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Bench Models for Assessing the Mechanics of Mitral Valve Repair and Percutaneous Surgery

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Abstract

Rapid preclinical evaluations of mitral valve (MV) mechanics are currently best facilitated by bench models of the left ventricle (LV). This review aims to provide a comprehensive assessment of these models to aid interpretation of their resulting data, inform future experimental evaluations, and further the translation of results to procedure and device development. For this review, two types of experimental bench models were evaluated. Rigid LV models were characterized as fluid-mechanical systems capable of testing explanted MVs under static and or pulsatile left heart hemodynamics. Passive LV models were characterized as explanted hearts whose left side is placed in series with a static or pulsatile flow-loop. In both systems, MV function and mechanics can be quantitatively evaluated. Rigid and passive LV models were characterized and evaluated. The materials and methods involved in their construction, function, quantitative capabilities, and disease modeling were described. The advantages and disadvantages of each model are compared to aid the interpretation of their resulting data and inform future experimental evaluations. Repair and percutaneous studies completed in these models were additionally summarized with perspective on future advances discussed. Bench models of the LV provide excellent platforms for quantifying MV repair mechanics and function. While exceptional work has been reported, more research and development is necessary to improve techniques and devices for repair and percutaneous surgery. Continuing efforts in this field will significantly contribute to the further development of procedures and devices, predictions of long-term performance, and patient safety.

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Abbreviations

ETER:

Edge-to-edge repair

LV:

Left ventricle

MR:

Mitral regurgitation

MV:

Mitral valve

PM:

Papillary muscle

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Acknowledgments

We would like to acknowledge the intellectual contributions of Dr. Jean-Pierre Rabbah (Irvine, CA). We would like to additionally acknowledge the images provided by Eric L. Pierce (Atlanta, GA), Dr. Jean-Pierre Rabbah, Dr. Morten Ø. Jensen (Atlanta, GA), and Dr. Manual K. Rausch (Newton, PA), and Dr. Ajit P. Yoganathan (Atlanta, GA).

Disclosures

Dr. Andrew W. Siefert and Ryan Siskey are employees of Exponent Failure Analysis Associates, a scientific and engineering consulting firm. Exponent has been paid fees by companies and suppliers for their consulting services on behalf of such companies and suppliers. No human subjects or vertebrate animals were used in this study.

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  1. Exponent Failure Analysis Associates, 3440 Market Street Suite 600, Philadelphia, PA, 19104, USA

    Andrew W. Siefert & Ryan L. Siskey

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  1. Andrew W. Siefert
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Correspondence to Andrew W. Siefert.

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Associate Editor Ajit P. Yoganathan oversaw the review of this article.

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Siefert, A.W., Siskey, R.L. Bench Models for Assessing the Mechanics of Mitral Valve Repair and Percutaneous Surgery. Cardiovasc Eng Tech 6, 193–207 (2015). https://doi.org/10.1007/s13239-014-0196-4

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  • DOI: https://doi.org/10.1007/s13239-014-0196-4

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