Annular height-to-commissural width ratio of annulolasty rings in vivo
A "saddle-shaped" mitral annulus with an optimal ratio between annular height and commissural diameter may reduce leaflet and chordal stress and is purported to be conserved across mammalian species. Whether annuloplasty rings maintain this relationship is unknown. Twenty-three adult sheep...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2005-08, Vol.112 (9), p.I423-I428 |
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| container_title | Circulation (New York, N.Y.) |
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| creator | TIMEK, Tomasz A GLASSON, Julie R LAI, David T LIANG, David DAUGHTERS, George T INGELS, Neil B MILLER, D. Craig |
| description | A "saddle-shaped" mitral annulus with an optimal ratio between annular height and commissural diameter may reduce leaflet and chordal stress and is purported to be conserved across mammalian species. Whether annuloplasty rings maintain this relationship is unknown.
Twenty-three adult sheep underwent implantation of radiopaque markers on the left ventricle and mitral annulus. Eight animals underwent implantation of a Carpentier-Edwards Physio ring, 7 underwent a Medtronic Duran flexible ring, and 8 served as controls. Animals were studied with biplane videofluoroscopy 7 to 10 days postoperatively. Annular height and commissural width (CW) were determined from 3D marker coordinates, and annular height:CW ratio (AHWCR) was calculated. Annular height was similar in Control and Duran animals but significantly lower in the Physio group at end diastole (8.4+/-3.8, 6.7+/-2.3, and 3.4+/-0.6 mm, respectively, for Control, Duran, and Physio; ANOVA=0.005) and at end systole (14.5+/-6.2, 10.5+/-5.5, and 5.8+/-2.5 mm, respectively, for Control, Duran, and Physio; ANOVA=0.004). Both ring groups reduced CW significantly relative to Control. AHCWR did not differ between Control and Duran but was lower in Physio (23+/-11%, 24+/-7%, and 12+/-2% at end diastole and 42+/-17%, 37+/-17%, and 21+/-10% at end systole, respectively, for Control, Duran, and Physio, respectively; ANOVA |
| doi_str_mv | 10.1161/CIRCULATIONAHA.104.525485 |
| format | Article |
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Twenty-three adult sheep underwent implantation of radiopaque markers on the left ventricle and mitral annulus. Eight animals underwent implantation of a Carpentier-Edwards Physio ring, 7 underwent a Medtronic Duran flexible ring, and 8 served as controls. Animals were studied with biplane videofluoroscopy 7 to 10 days postoperatively. Annular height and commissural width (CW) were determined from 3D marker coordinates, and annular height:CW ratio (AHWCR) was calculated. Annular height was similar in Control and Duran animals but significantly lower in the Physio group at end diastole (8.4+/-3.8, 6.7+/-2.3, and 3.4+/-0.6 mm, respectively, for Control, Duran, and Physio; ANOVA=0.005) and at end systole (14.5+/-6.2, 10.5+/-5.5, and 5.8+/-2.5 mm, respectively, for Control, Duran, and Physio; ANOVA=0.004). Both ring groups reduced CW significantly relative to Control. AHCWR did not differ between Control and Duran but was lower in Physio (23+/-11%, 24+/-7%, and 12+/-2% at end diastole and 42+/-17%, 37+/-17%, and 21+/-10% at end systole, respectively, for Control, Duran, and Physio, respectively; ANOVA <0.05 for both).
