Valve Deformity Research Articles

Cardiovascular findings and effects of enzyme replacement therapy in patients with mucopolysaccharidosis type VI

The mucopolysaccharidoses (MPS) are an important group of lysosomal storage diseases. Commonly reported cardiac involvement includes mitral leaflet thickening and accompanying prolapsus, regurgitation, and rarely, stenosis. The aim of this study was to evaluate cardiac involvement in patients with MPS type VI. The study included a total of 13 children with MPS type VI who were admitted to a single pediatric department between 2016 and 2018. Cardiac status was evaluated prospectively with clinical findings, electrocardiography, and echocardiography. The age of the patients (8 boys, 5 girls) ranged between 2 and 14 years (median: 9 years). No arrhythmia was observed in any patient. Thickening of the mitral valve with or without regurgitation and prolapsus was the most common lesion seen. Additional involvement of the aortic valve was detected in 12 (92.3%) patients, and additional involvement of the tricuspid valve in 4 (30.8%). Isolated septal hypertrophy was found in 2 patients, and congestive heart failure in another. Cardiac involvement is frequent in MPS. Mitral valve deformation is the most frequent finding. An echocardiographic examination should be performed periodically even if the patient has no clinical signs of cardiac disease, and any cardiac involvement should be kept under control with medical treatment.

Inflammation and Mechanical Stress Stimulate Osteogenic Differentiation of Human Aortic Valve Interstitial Cells.

Background: Aortic valve calcification is an active proliferative process, where interstitial cells of the valve transform into either myofibroblasts or osteoblast-like cells causing valve deformation, thickening of cusps and finally stenosis. This process may be triggered by several factors including inflammation, mechanical stress or interaction of cells with certain components of extracellular matrix. The matrix is different on the two sides of the valve leaflets. We hypothesize that inflammation and mechanical stress stimulate osteogenic differentiation of human aortic valve interstitial cells (VICs) and this may depend on the side of the leaflet.Methods: Interstitial cells isolated from healthy and calcified human aortic valves were cultured on collagen or elastin coated plates with flexible bottoms, simulating the matrix on the aortic and ventricular side of the valve leaflets, respectively. The cells were subjected to 10% stretch at 1 Hz (FlexCell bioreactor) or treated with 0.1 μg/ml lipopolysaccharide, or both during 24 h. Gene expression of myofibroblast- and osteoblast-specific genes was analyzed by qPCR. VICs cultured in presence of osteogenic medium together with lipopolysaccharide, 10% stretch or both for 14 days were stained for calcification using Alizarin Red.Results: Treatment with lipopolysaccharide increased expression of osteogenic gene bone morphogenetic protein 2 (BMP2) (5-fold increase from control; p = 0.02) and decreased expression of mRNA of myofibroblastic markers: α-smooth muscle actin (ACTA2) (50% reduction from control; p = 0.0006) and calponin (CNN1) (80% reduction from control; p = 0.0001) when cells from calcified valves were cultured on collagen, but not on elastin. Mechanical stretch of VICs cultured on collagen augmented the effect of lipopolysaccharide. Expression of periostin (POSTN) was inhibited in cells from calcified donors after treatment with lipopolysaccharide on collagen (70% reduction from control, p = 0.001), but not on elastin. Lipopolysaccharide and stretch both enhanced the pro-calcific effect of osteogenic medium, further increasing the effect when combined for cells cultured on collagen, but not on elastin.Conclusion: Inflammation and mechanical stress trigger expression of osteogenic genes in VICs in a side-specific manner, while inhibiting the myofibroblastic pathway. Stretch and lipopolysaccharide synergistically increase calcification.

