Key result
Narrower strut chordae insertion increases coaptation length and reduces leaflet stress in virtual mitral models.
Why the study?
The strut chordae play an important role in reinforcing mitral valve configuration, but the effect of varying their insertion location on normal mitral valve function and dynamics was not fully understood.
Does the location of strut chordae insertion affect mitral valve dynamics and leaflet stress in a computational model?
Does the location of strut chordae insertion affect mitral valve dynamics and leaflet stress in a computational model?
Answers are grounded in this paper and cite their sources.
Computational modeling demonstrates that narrower strut chordae insertion locations optimize mitral valve biomechanics by reducing leaflet stress and improving coaptation.
The strut chordae (SC) have a unique structure and play an important role in reinforcing the tunnel-shaped configuration of the mitral valve (MV) at the inflow and outflow tracts. We investigated the effect of varying the SC insertion location on normal MV function and dynamics to better understand the complex MV structures. A virtual parametric MV model was designed to replicate a normal human MV, and a total of nine MV modes were created from combinations of apical and lateral displacements of the SC insertion location. MV function throughout the full cardiac cycle was simulated using dynamic finite element analysis for all MV models. While the leaflet stress distribution and coaptation showed similar patterns in all nine MV models, the maximum leaflet stress values increased in proportion to the width of the SC insertion locations. A narrower SC insertion location resulted in a longer coaptation length and a smaller anterior coaptation angle. The top-narrow MV model demonstrated the shortest anterior leaflet bulging distance, lower stresses across the anterior leaflet, and the lowest maximum stresses. This biomechanical evaluation strategy can help us better understand the effect of the SC insertion locations on mechanism, function, and pathophysiology of the MV.
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Hong et al. (2021) studied Mitral valve dynamics. Varying strut chordae insertion location vs. Alternative insertion locations was evaluated on Leaflet stress distribution and coaptation. In a virtual model of 9 mitral valve modes, narrower strut chordae insertion locations resulted in longer coaptation length, smaller anterior coaptation angle, and lower maximum leaflet stresses.
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