Abstract
Force transfer from the papillary muscle tip through the chordae tendineae to the mitral valve is a crucial element of valvular-ventricular interaction and essential in maintaining proper valvular and left ventricular function; however, the complete force exchange between the papillary muscles and the mitral valve has never been assessed in vivo. The purpose of this study was to design a transducer capable of measuring the force transferred from the chordae tendineae to the papillary muscle tip with minimum interference with subvalvular geometries and papillary muscle contraction. Using computer aided design the force transducer was configured to be implanted in between the fibrous part of the papillary muscle tip and the remaining papillary muscle. The active height of the force transducer was 2 mm in order to preserve native subvalvular geometries. Strain gauges were mounted on the force transducer frame, and the force transducer was calibrated with respect to a force acting perpendicular on the plates. Furthermore, linearity, sensitivity, noise floor, and frequency response of the force transducer was tested in a dedicated setup, and the device was evaluated in an acute porcine model. Testing of the transducer confirmed it was capable of measuring the papillary muscle force in a detailed and precise fashion. In a porcine model during extracorporeal circulation, prototypes of the force transducer were implanted in the anterior and posterior papillary muscles. After weaning from cardiopulmonary bypass proper mitral valve function was verified by echocardiography and it was confirmed that the force transducer was suitable for dynamic measurements of the papillary muscle force in vivo. A force transducer capable of quantifying the force exchange between the papillary muscle and the chordae tendineae was developed and evaluated. Technical testing and animal evaluation of the force transducer confirmed that it was suitable for force measurements in an in vivo setting.
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