Key result
Altering chordae tendineae geometry significantly impacts clinically relevant valve metrics in finite element simulations.
Why the study?
Current functional chordae tendineae geometries in finite element simulations of atrioventricular heart valves lack fidelity, such as branching, that would be helpful when informing clinical decisions.
Does parametric variation of chordae tendineae geometry affect finite element simulations of atrioventricular valve closure?
Does parametric variation of chordae tendineae geometry affect finite element simulations of atrioventricular valve closure?
This study provides an open-source computational workflow demonstrating that chordae tendineae geometry, particularly cross-sectional area and density, significantly impacts finite element predictions of atrioventricular valve closure.
Answers are grounded in this paper and cite their sources.
Provides a higher-fidelity computational model for atrioventricular valve biomechanics; leaves open.
Purpose: Many approaches have been used to model chordae tendineae geometries in finite element simulations of atrioventricular heart valves. Unfortunately, current "functional" chordae tendineae geometries lack fidelity (e.g., branching) that would be helpful when informing clinical decisions. The objectives of this work are (i) to improve synthetic chordae tendineae geometry fidelity to consider branching and (ii) to define how the chordae tendineae geometry affects finite element simulations of valve closure. Methods: In this work, we develop an open-source method to construct synthetic chordae tendineae geometries in the SlicerHeart Extension of 3D Slicer. The generated geometries are then used in FEBio finite element simulations of atrioventricular valve function to evaluate how variations in chordae tendineae geometry influence valve behavior. Effects are evaluated using functional and mechanical metrics. Results: Our findings demonstrated that altering the chordae tendineae geometry of a stereotypical mitral valve led to changes in clinically relevant valve metrics (regurgitant orifice area, contact area, and billowing volume) and valve mechanics (first principal strains). Specifically, cross sectional area had the most influence over valve closure metrics, followed by chordae tendineae density, length, radius and branches. We then used this information to showcase the flexibility of our new workflow by altering the chordae tendineae geometry of two additional geometries (mitral valve with annular dilation and tricuspid valve) to improve finite element predictions. Conclusion: This study presents a flexible, open-source method for generating synthetic chordae tendineae with realistic branching structures. Further, we establish relationships between the chordae tendineae geometry and valve functional/mechanical metrics. This research contribution helps enrich our opensource workflow and brings the finite element simulations closer to use in a patient-specific clinical setting.
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Mangine et al. (2026) studied Atrioventricular valve closure (in silico model). Parametric variation of chordae tendineae structure vs. Baseline/simplified chordae tendineae geometry was evaluated on Valve functional and mechanical metrics (regurgitant orifice area, contact area, billowing volume, first principal strains). Altering the chordae tendineae geometry, particularly cross-sectional area and density, significantly influenced clinically relevant valve metrics in finite element simulations.
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