ArticleJTCVS open2020
Computer simulations of transapical mitral valve repair with neochordae implantation: Clinical implications.
Article in JTCVS open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 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
7 citing papers in PubMed, 9 citations in OpenAlex.
- Interactive Effects Between Papillary Muscle Approximation and Ring Annuloplasty to Repair Functional Mitral Regurgitation in Enlarged Ventricles.Functional imaging and modeling of the heart : ... International Workshop, FIMH ..., proceedings. FIMH (Conference) · 2025Article
- Numerical validation of the applicability of the simplified ventricular model in the analysis of hemolysis in the mitral paravalvular leak.Frontiers in bioengineering and biotechnology · 2025Article
- A CFD study on the interplay of torsion and vortex guidance by the mitral valve on the left ventricular wash-out making use of overset meshes (Chimera technique).Frontiers in medical technology · 2022Article
- Article
- Commentary: Mitral valve neo-chords, still a lot to learn!JTCVS open · 2020Article
- Article
- Isolated and combined effects of papillary muscle approximation and mitral annuloplasty in dilated left ventricles.JRSM cardiovascular diseaseArticle
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: Transapical beating heart neochordae implantation is an innovative mitral valve repair technique that has demonstrated promising clinical results in patients with primary mitral regurgitation. However, as clinical experience continues to increase, neochordae implantation criteria have not been fully standardized. The aim of this study was to investigate the biomechanical effects of selecting an antero-lateral apical access site compared with a postero-lateral site, and suboptimal neochordae length compared with optimal suture length, on restoring physiologic left heart dynamics. Methods: Transapical neochordae implantation using 3 and 4 sutures was computer simulated under 3 posterior mitral leaflet prolapse conditions: isolated P2, multiscallop P2/P3 and multiscallop P2/P1. Physiologic, pre- and postrepair left heart dynamics were evaluated using a fluid-structure interaction modeling framework. Results: Despite the absence of residual mitral regurgitation in all postrepair models with optimal neochordae length, selecting an antero-lateral apical entry site for the treatment of P2/P3 prolapse generated a significant increase (>80%) in neochordae tension and P2 peak stress, with respect to a postero-lateral entry site. During isolated P2 prolapse repair, although neochordae overtension by 5% led to minimal hemodynamic changes in the regurgitant volume compared with using an optimal suture length, a significant increase in systolic and diastolic neochordae tension (>300%) and posterior leaflet average stress (70%-460%) was quantified. On the other hand, neochordae undertension by 5% led to worsening of regurgitation severity. Conclusions: This parametric computer study represents a further step toward an improved understanding of the biomechanical outcomes of transapical neochordae technologies.
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