Annuloplasty ring choice and design are critical to the long-term efficacy of mitral valve (MV) repair. DynaRing is a selectively compliant annuloplasty ring composed of varying stiffness elastomer segments, a shape-set nitinol core, and a cross diameter filament. The ring provides sufficient stiffness to stabilize a diseased annulus while allowing physiological annular dynamics. Moreover, adjusting elastomer properties provides a mechanism for effectively tuning key MV metrics to specific patients. We evaluate the ring embedded in porcine valves with an ex-vivo left heart simulator and perform a 150 million cycle fatigue test via a custom oscillatory system. We present a patient-specific design approach for determining ring parameters using a finite element model optimization and patient MRI data. Ex-vivo experiment results demonstrate that motion of DynaRing closely matches literature values for healthy annuli. Findings from the patient-specific optimization establish DynaRing's ability to adjust the anterior-posterior and intercommissural diameters and saddle height by up to 8.8%, 5.6%, 19.8%, respectively, and match a wide range of patient data.
Keyphrases
- mitral valve
- left atrial
- left ventricular
- end stage renal disease
- magnetic resonance imaging
- systematic review
- case report
- newly diagnosed
- chronic kidney disease
- aortic valve
- big data
- body mass index
- finite element
- magnetic resonance
- atrial fibrillation
- computed tomography
- machine learning
- aortic valve replacement
- depressive symptoms
- patient reported outcomes
- high resolution
- mass spectrometry
- high frequency
- decision making