Image-based modelling and numerical simulations of the Cardioband® procedure for mitral valve regurgitation repair

Abstract

Mitral regurgitation is one of the most common valvular heart diseases and is mainly caused by dilatation of the valvular annulus as a result of remodelling of the left ventricle. Transcatheter techniques have been developed as an alternative to standard surgical procedures to correct mitral valve regurgitation in patients at high surgical risk. The Cardioband® system (Edwards Lifesciences, Irvine, USA) is a percutaneous technique that can reduce mitral regurgitation by reducing the size of the mitral annulus. In this study, we describe the analytical formulation of this procedure and its numerical implementation to simulate the entire Cardioband® procedure on patient-specific cases. The developed tool combines the integration of clinical image processing and finite element method. The routine was validated by simulating the clinical procedure on three different patient cases and comparing the numerical results with clinical data. The simulation results and clinical data were comparable, confirming the reliability of the presented approach. Moreover, the results show how the implanted device affects the cardiac structures. The proposed method has the potential to be used in a pre-planning phase to evaluate the effect of the Cardioband® procedure on cardiac structures.