A 3-COMPONENT FORCE VECTOR CELL FOR IN-VITRO QUANTIFICATION OF THE FORCE EXERTED BY THE PAPILLARY-MUSCLE ON THE LEFT-VENTRICULAR WALL

Recent clinical studies indicate that functional mitral regurgitation, which is a common complication in patients who suffer from ischemic h eart disease, is related to an increase in the tethering forces acting on the mitral valve leaflets. Alterations in the valvular assembly, d isplacement of the papillary muscles or dilatation of the mitral valve annulus can disrupt the normal force balance on the mitral leaflets a nd result in an abnormal coaptation geometry with incomplete mitral le aflet closure. The force balance imposed on the mitral leaflets is cre ated by the coapting forces generated by the transmitral pressure diff erence and the tethering forces at the leaflet attachments. A unique f orce vector cell capable of accurately measuring the three-component f orce vector applied by the papillary muscle on the left-ventricular wa ll was designed and manufactured to permit quantification of the alter ation in the force balance acting on the mitral leaflets, and to allow for the study of the influence of papillary muscle displacement on mi tral regurgitation. (C) 1997 Elsevier Science Ltd.