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Physio 2 annuloplasty ring

Wolfgang Bothe, John-Peder Escobar Kvitting, Manuel K Rausch, Tomasz A Timek, Julia C Swanson, David H Liang, Mario Walther, Ellen Kuhl, Neil B Ingels, D Craig Miller
OBJECTIVE: To quantify the effects of annuloplasty rings designed to treat ischemic/functional mitral regurgitation on left ventricular septal-lateral (S-L) and commissure-commissure (C-C) dimensions. METHODS: Radiopaque markers were placed as opposing pairs on the S-L and C-C aspects of the mitral annulus and the basal, equatorial, and apical level of the left ventricle (LV) in 30 sheep. Ten true-sized Carpentier-Edwards Physio (PHY), Edwards IMR ETlogix (ETL), and GeoForm (GEO; all from Edwards Lifesciences, Irvine, Calif) annuloplasty rings were inserted in a releasable fashion...
January 11, 2019: Journal of Thoracic and Cardiovascular Surgery
Stefaan Bouchez, Frank Timmermans, Tine Philipsen, Katrien François, Thierry Bové
OBJECTIVES: The choice of annuloplasty device is fundamental at the time of mitral valve repair, the goal being to optimally restore the physiological 3-dimensional (3D) structure and dynamics of the mitral annulus (MA). This study evaluated MA dynamics after annuloplasty with 2 different semi-rigid devices. METHODS: Thirty-three patients eligible for mitral valve repair were selected for annuloplasty with the Physio II ring (Edwards Lifesciences, Irving, CA, USA) (n = 17) or the Memo 3D ring (LivaNova, Saluggia, Italy) (n = 16)...
February 15, 2019: European Journal of Cardio-thoracic Surgery
Eric L Pierce, Charles H Bloodworth, Andrew W Siefert, Thomas F Easley, Tetsushi Takayama, Tomonori Kawamura, Robert C Gorman, Joseph H Gorman, Ajit P Yoganathan
OBJECTIVE: The study objective was to quantify the effect of ring type, ring-annulus sizing, suture position, and surgeon on the forces required to tie down and constrain a mitral annuloplasty ring to a beating heart. METHODS: Physio (Edwards Lifesciences, Irvine, Calif) or Profile 3D (Medtronic, Dublin, Ireland) annuloplasty rings were instrumented with suture force transducers and implanted in ovine subjects (N = 23). Tie-down forces and cyclic contractile forces were recorded and analyzed at 10 suture positions and at 3 levels of increasing peak left ventricular pressure...
January 2018: Journal of Thoracic and Cardiovascular Surgery
Søren Nielsen Skov, Diana Mathilde Røpcke, Marcell Juan Tjørnild, Christine Ilkjær, Jonas Rasmussen, Hans Nygaard, Morten Olgaard Jensen, Sten Lyager Nielsen
OBJECTIVES: To characterize the remodelling effects and deformational forces of normosized rigid, semirigid and flexible mitral annuloplasty rings after implantation in healthy pigs. METHODS: Measurements were performed in vivo with 80-kg porcine animals. Twenty-eight animals were randomized into a no ring group, a flexible ring group (Duran AnCore Ring, Medtronic, Minneapolis, MN, USA), a rigid ring group (Carpentier-Edwards Classic annuloplasty ring, Edwards Lifesciences, Irvine, CA, USA) and a semirigid ring group (Carpentier-Edwards Physio I annuloplasty ring, Edwards Lifesciences)...
May 1, 2017: Interactive Cardiovascular and Thoracic Surgery
Ilhan Ozgol, Burak Can Depboylu, Aybala Tongut, Sinem Ozdemir, Yasar Bagdatlı, Sanaz Ainechi, Buge Oz, Jean-Claude Pache, Selim Erenturk, Afksendiyos Kalangos, Ali Can Hatemi, Mustafa Cikirikcioglu
BACKGROUND: Biodegradable atrioventricular annuloplasty rings are theoretically more infection resistant due to their intra-annular implantation technique and nonporous structures (monofilament of poly-1,4-dioxanone). The aim of this study was to investigate the infection resistance of a biodegradable annuloplasty ring (Kalangos-Bioring®) in a rat subcutaneous implantation model and to compare it with a commonly used conventional annuloplasty ring (Edwards Physio II®). METHODS: This study included 32 Wistar albino rats which were divided into 2 groups according to the implantation of sterile or infected annuloplasty rings as control and study groups...
