An axis-specific mitral annuloplasty ring eliminates mitral regurgitation allowing mitral annular motion in an ovine model
Abstract Introduction Current mitral annuloplasty rings fail to restrict the anteroposterior distance while allowing dynamic mitral annular changes. We designed and manufactured a mitral annuloplasty ring that demonstrated axis-specific, selective flexibility to meet this clinical need. The objectiv...
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Nature Portfolio
2025-02-01
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| Online Access: | https://doi.org/10.1038/s43856-025-00753-6 |
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| author | Yuanjia Zhu Annabel M. Imbrie-Moore Matthew H. Park Tyler E. Cork Shin Yajima Robert J. Wilkerson Nicholas A. Tran Mateo Marin-Cuartas Danielle M. Mullis Sam W. Baker Yuko Tada Tsuyoshi Ueyama Matthew Leipzig Vicky Y. Wang Sidarth Ethiraj Sarah Madira Shreya Anilkumar Sabrina K. Walsh Haley J. Lucian Chris Huynh Kimberly Morris Ok S. Kim Jack Mulligan Hanjay Wang Yasuhiro Shudo Daniel B. Ennis Y. Joseph Woo |
| author_facet | Yuanjia Zhu Annabel M. Imbrie-Moore Matthew H. Park Tyler E. Cork Shin Yajima Robert J. Wilkerson Nicholas A. Tran Mateo Marin-Cuartas Danielle M. Mullis Sam W. Baker Yuko Tada Tsuyoshi Ueyama Matthew Leipzig Vicky Y. Wang Sidarth Ethiraj Sarah Madira Shreya Anilkumar Sabrina K. Walsh Haley J. Lucian Chris Huynh Kimberly Morris Ok S. Kim Jack Mulligan Hanjay Wang Yasuhiro Shudo Daniel B. Ennis Y. Joseph Woo |
| author_sort | Yuanjia Zhu |
| collection | DOAJ |
| description | Abstract Introduction Current mitral annuloplasty rings fail to restrict the anteroposterior distance while allowing dynamic mitral annular changes. We designed and manufactured a mitral annuloplasty ring that demonstrated axis-specific, selective flexibility to meet this clinical need. The objectives were to evaluate ex vivo biomechanics of this ring and to validate the annular dynamics and safety after ring implantation in vivo. Methods Healthy human mitral annuli (n = 3) were tracked, and motions were isolated. Using the imaging data, we designed and manufactured our axis-specific mitral annuloplasty ring. An ex vivo annular dilation model was used to compare hemodynamics and chordal forces after repair using the axis-specific, rigid, and flexible rings in five porcine mitral valves. In vivo, axis-specific (n = 6), rigid (n = 6), or flexible rings (n = 6) were implanted into male Dorset sheep for annular motion analyses. Five additional animals receiving axis-specific rings survived for up to 6 months. Results Here we show the axis-specific, rigid, and flexible rings reduced regurgitation fraction to 4.7 ± 2.7%, 2.4 ± 3.2%, and 17.8 ± 10.0%, respectively. The axis-specific ring demonstrated lower average forces compared to the rigid ring (p = 0.046). Five animals receiving axis-specific rings survived for up to 6 months, with mitral annular motion preserved in vivo. Mature neoendocardial tissue coverage over the device was found to be complete with full endothelialization in all animals. Conclusions The axis-specific mitral annuloplasty ring we designed demonstrates excellent capability to repair mitral regurgitation while facilitating dynamic mitral annular motion. This ring has tremendous potential for clinical translatability, representing a promising surgical solution for mitral regurgitation. |
| format | Article |
| id | doaj-art-b80ba82135ad4486a856d4e4bf2d6880 |
| institution | DOAJ |
| issn | 2730-664X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Nature Portfolio |
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| series | Communications Medicine |
