ArticleThe Journal of surgical research2016
Neochord placement versus triangular resection in mitral valve repair: A finite element model.
Article in The Journal of surgical research, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed, 14 citations in OpenAlex.
- Biomechanical modeling of surgical techniques to repair isolated segmental P2 prolapse of the mitral valve.JTCVS open · 2025Article
- Computer simulations of transapical mitral valve repair with neochordae implantation: Clinical implications.JTCVS open · 2020Article
- Mitral valve repair using adjustable posterior leaflet neochords.JTCVS techniques · 2020Article
- Commentary: Mitral valve repair using adjustable posterior leaflet neochords.JTCVS techniques · 2020Article
- Utility of cardiac magnetic resonance for evaluation of mitral regurgitation prior to mitral valve surgery.Journal of thoracic disease · 2017Review
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundRecurrent mitral regurgitation after mitral valve repair is common, occurring in nearly 50% of patients within 10 years of surgery. Durability of repair is partly related to stress distribution over the mitral leaflets. We hypothesized that repair with neochords (NCs) results in lower stress than leaflet resection (LR). MATERIALS AND
methodsMagnetic resonance imaging and 3D echocardiography were performed before surgical repair of P2 prolapse in a single patient. A finite element model of the left ventricle and mitral valve was created previously, and the modeling program LS-DYNA was used to calculate leaflet stress for the following repairs: Triangular LR; LR with ring annuloplasty (LR + RA); One NC; Two NCs; and 2NC + RA.
results(1) NC placement resulted in stable posterior leaflet stress: Baseline versus 2 NC at end diastole (ED), 12.1 versus 12.0 kPa, at end systole (ES) 20.3 versus 21.7 kPa. (2) In contrast, LR increased posterior leaflet stress: Baseline versus LR at ED 12.1 versus 40.8 kPa, at ES 20.3 versus 46.1 kPa. (3) All repair types reduced anterior leaflet stress: Baseline versus 2 NC versus LR 34.2 versus 25.8 versus 20.6 kPa at ED and 80.8 versus 76.8 versus 67.8 kPa at ES. (4) The addition of RA reduced leaflet stress relative to repair without RA.
conclusionsNeochord repair restored normal leaflet coaptation without creating excessive leaflet stress, whereas leaflet resection more than doubled stress across the posterior leaflet. The excess stress created by leaflet resection was partially, but not completely, mitigated by ring annuloplasty.
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