Biomedical Engineering Reference
In-Depth Information
Repair of Mitral Valve Prolapse Through
ePTFE Neochordae: A Finite Element
Approach From CMR
Francesco Sturla, Francesco Onorati, Emiliano Votta,
Marco Stevanella, Aldo D. Milano, Konstantinos Pechlivanidis,
Giovanni Puppini, Alberto Redaelli and Giuseppe Faggian
Abstract
Patient-specific finite element (FE) modeling is largely used to quantify
mitral valve (MV) biomechanics associated to pathological and post-surgical con-
ditions. We used this approach, integrated with non-invasive cardiac magnetic reso-
nance (CMR) imaging data, to numerically perform the repair of the isolated mitral
valve leaflet prolapse through expanded-polytetrafluoroethylene (ePTFE) sutures and
quantitatively compare the effects of different techniques of neochordal implantation
(NCI). CMR-derived FE models well reproduced MVP-related alterations and were
able to assess the efficacy of each repairing technique and its biomechanical effects
onMV apparatus; the quantification of biomechanical differences between NCI tech-
niques, especially in terms of both chordal tensions and leaflet stresses redistribution,
may impact on the short- and long-term the clinical outcome, potentially opening
the way to patient-specific optimization of NCIs and, if extensively and successfully
tested, improve surgical planning.
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Keywords
Mitral valve surgery
Neochordae
Cardiacmagnetic resonance
Finite
element models
1 Introduction
Isolated mitral valve posterior leaflet prolapse (MVP) represents the most common
dysfunction connected with degenerative mitral valve disease [
1
]: it is clinically
defined as the displacement of the posterior mitral leaflet in the left atrium, past the
annular plane. Chordal rupture or elongation are recognized as the main causes of
MVP whereas annular dilation is almost always an associate finding.
