Key result
Altering chordal tethering and coapting forces in vitro reproduces incomplete mitral leaflet coaptation and distorted geometry.
This in vitro study demonstrates that the interaction between chordal restraint and altered coaptation geometry is crucial for understanding systolic mitral leaflet configuration in functional mitral regurgitation.
May inform functional MR mechanisms; leaves open whether force modulation improves clinical outcomes.
Clinically observed incomplete mitral leaflet coaptation was reproduced in vitro by altering the balance of the chordal tethering and chordal coapting force components. Mitral leaflet coaptation geometry was distorted by changes of the spatial relations between the papillary muscles and the mitral valve as well as hemodynamics. Mitral leaflet malalignment was accentuated by a redistribution of the chordal tethering and coapting force components. For the overall assessment of systolic mitral leaflet configuration in functional mitral regurgitation it is important to consider the interaction between chordal restraint and an altered mitral leaflet coaptation geometry.
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Nielsen et al. (2002) studied Functional mitral regurgitation. Altering chordal tethering and coapting force components was evaluated on Mitral leaflet coaptation geometry and malalignment. Altering the balance of chordal tethering and coapting forces in vitro reproduced incomplete mitral leaflet coaptation and distorted coaptation geometry.
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