{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T04:26:27Z","timestamp":1740111987094,"version":"3.37.3"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2017,12,6]],"date-time":"2017-12-06T00:00:00Z","timestamp":1512518400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100006823","name":"Boston Children\u2019s Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006823","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>During mitral valve repair using the foldoplasty technique, correct judgement of the necessary dimensions and orientation of the leaflet fold is a critical but challenging step that can affect the chances of successful repair. In this study, we investigated whether a leaflet plication clip can be used to guide suture foldoplasty for posterior leaflet prolapse of the mitral valve.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Complete posterior leaflet prolapse was created in both in vivo and ex vivo pig hearts by severing the chordae supporting the middle scallop. A plication clip was applied to perform leaflet foldoplasty. Sutures were then placed using the clip as a template and the clip was removed. Leaflet width after flail creation, clip application and suture placement was determined in an ex vivo test. In vivo repair and evaluation was then performed in 7 pigs to determine the repair efficacy under normal physiological loading, at 1 and 6\u2009h after recovery from cardiopulmonary bypass.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Leaflet width after suture placement was comparable to the clip alone (7.0\u2009\u00b1\u20091.4 vs 9.0\u2009\u00b1\u20091.6) and both were significantly less than the flail width 15.7\u00b1\u20092.5\u2009mm. In vivo, average coaptation height following repair was restored to 4.7\u2009\u00b1\u20091.4\u2009mm and 4.2\u2009\u00b1\u20091.3\u2009mm at 1 and 6\u2009h, respectively, after recovery compared with the baseline height of 5.5\u2009\u00b1\u20090.9\u2009mm. Mitral regurgitation was reduced from moderate\u2013severe to mild or less, and addition of a De-Vega annuloplasty in the last 3 animals abolished residual leaks to trivial or none.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Application of the adjustable leaflet plication clip facilitated accurate determination of the correct position, width, height and orientation of the foldoplasty. Any necessary clip repositioning was made prior to the placement of sutures avoiding the need to redo the sutures. This approach could potentially help improve the ease and reproducibility of the foldoplasty repair.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezx423","type":"journal-article","created":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T20:20:35Z","timestamp":1510086035000},"page":"939-944","source":"Crossref","is-referenced-by-count":0,"title":["A leaflet plication clip is an effective surgical template for mitral valve foldoplasty"],"prefix":"10.1093","volume":"53","author":[{"given":"Isaac","family":"Wamala","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Boston Children\u2019s Hospital, Boston, MA, USA"},{"name":"Department of Cardiovascular Surgery, German Heart Center Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mossab","family":"Saeed","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Boston Children\u2019s Hospital, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunil J","family":"Ghelani","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Boston Children\u2019s Hospital, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberlee","family":"Gauvreau","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Boston Children\u2019s Hospital, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter E","family":"Hammer","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Boston Children\u2019s Hospital, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolay V","family":"Vasilyev","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Boston Children\u2019s Hospital, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro J","family":"del Nido","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Boston Children\u2019s Hospital, Boston, MA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2017,12,6]]},"reference":[{"key":"2024041009411912100_ezx423-B1","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1016\/S0195-668X(03)00201-X","article-title":"A prospective survey of patients with valvular heart disease in Europe: the Euro Heart Survey on Valvular Heart Disease","volume":"24","author":"Iung","year":"2003","journal-title":"Eur Hear J"},{"key":"2024041009411912100_ezx423-B2","doi-asserted-by":"crossref","first-page":"1958.","DOI":"10.1093\/eurheartj\/ehq222","article-title":"Degenerative mitral valve regurgitation: best practice revolution","volume":"31","author":"Adams","year":"2010","journal-title":"Eur. 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