Biomechanical engineering analysis of commonly utilized mitral neochordae

Abstract

Objective: To evaluate the suture rupture forces of commonly clinically utilized neochord repair techniques to identify the most biomechanically resistant most biomechanically resistant technique. Methods: Several types of neochord techniques (standard interrupted neochordae, continuous running neochordae, and loop technique), numbers of neochordae, and suture calibers (polytetrafluoroethylene CV-3 to CV-6) were compared. To perform the tests, both ends of the neochordae were loaded in a tensile force analysis machine. During the test, the machine applied tension to the neochord until rupture was achieved. The tests were performed 3 times for each variation, and the rupture forces were averaged for statistical analysis. Results: < .01). A greater number of loops did not significantly increase the rupture force of loop neochordae. Observed rupture forces for all techniques were higher than those normally observed in physiologic conditions. Conclusions: Under experimental conditions, the running neochord technique has the best mechanical performance due to an increased rupture force. If using running neochordae, more than 1 independent set of multiple running neochordae are advised (ie, >2 independent sets of multiple running neochordae in each set).