A Novel Transcatheter Posterior Ventricular Anchoring Neochordoplasty Mitral Valve Repair Device

Matthew H Park; Annabel M Imbrie-Moore; Michael J Paulsen; Yuanjia Zhu; John W MacArthur; Y Joseph Woo

doi:10.1007/s13239-024-00764-9

A Novel Transcatheter Posterior Ventricular Anchoring Neochordoplasty Mitral Valve Repair Device

Cardiovasc Eng Technol. 2024 Dec 26. doi: 10.1007/s13239-024-00764-9. Online ahead of print.

Authors

Matthew H Park^{1

2}, Annabel M Imbrie-Moore^{1

2}, Michael J Paulsen¹, Yuanjia Zhu^{1

3}, John W MacArthur¹, Y Joseph Woo^{4

5

6}

Affiliations

¹ Department of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA.
² Department of Mechanical Engineering, Stanford University, Stanford, CA, USA.
³ Department of Bioengineering, Stanford University, Stanford, CA, USA.
⁴ Department of Cardiothoracic Surgery, Stanford University, Stanford, CA, USA. joswoo@stanford.edu.
⁵ Department of Bioengineering, Stanford University, Stanford, CA, USA. joswoo@stanford.edu.
⁶ Department of Cardiothoracic Surgery, Department of Bioengineering, Stanford University, Falk Cardiovascular Research Building, 300 Pasteur Drive, Stanford, CA, 94305-5407, USA. joswoo@stanford.edu.

PMID: 39724314
DOI: 10.1007/s13239-024-00764-9

Abstract

Purpose: Advancements in minimally invasive technologies to decrease postoperative morbidity and recovery times represent a large opportunity for mitral valve repair operations. However, current technologies are unable to replicate gold standard surgical neochord implantation.

Methods: We developed a novel neochordal repair device, Minimally Invasive Ventricular Anchoring Neochordoplasty (MIVAN), which operates via transcatheter, trans-septal anchoring to the posterior ventricular wall. We evaluated MIVAN in an ex vivo heart simulator and compared it with surgical neochordal repair and MitraClip using a prolapse model.

Results: Upon MIVAN repair of the model (n = 5), regurgitant fraction was reduced from 19.46 ± 1.77% to 7.30 ± 0.99% (p = 0.01). Surgical neochordal repair reduced regurgitant fraction to 5.65 ± 0.66%, but there was no significant difference between MIVAN and surgical repair (p = 0.22). Unpaired MitraClip repair had significantly higher regurgitant fraction of 11.9 ± 1.40%, compared with those of neochord (p < 0.01) and MIVAN (p = 0.03) repairs.

Conclusions: MIVAN represents a high-value opportunity for minimally invasive mitral valve repair. The benefits of the percutaneous, trans-septal approach for implantation on the posterior ventricular wall necessitate the expanded exploration of this device as a treatment alternative.

Keywords: Mitral valve; Neochord repair; Surgical device; Transcatheter.

Abstract

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