A new percutaneous annuloplasty technique for mitral regurgitation is proposed here. In this technique, inter-related anchors are first inserted around the annulus via a trans-septal catheter. The tethered wire passed through the anchors is then pulled to shrink the annulus and stop regurgitation. The anchors should withstand large deformation, applied during the delivery process, and should recover their original shape after being released inside the tissue. The shape of the anchors is, thus, optimized in an iterative process, to avoid stress concentration by minimizing the weighted rms value of the curvature along the anchor. The weight coefficients in each iteration are defined based on the stress distribution of the anchor obtained in the previous iteration. The procedure finally results in a structurally optimum anchor with a minimum in the maximum von Mises stress. This anchor is fabricated from Nitinol and tested in a cadaveric swine heart.

References

References
1.
Yiu
,
S. F.
,
Enriquez-Sarano
,
M.
,
Tribouilloy
,
C.
,
Seward
,
J. B.
, and
Tajik
,
A. J.
, 2000, “
Determinants of the Degree of Functional Mitral Regurgitation in Patients with Systolic Left Ventricular Dysfunction: A Quantitative Clinical Study
,”
Circulation
,
102
(
12
), pp.
1400
1406
.
2.
Azar
,
T.
,
Angeles
,
J.
,
Kovecses
,
J.
, and
Cecere
,
R.
, 2010, “
The Mathematical Model of a Procedure for Percutaneous Annuloplasty
,”
ASME International Design Engineering Technical Conferences and Computers and Information in Engineering Conference
, Vol.
1
of 36th Design Automation Conference,
ASME
, pp.
1219
1224
.
3.
Javid
,
F.
,
Angeles
,
J.
,
Pasini
,
D.
, and
Cecere
,
R.
, 2010, “
Optimum Design of an Anchoring System for Percutaneous Mitral Valve Repair
,”
ASME International Design Engineering Technical Conferences and Computers and Information in Engineering Conference
, Vol.
1
of 36th Design Automation Conference,
ASME
, pp.
1181
1189
.
4.
Villa
,
M. T.
,
White
,
L. E.
,
Alam
,
M.
,
Yoo
,
S. S.
, and
Walton
,
R. L.
, 2008. “
Barbed Sutures: A Review of the Literature
,”
Plast. Reconstr. Surg.
,
121
(
3
), pp.
102e
108e
.
5.
Swain
,
C. P.
, 1999, “
Endoscopic Suturing
,”
Best Pract.Res. Clin. Gastroenterol.
,
13
(
1
), pp.
97
108
.
6.
Hill
,
A. C.
,
Maroney
,
T. P.
, and
Virmani
,
R.
, 2001, “
Facilitated Coronary Anastomosis Using a Nitinol U-clip Device: Bovine Model
,”
J. Thorac. Cardiovasc. Surg.
,
121
(
5
), pp.
859
870
.
7.
Qadeer
,
M. A.
,
Dumot
,
J. A.
,
Vargo
,
J. J.
,
Lopez
,
M. R.
, and
Rice
,
T. W.
, 2007, “
Endoscopic Clips for Closing Esophageal Perforations: Case Report and Pooled Analysis
,”
Gastrointest.Endosc.
,
66
(
3
), pp.
605
611
.
8.
Reade
,
C. C.
,
Bower
,
C. E.
,
Bailey
,
B. M.
,
Maziarz
,
D. M.
,
Masroor
,
S.
,
Kypson
,
A. P.
,
Nifong
,
L. W.
, and
Chitwood
,
W. R.
, 2005, “
Robotic mitral valve Annuloplasty With Double-Arm Nitinol U-Clips
,”
Ann. Thorac. Surg.
,
79
(
4
), pp.
1372
1376
.
9.
Ingle
,
N. P.
and
King
,
M. W.
, 2010, “
Optimizing the Tissue Anchoring Performance of Barbed Sutures in Skin and Tendon Tissues
,”
J. Biomech.
,
43
(
2
), pp.
302
309
.
10.
Ingle
,
N. P.
,
King
,
M. W.
, and
Zikry
,
M. A.
, 2010, “
Finite Element Analysis of Barbed Sutures in Skin and Tendon Tissues
,”
J. Biomech.
,
43
(
5
), pp.
879
886
.
11.
Burstin
,
P. P.
and
Merry
,
D.
, 1998, “
Endoscopic Stapling Treatment of Pharyngeal Pouch
,”
Aust. N. Z. J. Surg.
