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Experimental Mechanics

Erschienen in:

26.10.2020 | Sp Iss: Experimental Advances in Cardiovascular Biomechanics

Radiofrequency Ablation Alters the Microstructural Organization of Healthy and Enzymatically Digested Porcine Mitral Valves

verfasst von: J. M. Bender, W. R. Adams, A. Mahadevan-Jansen, W. D. Merryman, M. R. Bersi

Erschienen in: Experimental Mechanics | Ausgabe 1/2021

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Abstract

Background

Myxomatous mitral valve degeneration is a common cause of mitral regurgitation and is often associated with mitral valve prolapse. With no known targets to pharmacologically treat mitral valve prolapse, surgery is often the only treatment option. Recently, radiofrequency ablation has been proposed as a percutaneous alternative to surgical resection for the reduction of mitral valve leaflet area.

Objective

Using an in vitro model of porcine mitral valve anterior leaflet enlargement following enzymatic digestion, we sought to investigate mechanisms by which radiofrequency ablation alters the geometry, microstructural organization, and mechanical properties of healthy and digested leaflets.

Methods

Paired measurements before and after radiofrequency ablation revealed the impact of ablation on leaflet properties. Multiphoton imaging was used to characterize changes in the structure and organization of the valvular extracellular matrix; planar biaxial mechanical testing and constitutive modeling were used to estimate mechanical properties of healthy and digested leaflets.

Results

Enzymatic digestion increased leaflet area and thickness to a similar extent as clinical mitral valve disease. Radiofrequency ablation altered extracellular matrix alignment and reduced the area of digested leaflets to that of control. Additionally, enzymatic digestion resulted in fiber alignment and reorientation toward the radial direction, causing increased forces during ablation and a structural stiffening which was improved by radiofrequency ablation.

Conclusions

Radiofrequency ablation induces radial extracellular matrix alignment and effectively reduces the area of enlarged mitral valve leaflets. Hence, this technique may be a therapeutic approach for myxomatous mitral valve disease and is thus an avenue for future study.

Vorheriger Artikel Effects of Red Blood Cell Sickling on Right Ventricular Afterload in vivo

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Titel: Radiofrequency Ablation Alters the Microstructural Organization of Healthy and Enzymatically Digested Porcine Mitral Valves
verfasst von: J. M. Bender
W. R. Adams
A. Mahadevan-Jansen
W. D. Merryman
M. R. Bersi
Publikationsdatum: 26.10.2020
Verlag: Springer US
Erschienen in: Experimental Mechanics / Ausgabe 1/2021
Print ISSN: 0014-4851
Elektronische ISSN: 1741-2765
DOI: https://doi.org/10.1007/s11340-020-00662-w

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Abstract

Background

Objective

Methods

Results

Conclusions

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