A dynamic mitral valve simulator for surgical training and patient specific preoperative planning

Mitral valve disease affects 2% of the Canadian population and 10% of those over the age of 75. Mitral valve regurgitation is a common valve disease often requiring surgical intervention for repair or replacement. Repair is often preferred over replacement, as it is associated with improved outcomes. Current mitral valve repair training is typically limited primarily to intraoperative experience. Additionally, the outcome of complex repair procedures is often unknown preoperatively, and is particularly true of new, off-pump repair techniques. Further challenges include identifying the most effective repair technique based on patient pathology, as multiple approaches exist. We present a hemodynamically accurate mitral valve phantom for testing previously validated patient specific pathological mitral valves. The device can be used for surgical resident training as well as complex procedure planning. The simulator is validated using pressure measurements across the mitral valve demonstrating realistic hemodynamics across a range of heart rates , and by evaluating valve function using 2D and 3D transesophageal echocardiography (TEE).

[1]  Maurizio Taramasso,et al.  Cardioband system as a treatment for functional mitral regurgitation , 2018, Expert review of medical devices.

[2]  Henry E Fessler,et al.  The Death of Animals in Medical School. , 2017, The New England journal of medicine.

[3]  John Vozenilek,et al.  See one, do one, teach one: advanced technology in medical education. , 2004, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[4]  Artur Polinski,et al.  Analysis of correlation between heart rate and blood pressure , 2011, 2011 Federated Conference on Computer Science and Information Systems (FedCSIS).

[5]  Terry M. Peters,et al.  Dynamic heart phantom with functional mitral and aortic valves , 2015, Medical Imaging.

[6]  Patric Biaggi,et al.  Two-year outcomes after percutaneous mitral valve repair with the MitraClip system: durability of the procedure and predictors of outcome , 2014, Open Heart.

[7]  Alberto Redaelli,et al.  In vitro assessment of mitral valve function in cyclically pressurized porcine hearts. , 2016, Medical engineering & physics.

[8]  F. Jatene,et al.  Low Cost Simulator for Heart Surgery Training , 2016, Brazilian journal of cardiovascular surgery.

[9]  J. Maessen,et al.  Preoperative planning with three-dimensional reconstruction of patient's anatomy, rapid prototyping and simulation for endoscopic mitral valve repair. , 2016, Interactive cardiovascular and thoracic surgery.

[10]  Jules Hernández-Sánchez,et al.  Early Outcomes After Mitral Valve Repair versus Replacement in the Elderly: A Propensity Matched Analysis. , 2017, Heart, lung & circulation.

[11]  Krzysztof Wrobel,et al.  The dynamic cardiac biosimulator: A method for training physicians in beating‐heart mitral valve repair procedures , 2018, The Journal of thoracic and cardiovascular surgery.

[12]  Joanna Chikwe,et al.  Relation of Mitral Valve Surgery Volume to Repair Rate, Durability, and Survival. , 2017, Journal of the American College of Cardiology.

[13]  Paul E. Drawz,et al.  Heart Rate and Blood Pressure: Any Possible Implications for Management of Hypertension? , 2012, Current Hypertension Reports.

[14]  Alberto Pozzoli,et al.  Current challenges in interventional mitral valve treatment. , 2015, Journal of thoracic disease.

[15]  Daniel Bainbridge,et al.  Dynamic Patient-Specific Three-Dimensional Simulation of Mitral Repair , 2018, Innovations.

[16]  Josep Rodés-Cabau,et al.  Structural Heart Disease Intervention: The Canadian Landscape. , 2017, The Canadian journal of cardiology.

[17]  H. G. Goovaerts,et al.  A new electric method for non-invasive continuous monitoring of stroke volume and ventricular volume-time curves , 2012, BioMedical Engineering OnLine.