Abstract 3174: The Impact of Annuloplasty Ring Geometry on Mitral Leaflet Curvature
Objectives Recently, we presented a finite element model describing the contribution of annular non-planarity to leaflet curvature and stress reduction. We hypothesize that annuloplasty ring shape influences leaflet curvature (stress) and potentially repair durability. We describe a novel methodolgy for quantifying mitral leaflet geometry and apply it to the description of mitral leaflet geometry following annuloplasty utilizing two distinct ring types.
Methods Epicardial data sets were acquired in 8 adult male sheep at baseline. Four animals then underwent mitral annuloplasty utilizing a 30 mm Physio rindg while the remaining 4 animals underwent mitral annuloplasty utilizing a 30 mm “saddle” ring. Echocardiography was repeated in all animals following annuloplasty. Hybrid three-dimensional renderings were constructed for each cohort with color contouring determined by Gaussian curvature (K), septolateral curvature (KSL) and intercommissural curvature (KIC).
Results K, KSL and KIC increased across both anterior and posterior leaflets when compared to baseline (Panel A) following implantation of the saddle ring (Panel B). While KIC increased across both anterior and posterior leaflets following implantation of the 30 mm Physio ring (Panel C), K was increased only across the posterior leaflet. and KSL did not increase across any leaflet region.
Conclusions Mitral annuloplasty utilizing a custom designed saddle shaped annuloplasty ring augmented K, KSL and KIC across both anterior and posterior leaflets, while that utilizing a Physio ring augmented only KIC. These findings confirm that ring design influences leaflet curvature and potentially repair durabilitiy.