Dynamic evaluation of the loop technique using the U-Clip. (February 2014)

• Record Type: Journal Article
• Authors: Moriyama, Hideki; Tomita, Shigeyuki; Watanabe, Go
• Is Part Of: Asian cardiovascular & thoracic annals. Volume 22:Number 2(2014)
• Page Start: 160
• Page End: 164
• Publication Date: 2014-02
• Subjects: Chordae tendineae -- Mitral valve prolapse -- Surgical instruments -- Suture techniques; Heart -- Diseases -- Asia -- Periodicals; Heart -- Diseases -- Pacific Area -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Surgery -- Asia -- Periodicals; Heart -- Surgery -- Pacific Area -- Periodicals; Heart -- Surgery -- Periodicals; Chest -- Surgery -- Asia -- Periodicals; Chest -- Surgery -- Pacific Area -- Periodicals; Chest -- Surgery -- Periodicals; 617.412
• DOI: 10.1177/0218492313478215
• Languages: English
• ISSNs: 0218-4923

Abstract

Background: We set out to evaluate mitral valve repair with the loop technique under dynamic conditions, using a U-Clip to anchor the loop unit to a papillary muscle. Methods: Mitral valve prolapse was artificially developed by resecting 4 chordae tendineae of a resected porcine heart. The loop unit was anchored to the papillary muscle using U-Clips. Each chordal loop was fixed on the prolapsed leaflet. A roller pump perfused the left ventricle. The left ventricular pressure was maintained at 250 mm Hg. Morphological assessment of the loop reconstruction was performed using an endoscope. Results: 10 independent chordal reconstructions were performed. In all cases, the loop unit remained anchored against pressures exceeding 250 mm Hg. Upon increasing the water filling volume, rupture of a chorda tendinea occurred in 7 cases, rupture of the papillary muscle occurred in 2 cases, and left ventricle rupture occurred in 1 case. In all rupture cases, the loop unit remained anchored to the papillary muscle. Conclusion: This dynamic evaluation of the loop technique using U-Clips to anchor the loop unit to a papillary muscle showed that the loop technique using U-Clips is a safe method.