Key result
Surgical repair on the pathological mitral valve model reduced stress concentration on leaflets by 75%, while crash acceleration loads increased stress and chordae tension by 27% and 23%.
Why the study?
Mitral valve dynamics depend on force stability, and chordal rupture disrupts valve function causing mitral regurgitation.
How do surgical repair and high acceleration loads affect biomechanical stress and chordal tension in computational models of the human mitral valve?
How do surgical repair and high acceleration loads affect biomechanical stress and chordal tension in computational models of the human mitral valve?
Computational fluid-structure interaction modeling demonstrates that surgical repair significantly reduces leaflet stress in pathologic mitral valves, while high acceleration loads exacerbate stress and tension.
Novel FSI models of mitral repair offer mechanistic insights; leaves open clinical translation pending validation.
Mitral valve dynamics depend on force stability in the mitral leaflets, the mitral annulus, the chordae tendineae, and the papillary muscles. In chordal rupture conditions, the proper function of the valve disrupts, causing mitral regurgitation, the most prevalent valvular disease. In this study, Structural and FSI frameworks were employed to study valve dynamics in healthy, pathologic, and repaired states. Anisotropic, non-linear, hyper-elastic material properties applied to tissues of the valve while the first-order Ogden model reflected the best compatibility with the empirical data. Hemodynamic blood pressure of the cardiovascular system is applied on the leaflets as uniform loads varying by time, and exposure to high acceleration loads imposed on models. Immersed boundary method used for simulation of fluid in a cardiac cycle. In comparison between healthy and pathologic models, stress values and chordal tensions are increased, by nearly threefold and twofold, respectively. Stress concentration on leaflets is reduced by 75% after performing a successful surgical repair on the pathological model. Crash acceleration loads led to more significant stress and chordae tension on models, by 27% and 23%, respectively. It is concluded that a more sophisticated model could lead to a better understanding of human heart valve biomechanics in various conditions. If a preoperative plan is developed based on these modeling methods, the requirement for multiple successive repairs would be eliminated, operative times are shortened, and patient outcomes are improved.
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Masoud Asgari (2023) studied Mitral regurgitation. Surgical repair simulation vs. Pathological model was evaluated on Stress values and chordal tensions. Surgical repair on the pathological mitral valve model reduced stress concentration on leaflets by 75%, while crash acceleration loads increased stress and chordae tension by 27% and 23%.
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