Prevalence, Predictors, and Prognostic Value of Residual Tricuspid Regurgitation in Patients With Left Ventricular Assist Device

BackgroundAlthough implantation of a left ventricular assist device (LVAD) generally improves tricuspid regurgitation (TR) in short‐term follow‐up, the clinical significance of residual TR in patients with mid‐ to long‐term LVAD support is unknown. This study aimed to identify the prevalence, predictors, and prognostic value of residual TR in LVAD patients in association with tricuspid valve (TV) deformation.Methods and ResultsThe study cohort consisted of 127 patients who underwent LVAD implantation without TV procedure and were supported with LVAD at least 1 year. All patients underwent echocardiographic examination preoperatively and 1 year after LVAD implantation. TR was quantitatively assessed by ratio of TR color jet area/right atrial area, and significant residual TR was defined as ≥20% of %TR at follow‐up echocardiographic examination. Detailed echocardiographic measurements were also performed, including TV annulus diameter, TV leaflet displacement, and left ventricular and right ventricular systolic function. LVAD implantation significantly improved ratio of TR color jet area/right atrial area as well as left ventricular and right ventricular systolic function and tethering distance (all P<0.05), whereas it enlarged TV annulus diameter (P=0.002). Significant residual TR was observed in 30 (23.6%) patients. Age, preoperative TV annulus diameter, and residual mitral regurgitation were significantly associated with significant residual TR (all P<0.05), whereas TV tethering was not. During a mean follow‐up of 21±17 months, patients with residual TR had significantly higher mortality than those without residual TR (log‐rank P<0.001).ConclusionsSignificant residual TR was observed in ≈25% patients supported with LVAD over 1 year and was associated with unfavorable outcome.

Impact of Clinically Relevant Elliptical Deformations on the Damage Patterns of Sagging and Stretched Leaflets in a Bioprosthetic Heart Valve.

After implantation of a transcatheter bioprosthetic heart valve its original circular circumference may become distorted, which can lead to changes in leaflet coaptation and leaflets that are stretched or sagging. This may lead to early structural deterioration of the valve as seen in some explanted transcatheter heart valves. Our in vitro study evaluates the effect of leaflet deformations seen in elliptical configurations on the damage patterns of the leaflets, with circular valve deformation as the control. Bovine pericardial tissue heart valves were subjected to accelerated wear testing under both circular (N = 2) and elliptical (N = 4) configurations. The elliptical configurations were created by placing the valve inside custom-made elliptical holders, which caused the leaflets to sag or stretch. The hydrodynamic performance of the valves was monitored and high resolution images were acquired to evaluate leaflet damage patterns over time. In the elliptically deformed valves, sagging leaflets experienced more damage from wear compared to stretched leaflets; the undistorted leaflets of the circular valves experienced the least leaflet damage. Free-edge thinning and tearing were the primary modes of damage in the sagging leaflets. Belly region thinning was seen in the undistorted and stretched leaflets. Leaflet and fabric tears at the commissures were seen in all valve configurations. Free-edge tearing and commissure tears were the leading cause of valve hydrodynamic incompetence. Our study shows that mechanical wear affects heart valve pericardial leaflets differently based on whether they are undistorted, stretched, or sagging in a valve configuration. Sagging leaflets are more likely to be subjected to free-edge tear than stretched or undistorted leaflets. Reducing leaflet stress at the free edge of non-circular valve configurations should be an important factor to consider in the design and/or deployment of transcatheter bioprosthetic heart valves to improve their long-term performance.

A transverse isotropic constitutive model for the aortic valve tissue incorporating rate-dependency and fibre dispersion: Application to biaxial deformation.

This paper presents a continuum-based transverse isotropic model incorporating rate-dependency and fibre dispersion, applied to the planar biaxial deformation of aortic valve (AV) specimens under various stretch rates. The rate dependency of the mechanical behaviour of the AV tissue under biaxial deformation, the (pseudo-) invariants of the right Cauchy-Green deformation-rate tensor Ċ associated with fibre dispersion, and a new fibre orientation density function motivated by fibre kinematics are presented for the first time. It is shown that the model captures the experimentally observed deformation of the specimens, and characterises a shear-thinning behaviour associated with the dissipative (viscous) kinematics of the matrix and the fibres. The application of the model for predicting the deformation behaviour of the AV under physiological rates is illustrated and an example of the predicted σ-λ curves is presented. While the development of the model was principally motivated by the AV biomechanics requisites, the comprehensive theoretical approach employed in the study renders the model suitable for application to other fibrous soft tissues that possess similar rate-dependent and structural attributes.