Mitral annular height and AHWCR of the native valve were unchanged by a Duran ring, whereas the Physio ring led to a lower AHWCR. Theoretically, such a flexible annuloplasty ring may provide better leaflet stress distribution by maintaining normal AHWCR.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/CIRCULATIONAHA.104.525485</identifier><identifier>PMID: 16159857</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Animals ; Biological and medical sciences ; Biometry ; Blood and lymphatic vessels ; Cardiac Catheterization ; Cardiology. Vascular system ; Diastole ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Equipment Design ; Fluoroscopy ; Implants, Experimental ; Medical sciences ; Mitral Valve - anatomy & histology ; Mitral Valve - diagnostic imaging ; Mitral Valve - surgery ; Motion ; Pliability ; Sheep ; Stress, Mechanical ; Systole</subject><ispartof>Circulation (New York, N.Y.), 2005-08, Vol.112 (9), p.I423-I428</ispartof><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c445t-2f65849f768442f65dc15599ba75938e10ae445b680b19bc66810bb61308a58f3</citedby><cites>FETCH-LOGICAL-c445t-2f65849f768442f65dc15599ba75938e10ae445b680b19bc66810bb61308a58f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17191050$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16159857$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>TIMEK, Tomasz A</creatorcontrib><creatorcontrib>GLASSON, Julie R</creatorcontrib><creatorcontrib>LAI, David T</creatorcontrib><creatorcontrib>LIANG, David</creatorcontrib><creatorcontrib>DAUGHTERS, George T</creatorcontrib><creatorcontrib>INGELS, Neil B</creatorcontrib><creatorcontrib>MILLER, D. Craig</creatorcontrib><title>Annular height-to-commissural width ratio of annulolasty rings in vivo</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>A "saddle-shaped" mitral annulus with an optimal ratio between annular height and commissural diameter may reduce leaflet and chordal stress and is purported to be conserved across mammalian species. Whether annuloplasty rings maintain this relationship is unknown.
Twenty-three adult sheep underwent implantation of radiopaque markers on the left ventricle and mitral annulus. Eight animals underwent implantation of a Carpentier-Edwards Physio ring, 7 underwent a Medtronic Duran flexible ring, and 8 served as controls. Animals were studied with biplane videofluoroscopy 7 to 10 days postoperatively. Annular height and commissural width (CW) were determined from 3D marker coordinates, and annular height:CW ratio (AHWCR) was calculated. Annular height was similar in Control and Duran animals but significantly lower in the Physio group at end diastole (8.4+/-3.8, 6.7+/-2.3, and 3.4+/-0.6 mm, respectively, for Control, Duran, and Physio; ANOVA=0.005) and at end systole (14.5+/-6.2, 10.5+/-5.5, and 5.8+/-2.5 mm, respectively, for Control, Duran, and Physio; ANOVA=0.004). Both ring groups reduced CW significantly relative to Control. AHCWR did not differ between Control and Duran but was lower in Physio (23+/-11%, 24+/-7%, and 12+/-2% at end diastole and 42+/-17%, 37+/-17%, and 21+/-10% at end systole, respectively, for Control, Duran, and Physio, respectively; ANOVA <0.05 for both).
Mitral annular height and AHWCR of the native valve were unchanged by a Duran ring, whereas the Physio ring led to a lower AHWCR. Theoretically, such a flexible annuloplasty ring may provide better leaflet stress distribution by maintaining normal AHWCR.</description><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Biometry</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiac Catheterization</subject><subject>Cardiology. Vascular system</subject><subject>Diastole</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Equipment Design</subject><subject>Fluoroscopy</subject><subject>Implants, Experimental</subject><subject>Medical sciences</subject><subject>Mitral Valve - anatomy & histology</subject><subject>Mitral Valve - diagnostic imaging</subject><subject>Mitral Valve - surgery</subject><subject>Motion</subject><subject>Pliability</subject><subject>Sheep</subject><subject>Stress, Mechanical</subject><subject>Systole</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkF9LwzAUxYMobk6_gsQHfetM2iRNHktxbjAcyPZc0izdIm2jSTvZtzdjheHT5Vx-5_45ADxhNMWY4dd88Zlvltl6sfrI5tkUIzKlMSWcXoExpjGJCE3ENRgjhESUJnE8AnfefwXJkpTeglEYQgWn6RjMsrbta-ngXpvdvos6GynbNMb73ska_pptt4dOdsZCW0F5gm0tfXeEzrQ7D00LD-Zg78FNJWuvH4Y6AZvZ2zqfR8vV-yLPlpEihHZRXDHKiahSxgk5ia3ClApRypSKhGuMpA5gyTgqsSgVYxyjsmQ4QVxSXiUT8HKe--3sT699V4RTla5r2Wrb-4KFpxCjcQDFGVTOeu90VXw700h3LDAqTiEW_0MMbVKcQwzex2FJXzZ6e3EOqQXgeQCkV7KunGyV8RcuxQIjipI_8C97Wg</recordid><startdate>20050830</startdate><enddate>20050830</enddate><creator>TIMEK, Tomasz A</creator><creator>GLASSON, Julie