Impact of Anchor Location on Mitral Neochordae Forces: An In Vitro Study

PURPOSE This study examined changes in force distribution between the neochordae corresponding to different ventricular anchor locations.& nbsp;DESCRIPTION Seven porcine mitral valves were mounted in a left heart simulator. Neochordae (expanded polytetrafluoroethylene) originated from either a simulated left ventricular apex, papillary muscle base, or papillary muscle tip location. The neochordae were attached at three sites along the P-2 leaflet segment: P-2Lateral; P-2Center, and P-2Medial. Mitral regurgitation was induced by cutting posterior leaflet P2 marginal chordae. The forces on each neochord required to restore normal mitral valve coaptation were quantified for different ventricular anchoring origins and leaflet insertion sites.& nbsp;EVALUATION The results showed that under both normotensive and hypertensive conditions, the force exerted was much higher at P-2Center than either P(2Lateral )or P-2Medial, independent of ventricular anchor location. Also, forces on both P-2Lateral and P-2Medial were not statistically different.& nbsp;CONCLUSIONS Artificial neochordae treatment for all anchoring locations was effective in correcting induced mitral regurgitation. The P-2 central neochordae had a significantly higher force than both lateral neochords under all conditions. (C) 2022 by The Society of Thoracic Surgeons