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Abstract
Development and application of the numerical model for the simulation of human heart mitral valve (MV) transapical repair is presented. Transapical repair with neochordae implantation is a novel surgical technique allowing beating-heart correction of mitral regurgitation caused by chordae tendineae rupture through a minimally-invasive approach. In the present study, the structural finite element model of the MV decoupled from the blood flow is considered. It comprises two leaflets and chordae tendineae described by nonlinear material model. Geometry of the model and kinematic boundary conditions for fixed points of MV annulus, papillary muscles, and left ventricle apex are defined by patient-specific data. Decoupled behavior of blood is specified by the time-dependent physiologic transvalvular pressure. Personalized computational modelling strategy is applied to perform virtual transapical MV repair by positioning neochordae following the real-life surgery procedure executed by surgeons. A transient analysis in time frame between end-diastole and peak systole is conducted to evaluate post-repair MV function. Computational MV simulation and modelling results provide quantitative information about the neochordae contribution to the MV function improvement and present practical value for the surgical planning of transapical MV repair.
Highlights
Mitral regurgitation (MR) is the most common heart valvular disease [23]
Development of the computational model for the simulation of the diseased valve function and mitral valve (MV) repair procedure requires an understanding of its normal anatomy and function, as well as how MV is altered by the disease
The MV leaflets are attached to the mitral annulus which is located between the left atrium (LA) and the left ventricle (LV)
Summary
Mitral regurgitation (MR) is the most common heart valvular disease [23] It is the abnormal leakage of blood backwards from the left ventricle (LV) through the mitral valve (MV) to the left atrium (LA) because of the insufficient MV closure during the cardiac cycle. The MV is a complex intracardiac structure that ensures unidirectional blood flow from the LA to the LV during the cardiac cycle It consists of two leaflets (anterior (AL) and posterior (PL)) attached to the mitral annulus and anchored to the papillary muscles (PMs) by a group of thread-like branched fibrous tendons called the chordae tendineae.
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