Morphological, physiological and molecular responses of Nitzschia palea under cadmium stress.

The impact of cadmium on the diatom Nitzschia palea (Kützing) W. Smith 1856 was studied by examining the relation between valve deformities and response through biological processes and genetic expression. Cultures of N. palea were exposed to two Cd treatments (C1 = 2.4 ± 0.6 and C2 = 42.6 ± 4.2 µg Cd/L) along with a control (C0 = 0 µg Cd/L) for 28 days. Cadmium bioaccumulation, diatoms growth, photosynthetic efficiencies, valve deformities and genetic expression were investigated during the course of the experiment. Cadmium exposure had significant effects on bioaccumulation, growth, valve deformities and genetic expression. Maximal effects for all studied endpoints were recorded after 7 days of exposure for the C2 treatment, which corresponded to the sampling time and condition with maximum cadmium bioaccumulation. Abnormal raphe formations (deviation from its lateral position) were significantly more abundant in the C2 treatment compared to the control. Molecular responses were related to cadmium level based on the number of genes impacted, intensity of the response and the frequency of observations. The expression of genes involved in the regulation of mitochondrial metabolism, photosynthesis, oxidative stress and silica metabolism was affected by cadmium exposure.

Usefulness of Tricuspid Annular Diameter to Predict Late Right Sided Heart Failure in Patients With Left Ventricular Assist Device

Although late-onset right-sided heart failure is recognized as a clinical problem in the treatment of patients with left ventricular assist devices (LVADs), the mechanism and predictors are unknown. Tricuspid valve (TV) deformation leads to the restriction of the leaflet motion and decreased coaptation, resulting in a functional tricuspid regurgitation that may act as a surrogate marker of late right-sided heart failure. This study aimed to investigate the association of preoperative TV deformation (annulus dilatation and leaflet tethering) with late right-sided heart failure development after continuous-flow LVAD implantation. The study cohort consisted of 274 patients who underwent 2-dimensional echocardiography before LVAD implantation. TV annulus diameter and tethering distance were measured in an apical 4-chamber view. Late right-sided heart failure was defined as right-sided heart failure requiring readmission and medical and/or surgical treatment after initial LVAD implantation. During a mean follow-up of 25.1 ± 19.0 months after LVAD implantation, late right-sided heart failure occurred in 33 patients (12.0%). Multivariate Cox proportional hazard analysis demonstrated that TV annulus diameter (hazard ratio 1.221 per 1 mm, p <0.001) was significantly associated with late right-sided heart failure development, whereas leaflet tethering distance was not. The best cut-off value of the TV annular diameter was 41 mm (area under the curve 0.787). Kaplan-Meier analysis showed that patients with dilated TV annulus (TV annular diameter ≥41 mm) exhibited a significantly higher late right-sided heart failure occurrence than those without TV annular enlargement (log-rank p <0.001). In conclusion, preoperative TV annulus diameter, but not leaflet tethering distance, predicted the occurrence of late right-sided heart failure after LVAD implantation.

Hybrid modeling and verification of disk-stacked shock absorber valve

The mathematical model of valve deformation of hydraulic shock absorber is established using the hybrid method of large deflection and beam deflection. The model can be used for design purposes and helps in developing damping valve based on single disk and shim stack. The model of the hydraulic shock absorber with valve system consists of shim stack and a spring preloaded disk is developed using AMESim. The correctness of the mathematical model of the valve deformation based on the hybrid method and the simulation model using AMESim is verified by the shock absorber bench test, which proves the method proposed in this article is reasonable and reliable. It is significant for reference in the design and development of hydraulic shock absorber.

In Vitro Validation of a Numerical Simulation of Leaflet Kinematics in a Polymeric Aortic Valve Under Physiological Conditions.

This paper describes a computational method to simulate the non-linear structural deformation of a polymeric aortic valve under physiological conditions. Arbitrary Lagrangian-Eulerian method is incorporated in the fluid-structure interaction simulation, and then validated by comparing the predicted kinematics of the valve's leaflets to in vitro measurements on a custom-made polymeric aortic valve. The predicted kinematics of the valve's leaflets was in good agreement with the experimental results with a maximum error of 15% in a single cardiac cycle. The fluid-structure interaction model presented in this study can simulate structural behaviour of a stented valve with flexible leaflets, providing insight into the haemodynamic performance of a polymeric aortic valve.

