Impact of Anchor Location on Mitral Neochordae Forces: An In Vitro Study

Abstract

PurposeThis study examined changes in force distribution between the neochordae corresponding to different ventricular anchor locations. DescriptionSeven porcine mitral valves were mounted in a left heart simulator. Neochordae (expanded polytetrafluoroethylene) originated from either a simulated left ventricular apex, papillary muscle base, or papillary muscle tip location. The neochordae were attached at three sites along the P2 leaflet segment: P2Lateral; P2Center, and P2Medial. Mitral regurgitation was induced by cutting posterior leaflet P2 marginal chordae. The forces on each neochord required to restore normal mitral valve coaptation were quantified for different ventricular anchoring origins and leaflet insertion sites. EvaluationThe results showed that under both normotensive and hypertensive conditions, the force exerted was much higher at P2Center than either P2Lateral or P2Medial, independent of ventricular anchor location. Also, forces on both P2Lateral and P2Medial were not statistically different. ConclusionsArtificial neochordae treatment for all anchoring locations was effective in correcting induced mitral regurgitation. The P2 central neochordae had a significantly higher force than both lateral neochords under all conditions.