| spelling | doaj-art-b80ba82135ad4486a856d4e4bf2d68802025-08-20T03:00:58ZengNature PortfolioCommunications Medicine2730-664X2025-02-015111410.1038/s43856-025-00753-6An axis-specific mitral annuloplasty ring eliminates mitral regurgitation allowing mitral annular motion in an ovine modelYuanjia Zhu0Annabel M. Imbrie-Moore1Matthew H. Park2Tyler E. Cork3Shin Yajima4Robert J. Wilkerson5Nicholas A. Tran6Mateo Marin-Cuartas7Danielle M. Mullis8Sam W. Baker9Yuko Tada10Tsuyoshi Ueyama11Matthew Leipzig12Vicky Y. Wang13Sidarth Ethiraj14Sarah Madira15Shreya Anilkumar16Sabrina K. Walsh17Haley J. Lucian18Chris Huynh19Kimberly Morris20Ok S. Kim21Jack Mulligan22Hanjay Wang23Yasuhiro Shudo24Daniel B. Ennis25Y. Joseph Woo26Department of Bioengineering, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Bioengineering, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Comparative Medicine, Stanford UniversityStanford Cardiovascular Institute and Division of Cardiovascular Medicine, Stanford UniversityStanford Cardiovascular Institute and Division of Cardiovascular Medicine, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Radiology, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Cardiothoracic Surgery, Stanford UniversityDepartment of Radiology, Stanford UniversityDepartment of Bioengineering, Stanford UniversityAbstract Introduction Current mitral annuloplasty rings fail to restrict the anteroposterior distance while allowing dynamic mitral annular changes. We designed and manufactured a mitral annuloplasty ring that demonstrated axis-specific, selective flexibility to meet this clinical need. The objectives were to evaluate ex vivo biomechanics of this ring and to validate the annular dynamics and safety after ring implantation in vivo. Methods Healthy human mitral annuli (n = 3) were tracked, and motions were isolated. Using the imaging data, we designed and manufactured our axis-specific mitral annuloplasty ring. An ex vivo annular dilation model was used to compare hemodynamics and chordal forces after repair using the axis-specific, rigid, and flexible rings in five porcine mitral valves. In vivo, axis-specific (n = 6), rigid (n = 6), or flexible rings (n = 6) were implanted into male Dorset sheep for annular motion analyses. Five additional animals receiving axis-specific rings survived for up to 6 months. Results Here we show the axis-specific, rigid, and flexible rings reduced regurgitation fraction to 4.7 ± 2.7%, 2.4 ± 3.2%, and 17.8 ± 10.0%, respectively. The axis-specific ring demonstrated lower average forces compared to the rigid ring (p = 0.046). Five animals receiving axis-specific rings survived for up to 6 months, with mitral annular motion preserved in vivo. Mature neoendocardial tissue coverage over the device was found to be complete with full endothelialization in all animals. Conclusions The axis-specific mitral annuloplasty ring we designed demonstrates excellent capability to repair mitral regurgitation while facilitating dynamic mitral annular motion. This ring has tremendous potential for clinical translatability, representing a promising surgical solution for mitral regurgitation.https://doi.org/10.1038/s43856-025-00753-6 |
| spellingShingle | Yuanjia Zhu Annabel M. Imbrie-Moore Matthew H. Park Tyler E. Cork Shin Yajima Robert J. Wilkerson Nicholas A. Tran Mateo Marin-Cuartas Danielle M. Mullis Sam W. Baker Yuko Tada Tsuyoshi Ueyama Matthew Leipzig Vicky Y. Wang Sidarth Ethiraj Sarah Madira Shreya Anilkumar Sabrina K. Walsh Haley J. Lucian Chris Huynh Kimberly Morris Ok S. Kim Jack Mulligan Hanjay Wang Yasuhiro Shudo Daniel B. Ennis Y. Joseph Woo An axis-specific mitral annuloplasty ring eliminates mitral regurgitation allowing mitral annular motion in an ovine model Communications Medicine |
| title | An axis-specific mitral annuloplasty ring eliminates mitral regurgitation allowing mitral annular motion in an ovine model |
| title_full | An axis-specific mitral annuloplasty ring eliminates mitral regurgitation allowing mitral annular motion in an ovine model |
| title_fullStr | An axis-specific mitral annuloplasty ring eliminates mitral regurgitation allowing mitral annular motion in an ovine model |
| title_full_unstemmed | An axis-specific mitral annuloplasty ring eliminates mitral regurgitation allowing mitral annular motion in an ovine model |
| title_short | An axis-specific mitral annuloplasty ring eliminates mitral regurgitation allowing mitral annular motion in an ovine model |
| title_sort | axis specific mitral annuloplasty ring eliminates mitral regurgitation allowing mitral annular motion in an ovine model |
| url | https://doi.org/10.1038/s43856-025-00753-6 |
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