Abstract
ObjectivesFunctional mitral regurgitation (FMR) is a significant complication of left ventricle (LV) dysfunction associated with poor prognosis and commonly treated by undersized ring annuloplasty. This study aimed to quantitatively simulate the treatment outcomes and mitral valve (MV) biomechanics following ring annulopalsty and papillary muscle relocation (PMR) procedures for a FMR patient.MethodsWe utilized a validated finite element model of the left heart for a patient with severe FMR and LV dilation from our previous study and simulated virtual ring annuloplasty procedures with various sizes of Edwards Classic and GeoForm annuloplasty rings. The model included detailed geometries of the left ventricle, mitral valve, and chordae tendineae, and incorporated age- and gender- matched nonlinear, anisotropic hyperelastic tissue material properties, and simulated chordal tethering at diastole due to LV dilation.ResultsRing annuloplasty with either the Classic or GeoForm ring improved leaflet coaptation and increased the total leaflet closing force while increased posterior mitral leaflet (PML) stresses and strains. Classic rings resulted in larger coaptation forces and areas compared to GeoForm rings. The PMR procedure further improved the leaflet coaptation, decreased the PML stress and strain for both ring shapes and all sizes in this patient model.ConclusionsThis study demonstrated that a rigorously developed patient-specific computational model can provide useful insights into annuloplasty repair techniques for the treatment of FMR patients and could potentially serve as a tool to assist in pre-operative planning for MV repair surgical or interventional procedures.
Highlights
Functional mitral regurgitation (FMR) is a significant complication of left ventricular (LV) dysfunction and is strongly associated with a poor prognosis in patients with heart failure
FE analysis of annuloplasty and papillary muscle relocation on a patient specific MR model patients and could potentially serve as a tool to assist in pre-operative planning for mitral valve (MV) repair surgical or interventional procedures
We evaluated ring annuloplasty and Papillary muscle relocation (PMR) treatments in the same FMR patient using computational modeling
Summary
Functional mitral regurgitation (FMR) is a significant complication of left ventricular (LV) dysfunction and is strongly associated with a poor prognosis in patients with heart failure. Papillary muscle relocation (PMR) as an adjunct procedure to downsized ring annuloplasty was developed to reduce leaflet tethering, tenting area, and coaptation depth by pulling the papillary muscle tips closer to the annulus[8]. Both techniques have demonstrated potential in effectively relieving MR and preventing recurrent MR, cases of recurrent MR still occur [7,8]
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have