Daisuke Onohara, MD, PhD, and Alicja Sielicka, PhD, postdoctoral research fellows in the Structural Heart Research and Innovation Lab of Muralidhar Padala, PhD, received Top 10 Abstract Awards during the annual dinner of the Council on Cardiovascular Surgery and Anesthesia (CVSA) at the 2016 Scientific Sessions of the American Heart Association. Onohara was also a finalist for the Vivien Thomas Young Investigator Award, which acknowledges the accomplishments of early career investigator members of the CVSA.
Onohara's abstract, "Divergent left ventricular remodeling pathways in chronic primary and secondary mitral regurgitation," examined temporal changes in the function, structure, and biology of left ventricular (LV) dilatation and the rate of its transition to decompensatory heart failure (HF) in primary and secondary mitral regurgitation (MR) using rat models. Concerned with determining the optimal timing of medical and surgical therapy for primary MR and secondary MR, the study concluded that progression to HF was more rapid in secondary MR due to the combination of LV dilatation with systolic dysfunction, and that secondary MR thereby would probably benefit from early intervention.
With a focus on the pathological leaflet remodeling that can follow undersizing ring annuloplasty (URA) to repair ischemic mitral regurgitation (IMR), Sielicka's "Fibrotic remodeling and stiffening of mitral valve leaflets after undersizing ring annuloplasty to correct ischemic mitral regurgitation" evaluated the effectiveness of adding a sub-valvular procedure to URA surgery to inhibit the remodeling process. Using swine with chronic IMR, Sielicka evaluated URA alone; URA with papillary muscle approximation (PMA), a method of sub-valvular repair; and PMA alone. She and her team found that anterior and posterior leaflet fibrosis was evident at three months after URA alone, but was inhibited with the addition of PMA, leading to their conclusion that PMA could have a positive impact on repair durability.