,
68
(
7
), pp.
532
535
.
12.
Ferroli
,
P.
,
Franzini
,
A.
,
Messina
,
G.
,
Tringali
,
G.
, and
Broggi
,
G.
, 2008, “
Use of Self-Closing U-Clips for Dural Repair in Mini-Invasive for Herniated Disk
,”
Acta Neurochir Suppl. (Wein)
,
150
(
10
), pp.
1103
1105
.
13.
Guglielminotti
,
P.
,
Bini
,
R.
,
Fontana
,
D.
, and
Leli
,
R.
, 2009, “
Laparoscopic Repair for Perforated Peptic Ulcers With U-Clip
,”
World J. Emerg. Surg.
,
4
(
28
), pp.
1
3
.
14.
Ono
,
M.
,
Wolf
,
R. K.
,
Angouras
,
D.
, and
Schneeberger
,
E. W.
, 2002., “
Early Experience of Coronary Artery Bypass Grafting With a New Self-Closing Clip Device
,”
J. Thorac. Cardiovasc. Surg
,,
123
(
4
), pp.
783
787
.
15.
Auricchio
,
F.
, 1996, “
Shape-Memory Alloys: Applications, Micromechanics, Macromodelling and Numerical Simulations
,” PhD thesis, University of California at Berkeley, Berkeley, CA.
16.
Neuber
,
L.
, 1961, “
Theory of Notch Stresses: Principles for Exact Calculation of Strength with Reference to Structural Form and Material
,” U.S. Atomic Energy Commission, Washington, D.C.
17.
Teng
,
C. P.
,
Bai
,
S.
, and
Angeles
,
J.
, 2007, “
Shape Synthesis in Mechanical Design
,”
Acta Polytech.
,
47
(
6
), pp.
56
62
.
18.
Gelfand
,
I. M.
and
Fomin
,
S. V.
, 2000,
Calculus of Variations
,
Dover
,
Mineola, NY
.
19.
Hillier
,
F. S.
and
Lieberman
,
G. J.
, 1995,
Introduction to Mathematical Programming
,
McGraw-Hill
,
New York
.
20.
Teng
,
C. P.
and
Angeles
,
J.
, 2001, “
A Sequential-Quadratic-Programming Algorithm Using Orthogonal Decomposition With Gerschgorin Stabilization
,”
J. Mech. Des.
,
123
(
4
), pp.
501
509
.
21.
Pook
,
L. P.
, 2000,
Linear Elastic Fracture Mechanics for Engineers: Theory and Applications
,
WIT
,
Southampton, Boston, MA
.
22.
ANSYS Inc.
, 2009,
ANSYS 12.1 Documentations
,
Canonsburg
,
PA
.
23.
Auricchio
,
F.
,
Taylor
,
R. L.
, and
Lubliner
,
J.
, 1997, “
Shape-Memory Alloys: Macromodelling And Numerical Simulations of the Superelastic Behavior
,”
Comput. Methods Appl. Mech. Eng.
,
146
(
4
), pp.
281
312
.
24.
Favier
,
D.
,
Liu
,
Y.
,
Orgeas
,
L.
,
Sandel
,
A.
,
Debovea
,
L.
, and
Comte-Gazc
,
P.
, 2006, “
Influence of Thermomechanical Processing on the Superelastic Properties of a Ni-rich Nitinol Shape Memory Alloy
,”
Mater. Sci. Eng., A
,
429
(
2
), pp.
130
136
.
25.
Wu
,
W.
,
Qi
,
M.
,
Liu
,
X.
,
Yang
,
D.
, and
Wang
,
W.
, 2007, “
Delivery and Release of Nitinol Stent in Carotid Artery and Their Interactions: A Finite Element Analysis
,”
J. Biomech.
,
40
(
13
), pp.
3034
3040
.
26.
Tolomeo
,
D.
,
Davidson
,
S.
, and
Santinoranont
,
M.
, 2000, “
Cyclic Properties of Superelastic Nitinol: Design Implications
,”
SMST: Proceedings of the International Conference on Shape Memory and Superelastic Technologies
, pp.
471
476
.
27.
Kugler
,
C.
,
Matson
,
D.
, and
Perry
,
K.
, 2000, “
Non-Zero Mean Fatigue Test Protocol for NiTi
,”
SMST: Proceedings of the International Conference on Shape Memory and Superelastic Technologies
, pp.
409
417
.
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