R</creator><creator>LAI, David T</creator><creator>LIANG, David</creator><creator>DAUGHTERS, George T</creator><creator>INGELS, Neil B</creator><creator>MILLER, D. Craig</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20050830</creationdate><title>Annular height-to-commissural width ratio of annulolasty rings in vivo</title><author>TIMEK, Tomasz A ; GLASSON, Julie R ; LAI, David T ; LIANG, David ; DAUGHTERS, George T ; INGELS, Neil B ; MILLER, D. Craig</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c445t-2f65849f768442f65dc15599ba75938e10ae445b680b19bc66810bb61308a58f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Biometry</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiac Catheterization</topic><topic>Cardiology. Vascular system</topic><topic>Diastole</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Equipment Design</topic><topic>Fluoroscopy</topic><topic>Implants, Experimental</topic><topic>Medical sciences</topic><topic>Mitral Valve - anatomy & histology</topic><topic>Mitral Valve - diagnostic imaging</topic><topic>Mitral Valve - surgery</topic><topic>Motion</topic><topic>Pliability</topic><topic>Sheep</topic><topic>Stress, Mechanical</topic><topic>Systole</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>TIMEK, Tomasz A</creatorcontrib><creatorcontrib>GLASSON, Julie R</creatorcontrib><creatorcontrib>LAI, David T</creatorcontrib><creatorcontrib>LIANG, David</creatorcontrib><creatorcontrib>DAUGHTERS, George T</creatorcontrib><creatorcontrib>INGELS, Neil B</creatorcontrib><creatorcontrib>MILLER, D. Craig</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>TIMEK, Tomasz A</au><au>GLASSON, Julie R</au><au>LAI, David T</au><au>LIANG, David</au><au>DAUGHTERS, George T</au><au>INGELS, Neil B</au><au>MILLER, D. Craig</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Annular height-to-commissural width ratio of annulolasty rings in vivo</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2005-08-30</date><risdate>2005</risdate><volume>112</volume><issue>9</issue><spage>I423</spage><epage>I428</epage><pages>I423-I428</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>A "saddle-shaped" mitral annulus with an optimal ratio between annular height and commissural diameter may reduce leaflet and chordal stress and is purported to be conserved across mammalian species. Whether annuloplasty rings maintain this relationship is unknown.
Twenty-three adult sheep underwent implantation of radiopaque markers on the left ventricle and mitral annulus. Eight animals underwent implantation of a Carpentier-Edwards Physio ring, 7 underwent a Medtronic Duran flexible ring, and 8 served as controls. Animals were studied with biplane videofluoroscopy 7 to 10 days postoperatively. Annular height and commissural width (CW) were determined from 3D marker coordinates, and annular height:CW ratio (AHWCR) was calculated. Annular height was similar in Control and Duran animals but significantly lower in the Physio group at end diastole (8.4+/-3.8, 6.7+/-2.3, and 3.4+/-0.6 mm, respectively, for Control, Duran, and Physio; ANOVA=0.005) and at end systole (14.5+/-6.2, 10.5+/-5.5, and 5.8+/-2.5 mm, respectively, for Control, Duran, and Physio; ANOVA=0.004). Both ring groups reduced CW significantly relative to Control. AHCWR did not differ between Control and Duran but was lower in Physio (23+/-11%, 24+/-7%, and 12+/-2% at end diastole and 42+/-17%, 37+/-17%, and 21+/-10% at end systole, respectively, for Control, Duran, and Physio, respectively; ANOVA <0.05 for both).
Mitral annular height and AHWCR of the native valve were unchanged by a Duran ring, whereas the Physio ring led to a lower AHWCR. Theoretically, such a flexible annuloplasty ring may provide better leaflet stress distribution by maintaining normal AHWCR.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>16159857</pmid><doi>10.1161/CIRCULATIONAHA.104.525485</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | Circulation (New York, N.Y.), 2005-08, Vol.112 (9), p.I423-I428 |
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| source | MEDLINE; EZB Electronic Journals Library; American Heart Association; Journals@Ovid Complete |
| subjects | Animals Biological and medical sciences Biometry Blood and lymphatic vessels Cardiac Catheterization Cardiology. Vascular system Diastole Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Equipment Design Fluoroscopy Implants, Experimental Medical sciences Mitral Valve - anatomy & histology Mitral Valve - diagnostic imaging Mitral Valve - surgery Motion Pliability Sheep Stress, Mechanical Systole |
| title | Annular height-to-commissural width ratio of annulolasty rings in vivo |
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