Intraventricular flow features and cardiac mechano-energetics after mitral valve interventions - Feasibility of an isolated heart model

The aim of this work was the development of an isolated heart setup to delineate the interactions between intraventricular flow features, hemodynamic parameters and mechano-energetics after certain mitral valve therapies. Five porcine hearts were explanted and prepared for (i) edge-to-edge mitral valve repair, (ii) implantation of a rotatable biscupid mechanical valve prosthesis. Flow structures were visualized using echocardiography while hemodynamics was recorded in terms of pressures, flow rates and ventricular volume. Hemodynamic and cardiac mechano-energetics implied a marginal effect (<5%) of alternating leaflet orientation on ventricular pre-load and stroke work. After edge-to-edge repair, substantial variations in flow structures were observed. Beside promoting profound insights into fundamental physiologic mechanisms, the setup may be used for validation of computer aided therapy planning tools.