2017: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
Søren Nielsen Skov, Diana Mathilde Røpcke, Marcell Juan Tjørnild, Christine Ilkjær, Jonas Rasmussen, Hans Nygaard, Morten Olgaard Jensen, Sten Lyager Nielsen
OBJECTIVES: Investigate myocardial stress adaptation and remodelling capacity of a rigid and semi-rigid mitral annuloplasty ring. METHODS: The annuloplasty rings were characterized in vitro in a mechanical setup with tensile and compressive forces from 0 to 3 N. The rings were tested with and without fixation of the ring to imitate the effect of annular implantation. In vivo measurements were performed with 21 porcine animals randomized into: A no ring group, a rigid ring group (Classic Annuloplasty Ring TM , Edwards Lifesciences) and a semi-rigid ring group (Physio I Annuloplasty Ring, Edwards Lifesciences)...
May 1, 2017: European Journal of Cardio-thoracic Surgery
Hiroyuki Nishi, Koichi Toda, Shigeru Miyagawa, Yasushi Yoshikawa, Satsuki Fukushima, Masashi Kawamura, Daisuke Yoshioka, Tetsuya Saito, Takayoshi Ueno, Toru Kuratani, Yoshiki Sawa
PURPOSE: We assessed the effects of different types of prosthetic rings on mitral annular dynamics using real-time three-dimensional echocardiography (RT3DE). METHODS: RT3DE was performed in 44 patients, including patients undergoing mitral annuloplasty using the Cosgrove-Edwards flexible band (Group A, n = 10), the semi-rigid Sorin Memo 3D ring (Group B, n = 17), the semi-rigid Edwards Physio II ring (Group C, n = 7) and ten control subjects. Various annular diameters were measured throughout the cardiac cycle...
September 2016: Surgery Today
Andrew W Siefert, Eric L Pierce, Madonna Lee, Morten Ø Jensen, Chikashi Aoki, Satoshi Takebayashi, Joan Fernandez Esmerats, Robert C Gorman, Joseph H Gorman, Ajit P Yoganathan
PURPOSE: To demonstrate the first use of a novel technology for quantifying suture forces on annuloplasty rings to better understand the mechanisms of ring dehiscence. DESCRIPTION: Force transducers were developed, attached to a size 24 Physio ring, and implanted in the mitral annulus of an ovine animal. Ring suture forces were measured after implantation and for cardiac cycles reaching peak left ventricular pressures (LVP) of 100, 125, and 150 mm Hg. EVALUATION: After implantation of the undersized ring to the flaccid annulus, the mean suture force was 2...
July 2014: Annals of Thoracic Surgery
Moritz A Konerding, Jarmo Simpanen, Leo Ihlberg, Juha Aittomäki, Kalervo Werkkala, Vera Delventhal, Maximilian Ackermann
BACKGROUND: The prevalence of mitral regurgitation in cardiac diseases requires annuloplasty systems that can be implanted without excessive patient burden. This study was designed to examine the morphological and functional outcome of a new double helix mitral annuloplasty ring in an ovine model in comparison to the classical Carpentier-Edwards (CE) annuloplasty ring as measured by reduction of mitral regurgitation and tissue integration. The Medtentia annuloplasty ring (MAR) is a helical device that is rotated into the annulus self-restoring the valve geometry, enabling a faster fixation without the need of elaborate repair of the valve geometry...
