J Thorac Cardiovasc Surg 2009;138:314-315
© 2009 The American Association for Thoracic Surgery
Discussion
Received for publication May 13, 2008; revisions received December 9, 2008; accepted for publication January 13, 2009.
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Dr Gus J. Vlahakes
(Boston, Mass). This study comes from two institutions that have considerable experience with both clinical mitral valve reconstruction surgery and fluid dynamics with respect to the mitral valve and a long history of work in this area. I have a couple of questions that have to do in part with the model and how the model is set up and, second, with potential interpretation.
In the single-frame picture you show of the echocardiogram, the valve apparatus appears to be slightly apically tethered; in other words, the coaptation surface seems to be displaced a little bit further into what would be the ventricle. When you set the apparatus up, how do you determine the initial position of the papillary muscles?
Dr Padala. In 1997 we published a paper in Circulation with Dr Bob Levine in which we looked at echocardiograms to find the relationship between the mitral annular plane and the papillary muscle tips in normal subjects. We used those measurements to set the mitral line from the papillary muscle to their normal positions in the simulator as used in that study.
Dr Vlahakes. Second, in the porcine valve, what is the nature of the anatomy of the posterior leaflet? Does it have partial clefts or a scallop?type design that you might see in humans, or is it a continuous sheet of . . . [Full Text of this Article]
Copyright © 2009 by The American Association for Thoracic Surgery.
