Evidence map›Paper›PMID 38258541›Full record

ArticleEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2024

Biomechanical engineering analysis of neochordae length's impact on chordal forces in mitral repair.

Yuanjia Zhu, Seung Hyun Lee, Akshay Venkatesh, Catherine A Wu, Charles J Stark, Sidarth Ethiraj, Justin J Lee, Matthew H Park, Shin Yajima, Y Joseph Woo

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In one paragraph

Article in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 3 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Yuanjia ZhuDepartment of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA.ORCID 0000-0001-5642-9883
Seung Hyun LeeDepartment of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA.
Akshay VenkateshDepartment of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA.
Catherine A WuDepartment of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA.
Charles J StarkDepartment of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA.
Sidarth EthirajDepartment of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA.
Justin J LeeDepartment of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA.
Matthew H ParkDepartment of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA.
Shin YajimaDepartment of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA.
Y Joseph WooDepartment of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA.ORCID 0000-0002-2506-492X
Stanford University · US

Funding

Biomechanical Optimization of Mitral Valve Repair OperationsR01HL152155 · NHLBI · STANFORD UNIVERSITY · PI WOO, Y JOSEPH · 2020 to 2025
$5.9M
NHLBI NIH HHS R01 HL152155NIH HHS NIH R01 HL152155
6 · The paper itself

Abstract

objectivesArtificial neochordae implantation is commonly used for mitral valve (MV) repair. However, neochordae length estimation can be difficult to perform. The objective was to assess the impact of neochordae length changes on MV haemodynamics and neochordal forces.

methodsPorcine MVs (n = 6) were implanted in an ex vivo left heart simulator. MV prolapse (MVP) was generated by excising at least 2 native primary chordae supporting the P2 segments from each papillary muscle. Two neochordae anchored on each papillary muscle were placed with 1 tied to the native chord length (exact length) and the other tied with variable lengths from 2× to 0.5× of the native length (variable length). Haemodynamics, neochordal forces and echocardiography data were collected.

resultsNeochord implantation repair successfully eliminated mitral regurgitation with repaired regurgitant fractions of approximately 4% regardless of neochord length (P < 0.01). Leaflet coaptation height also significantly improved to a minimum height of 1.3 cm compared with that of MVP (0.9 ± 0.4 cm, P < 0.05). Peak and average forces on exact length neochordae increased as variable length neochordae lengths increased. Peak and average forces on the variable length neochordae increased with shortened lengths. Overall, chordal forces appeared to vary more drastically in variable length neochordae compared with exact length neochordae.

conclusionsMV regurgitation was eliminated with neochordal repair, regardless of the neochord length. However, chordal forces varied significantly with different neochord lengths, with a preferentially greater impact on the variable length neochord. Further validation studies may be performed before translating to clinical practices.

Indexed as

Mitral Valve InsufficiencyMitral Valve ProlapseAnimalsChordae TendineaeMitral ValveProsthesis DesignSwineChordal forceMitral regurgitationNeochord lengthNeochord repair

Identifiers

PMID38258541
PMCPMC10931530
OpenAlexW4391141515

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.