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Title: Cardioscopic Evaluation and Qualitative Estimation of Mitral Apparatus in A Quasi-Dynamic State in An Ex-Vivo Swine Heart Model
Authors: Sazzad, Md Faizus 
Kofidis, Theo
Xian, Ong Zhi
Issue Date: 11-Apr-2020
Citation: Sazzad, Md Faizus, Kofidis, Theo, Xian, Ong Zhi (2020-04-11). Cardioscopic Evaluation and Qualitative Estimation of Mitral Apparatus in A Quasi-Dynamic State in An Ex-Vivo Swine Heart Model. Journal of Biomedical Engineering and Research 4 : 1-9. ScholarBank@NUS Repository.
Abstract: Mitral valve disease dominates a significant portion of diseases treated by the cardiothoracic discipline. Prosthetic-related complications such as thromboembolism are postulated to correlate with differences in flow patterns among various prostheses. Methods to observe flow patterns are limited to computational dynamics, cardiac MRI and echocardiography. We describe a novel approach of qualitative estimation of the mitral valve and flow pattern via the use of an endoscope in an ex-vivo swine model. Cardioscopy is utilized along with neutral buoyancy particles in a quasi- dynamic state created by the roller pumps of a cardiopulmonary bypass machine. Direct visualization of the mitral apparatus and flow pattern was achieved via insertion of the endoscope from the ventral surface of the heart and the video recorded was subsequently analyzed with particle tracking software to increase the fidelity of our experiment. Three explanted hearts were used for native mitral valve, Medtronic Mosaic bioprosthetic valve, and Medtronic Open Pivot mechanical valve respectively. Observations include the trajectory of the neutral buoyancy particles, the number of times it encounters the valve as well as the presence of a looped trajectory. Our analysis of the flow patterns concluded that the bioprosthetic valve model was observed to be similar in flow pattern to the native mitral valve while the mechanical valve model deviates from the norm. These results are consistent with the increased risk of post-operative thromboembolism in mechanical valves compared to bioprosthetic valves. This novel approach may find potential in the development and design of new prosthetic mitral valves in the future to emulate the native properties of mitral valve.
Source Title: Journal of Biomedical Engineering and Research
DOI: 10.17303/jber.2020.4.103
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