2013: Journal of Cardiothoracic Surgery
Mathieu Vergnat, Melissa M Levack, Arminder S Jassar, Benjamin M Jackson, Michael A Acker, Y Joseph Woo, Robert C Gorman, Joseph H Gorman
OBJECTIVES: Reports indicate that repair procedures for ischaemic mitral regurgitation (IMR) are less durable than previously thought. Repair failure has been shown to be stress related. Leaflet curvature is the major determinant of valve stress. Theoretical and animal experiments have shown that saddle-shaped annuloplasty optimizes leaflet curvature when compared with standard flat ring annuloplasty. Despite this, the influence of the ring shape on leaflet curvature has not been described in patients with IMR...
September 2012: European Journal of Cardio-thoracic Surgery
Sabet W Hashim, Samuel J Youssef, Bassem Ayyash, Anthony J Rousou, Sigurdur Ragnarsson, Susan Collazo, Arnar Geirsson
OBJECTIVE: Recurrence rates as high as 30% have been observed 6 months after treatment of chronic ischemic mitral regurgitation (CIMR) with isolated annuloplasty. We postulated that the high early recurrence rates resulted from the presence of untreated pseudoprolapse of the anterior leaflet. METHODS: We conducted a retrospective study of all mitral valve repairs for CIMR performed by a single surgeon (S.W.H.) from 1995 to 2011. After annuloplasty, Gore-Tex neochordae were added if the high-pressure saline test indicated the presence of pseudoprolapse of the anterior leaflet...
April 2012: Journal of Thoracic and Cardiovascular Surgery
Hideaki Mori, Hiroki Hayashi, Yasushi Matsushita
A 64-year-old female was admitted to our hospital because of severe dyspnea. Echocardiography revealed mitral valve regurgitation and atrial septal aneurysm (ASA). After instituting medical treatment for congestive heart failure, euvolemic status was achieved, and the patient underwent; (1) prosthetic patch repair for ASA; (2) mitral valvuloplasty with partial quadrangular resection of the posterior mitral leaflet; and (3) mitral annuloplasty using Physio ring. Pathological examination revealed myxomatous degeneration of the mitral valve, but the resected atrial septum was without any abnormality...
August 2011: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Wolfgang Bothe, John-Peder Escobar Kvitting, Elizabeth H Stephens, Julia C Swanson, David H Liang, Neil B Ingels, D Craig Miller
OBJECTIVE: The study objective was to quantify the effects of different annuloplasty rings on mitral leaflet septal-lateral tenting areas during acute myocardial ischemia. METHODS: Radiopaque markers were implanted along the central septal-lateral meridian of the mitral valve in 30 sheep: 1 each to the septal and lateral aspects of the mitral annulus and 4 and 2 along the anterior and posterior mitral leaflets, respectively. Ten true-sized Carpentier-Edwards Physio, Edwards IMR ETLogix, and GeoForm annuloplasty rings (Edwards Lifesciences, Irvine, Calif) were inserted in a releasable fashion...
February 2011: Journal of Thoracic and Cardiovascular Surgery
Hunaid A Vohra, Robert N Whistance, Laurynas Bezuska, Steve A Livesey
OBJECTIVE: The Carpentier-Edwards (CE) Physio II ring is a new prosthetic ring designed to accommodate the changing pathology seen in the spectrum of degenerative valve disease, particularly the larger anterior leaflet in repair of the Barlow valve. The aim of our study was to assess the safety and efficacy of mitral valve (MV) repair with the CE Physio II ring. METHODS: Between April 2009 and March 2010, 100 patients underwent MV repair using the Physio II ring...
June 2011: European Journal of Cardio-thoracic Surgery
Emiliano Votta, Riccardo Vismara, Alberto Redaelli, Lorenzo Arcobasso, Francesco Maisano, Ottavio Alfieri, Gianfranco B Fiore
Functional mitral regurgitation (FMR) is usually treated through annuloplasty, i.e., the restriction of the mitral annulus by implanting an undersized prosthetic ring. We conceived a steady-state fluid-dynamic mock simulator that allows for controlling the main mechanic determinants of FMR: transmitral pressure and papillary muscle (PM) apical and lateral dislocation. We used our system to compare the FMR-specific Geoform ring with the general purpose Physio ring in the treatment of FMR. Each ring was implanted on 10 excised fresh porcine valves...
