Biomedical Engineering Reference
In-Depth Information
3.
“classic” loop
(CL) with 3 different neochordae arising from the same PM tip,
in which all the 3 neochardae share the same length L
max
NC
, corresponding to the
maximal distance between PM tip and leaflet free margin, as measured in
Phy
model;
4.
“non-classic” loop
(LNH) with a common neochordal loop of 2/3 and 3 different
neochordae of 1/3 of the entire (PM tip-to-leaflet free margin) length L
max
NC
,
determined as in the CL configuration.
3 MV Biomechanics After NCI
Themodeling strategywell reproducedMVP-related anatomical alterations as visible
from CMR data (Fig.
3
a). The simulated
Pre-Op
model is reported at peak systole
in Fig.
3
. Both the colorbars reported the locally z-displacement of each MV leaflet
region with respect to the annular profile: a billowing height higher than 6 mm was
reported on the posterior leaflet whereas no prolapse was pre-operatively noticed on
the anterior mitral leaflet.
Simulated post-operative systolic function was compared with the corresponding
pre-operative simulation (Fig.
2
) and assessed in terms of several variables: (i) leaflets
coaptation area (CoA), (ii) coaptation length (CoL), (iii) leaflet mechanical stresses,
(iv) PMs reaction forces and (v) chordal tensions.
All NCI procedures repositioned the free margin of the prolapsing region of the
leaflet below the annular plane and a good leaflet coaptation was obtained between
anterior and posterior leaflet restoring a larger triangle of coaptation [
20
] if compared
Fig. 3 a
Simulated
Pre-Op
model reported at peak systole on a long-axis CMR-image;
b
MV pre-
operative model with prolapse location on the posterior leaflet. The colorbars report the prolapse
magnitude, defined as the distance between leaflet. tissue and the annular profile
