Bilgehan ÖZ SAVAŞ, Ahmet Barış DURUKAN, Faruk CİNGÖZ, Mustafa KÜRKLÜOĞLU, Mehmet ARSLAN, Adem GÜLER, Murat TAVLAŞOĞLU, Hasan Alper GÜRBÜZ

Mechanical and physiological effects of indentational chords in sliding leaflet plasty technique: an ex vivo bovine heart model

Amaç: Bu mitral kapak tamiri simülasyon modelinde, mitralkapak posterior yaprakçık çentiklerinin sliding yaprakçıkplasti tekniği sırasında kapatılması durumunda çentikleridestekleyen primer kordaların mekanik ve fizyolojiketkilerinin araştırılması amaçlandı.Çalışmaplanı: Posterior kuadrangüler rezeksiyon ve slidingyaprakçık tekniği 24 olguda sığır kalbinde simüle edildi.Tüm olgularda, posterior mitral yaprakçık çentikleri 5-0 ipekdikiş ile kapatıldı. Grup 1de (n=12) çentikleri destekleyenprimer kordalara dokunulmadı, grup 2de (n=12) ise çentikleridestekleyen primer kordalar rezeke edildi. Anterior veposterior yaprakçıklar arasındaki koaptasyon hatları heriki grupta değerlendirildi. Mitral kapak yetkinliği 170cmH 2O (125 mmHg) basınç altında test edilirken posterioryaprakçıkta gerginlik yapan korda varlığı araştırıldı.Bul gu lar: Grup 1deki tüm olgularda koaptasyon hatlarıasimetrik iken grup 2de asimetrik koaptasyon hattı tespitedilmedi (p

Sliding yaprakçık plasti tekniğinde "indentational" kordaların mekanik ve fizyolojik etkileri: Ex-vivo sığır kalbi modeli

Background: In this model of mitral valve repair simulation,we aim to analyze the mechanical and physiological effectsof primary chords supporting the intentionally closedindentations in sliding leaflet plasty of the posterior leafletof mitral valve. Methods: Posterior quadrangular resection and sliding leaflettechniques were simulated in 24 cases in bovine heart. In allcases, posterior mitral leaflet indentations were closed with5-0 silk sutures. The indentational chords were left untouchedin group 1 (n=12), and were resected in group 2 (n=12).The coaptation lines between anterior and posterior leafletswere assessed in both groups. Presence of tethering chordsin posterior leaflet was investigated while the mitral valvecompetence was tested under the pressure of 170 cmH 2O(125 mmHg). Results: While coaptation lines were asymmetric in all cases ingroup 1, no asymmetric coaptation line was detected in group 2(p

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