November 2010: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Wolfgang Bothe, John-Peder Escobar Kvitting, Julia C Swanson, Serdar Göktepe, Kathy N Vo, Neil B Ingels, D Craig Miller
OBJECTIVES: To define the effects of annuloplasty rings (ARs) on the dynamic motion of anterior mitral leaflet (AML) and posterior mitral leaflet (PML). METHODS: Fifty-eight adult, Dorsett-hybrid, male sheep (49 + or - 5 kg) had radiopaque markers inserted: eight around the mitral annulus, four along the central meridian (from edge to annulus) of the AML (#A(1)-#A(4)) and one on the PML edge (#P(1)). True-sized Edwards Cosgrove (COS, n=12), St Jude RSAR (St. Jude Medical, St...
September 2010: European Journal of Cardio-thoracic Surgery
Francesco Onorati, Antonino Salvatore Rubino, Domenico Marturano, Eugenia Pasceri, Giuseppina Mascaro, Stefania Zinzi, Filiberto Serraino, Attilio Renzulli
BACKGROUND: Despite restrictive mitral annuloplasty (RMA) being considered effective for chronic ischaemic mitral regurgitation (CIMR), few data exist on mid-term echocardiographic results with different prosthetic rings. Therefore, comparative echocardiographic analysis has been performed. METHODS: Sixty-four consecutive coronary artery bypass graft surgery (CABG) + RMA (downsizing by two-ring sizes; median size: 26 mm) for CIMR with a follow-up of at least 6 months were prospectively followed-up with serial echocardiograms (preoperative, discharge, 6 months, follow-up ending)...
August 2009: European Journal of Cardio-thoracic Surgery
Shao-Wei Chen, Feng-Chun Tsai, Feng-Chang Tsai, Chun-Chi Chen, Chun-Li Wang, Mon-Yue Wu, Yao-Kuang Huang, Jaw-Ji Chu, Pyng Jing Lin
BACKGROUND: The success rate of mitral annuloplasty (MA) for functional mitral regurgitation (FMR) varies. This study evaluated the effectiveness of this procedure in nonischemic dilated cardiomyopathy (DCM) patients after a selective treatment protocol was followed. METHODS AND RESULTS: This study analyzed 42 patients with nonischemic DCM and FMR (mean regurgitation grade, 3.6 +/- 0.3), aged a mean 56.5 +/- 15 years (range, 25 to 78 years), who underwent MA from April 2003 to December 2007...
May 2009: Journal of Cardiac Failure
Stephan Geidel, Michael Lass, Jörg Ostermeyer
BACKGROUND: This study investigated the results of restrictive mitral annuloplasty with the semirigid Carpentier-Edwards Physio ring in patients with moderately severe to severe chronic ischemic mitral regurgitation (IMR) and advanced ischemic cardiomyopathy (ICM). METHODS: From 2003 to 2007, 100 consecutive patients (mean age +/- SD, 69 +/- 10 years) with chronic IMR of grades 3 to 4 (3.6 +/- 0.5) and a left ventricular ejection fraction (LVEF) of 31% +/- 9% (range, 12%-45%) underwent standardized restrictive prosthetic ring annuloplasty (ie, downsizing of 2...
2008: Heart Surgery Forum
Liam P Ryan, Benjamin M Jackson, Hirotsuga Hamamoto, Thomas J Eperjesi, Theodore J Plappert, Martin St John-Sutton, Robert C Gorman, Joseph H Gorman
BACKGROUND: The effect of mitral leaflet curvature on stress reduction is an important mechanism in optimizing valve function. We hypothesize that annuloplasty ring shape could directly influence leaflet curvature and, potentially, repair durability. We describe an echocardiographically based methodology for quantifying mitral valve geometry and its application to the characterization of ovine mitral valve geometry before and after implantation of an annuloplasty ring. METHODS: Multiple mitral annular and leaflet geometric variables were calculated for 8 naïve adult male sheep using real-time three-dimensional echocardiographic images...
September 2008: Annals of Thoracic Surgery
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