The durability of different anchoring points and anchoring types in the left ventricle in an ex-vivo porcine model

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Abstract
Objective: Various percutaneous approaches are under development to perform transcatheter treatment of mitral valve disease, where many try to anchor in the left ventricle. This pilot study investigates the durability of different anchoring points and types in the left ventricle. Anchoring was tested in three different locations: the head of the papillary muscle, the lateral wall of the ventricle, and the apex of the ventricle. In addition, two different anchoring types were tested: PTFE sutures that mimicked mitral valve repair and a de novo developed 5 mm helix. Results: The lowest numerical strain/compliance during the first cycle was seen for the head of papillary muscle anchoring (both surgical and helix). Migration of strain limits over 300 cycles was seen for all locations. Numerically, the lowest migration was for the helix in the papillary muscle. PTFE in the head of the papillary muscle is standard practice in mitral valve repair and was used as a reference in the present study. The anchoring that gave the most consistent results was a helix in the papillary muscle, while other anchoring points showed larger compliance and/or migration.

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