Author + information
Mitral Regurgitation (MR) is the most common heart valve disease, affecting 7-9% of people over 75. The AccuCinch System (Ancora Heart, Santa Clara, CA) is a device and therapy designed to treat significant functional MR through a less invasive, off pump, closed heart procedure. The system works by implanting anchors in an arc around the basal left ventricle (LV) which are tightened together to promote reverse remodeling of the LV. The subannular space is accessed through the aortic valve via a pre-shaped guide-catheter which orients, directs, and provides support for other catheters. There are multiple guide shapes and choosing the best-fit is crucial for proper device deployment.
Prior to procedure, a high-resolution cardiac gated CT scan was acquired. The Mimics Innovation Suite (Materialise, Belgium) was used to model the Diastolic anatomy. The model was then 3D-printed in transparent stereolithography resin and used to assess guide-catheter fit. Each guide was placed into the model and evaluated based on tip location and direction relative to the mitral valve, tangency of the distal tip curve to the LV wall, and general stability. An appropriate guide-catheter shape was then chosen based on the target implant position for the patient.
The model was accurate in predicting guide fit for a total of 9 successful implants. Prediction of guide tip height, tangency to the LV wall, and stability was sufficiently accurate to allow successful deployment in the target location.
3D-printed anatomical models can be used to predict the best-fit guide-catheter shape for mitral repair.
STRUCTURAL: Valvular Disease: Mitral