany
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Abstract

Background Mitral valved stents tend to migrate or to develop paravalvular leakage due to high–left ventricular pressure in this cavity. Thus, this study describes a newly developed mitral valved stent anchoring technology.

Methods Based on an existing mitral valved stent, four anchoring units with curved surgical needles were designed and fabricated using three-dimensional (3D) software and print technology. Mitral nitinol stents assembled with four anchoring units were successively fixed on 10 porcine annuli. Mechanical tests were performed with a tensile force test system and recorded the tension forces of the 10 nitinol stents on the annulus.

Results The average maximum force was 28.3 ± 5.21 N, the lowest was 21.7 N, and the highest was 38.6 N until the stent lost contact with the annulus; for the break force (zero movement of stent from annulus), the average value was 18.5 ± 6.7 N with a maximum value of 26.9 N and a minimum value of 6.07 N. It was additionally observed that the puncture needles of the anchoring units passed into the mitral annulus in all 10 hearts and further penetrated the myocardium in only one additional heart. The anchoring units enhanced the tightness of the mitral valved stent and did not destroy the circumflex coronary artery, coronary sinus, right atrium, aortic root, or the left ventricular outflow tract.

Conclusion The new anchoring units for mitral nitinol stents were produced with 3D software and printing technology; with this new type of anchoring technology, the mitral valved stent can be tightly fixed toward the mitral annulus.

Keywords

3D printing - anchoring method - mechanical testing - mitral valved stent - in vitro study - transcatheter mitral valve replacement - TMVR


Publication History

Received: 03 September 2020

Accepted: 21 December 2020

Article published online:
04 February 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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