Prediction of the ischemic origin of functional mitral regurgitation in patients with systolic heart failure through posterior mitral leaflet angle.

BACKGROUNDDifferentiating ischemic from non-ischemic functional mitral regurgitationý (FMR) in patients with cardiomyopathy is important in terms of the therapeutic decision-making and prognosis, but might be clinically challenging. In this study, the deformation of mitral valve (MV) indices in the prediction of the etiology of FMR was assessed using 2D transthoracic and tissue Doppler echocardiography.METHODSThis case-control study was conducted from April 2015 to January 2016 in Imam Reza Hospital in Mashhad, Iran. The participants consisted of 40 patients with ischemic cardiomyopathy (ICM) and 22 with non-ischemic dilated cardiomyopathy (DCM) who referred to the heart failure clinic. Transthoracic echocardiography was performed using the conventional 2D and tissue Doppler imaging (TDI). MV tenting area (TA), coaptation distance (CD), anterior and posterior mitral leaflet angles (AMLA and PMLA), and regional systolic myocardial velocity (Sm) were measured.RESULTSThere were no significant differences in echocardiographic indices between the two groups, besides Sm and PMLA which were significantly lower and higher, respectively, in ICM subjects in comparison with DCM patients (P = 0.002). PMLA ≥ 40 degrees and Sm ≤ 4 cm/second have a relatively high value for discriminating the ischemic from non-ischemic origin of functional MR in subjects with systolic heart failure (sensitivity: 80.0% and 70.0%, specificity: 73.0% and 77.3%; P = 0.001 and P < 0.001; respectively). Multivariable logistic regression identified PMLA and anterior Sm as major determinants for ischemic MR {Odds ratio (OR) [95% confidence interval (CI)] = 0.89 (0.82-0.96), P = 0.003, OR (95% CI) = 0.29 (0.14-0.60), P = 0.001, respectively}.CONCLUSIONThe present study showed that PMLA and Sm had an independent significant association with the mechanism of FMR. These findings are suggestive of the predictive role of mitral deformation echocardiographic indices in the determination of the etiology of FMR in systolic heart failure.

Influence rules of geometric parameters on deformation of valve slices in valve-controlled adjustable damping shock absorber

PurposeThe purpose of this paper is to study the influence rules of geometric parameters on deformation of valve slices.Design/methodology/approachBased on the theory of flexural deformation of elastic thin slice, differential functions of deformation for both single and multi-slices are given and derived in detail. Furthermore, the effects of geometric dimensions on deformation are analyzed particularly by using Matlab/simulink.FindingsThe results indicated that the deformation decreases with the increment of fixed ring radius ra, slice thickness h, and its number n. Meanwhile, the deformation increases with a rise of slice radius rb, throttle position rk, the radius ratio λ1 and thickness ratio λ2 of slices.Originality/valueThis research can provide some theoretical supports for the parametric and optimal design of adjustable damping shock absorber.

River water quality assessment based on a multi-descriptor approach including chemistry, diatom assemblage structure, and non-taxonomical diatom metrics

In the present study, the ecological status of four major South Korean rivers flowing near industrial complexes is assessed using physico-chemical analyses and various descriptors based on benthic diatom assemblages. Principal component analysis conducted with physical and chemical variables singled-out four sites as more severely impacted (higher concentration of metals and total nitrogen, higher conductivity and biological oxygen demand), while the remaining 12 sites indicated less impacted conditions, although showing nutrient enrichment. Less-contaminated sites based on physico-chemical properties showed higher cell densities, higher richness and diversity, a larger proportion of live and healthy-looking diatoms, lower production of lipid bodies (in terms of number and size) and fewer teratologies than more-contaminated sites. Non-taxonomical metrics (cell heath status, cell size, lipid bodies and valve deformities) were in good agreement with traditional taxonomical metrics (assemblage structure, richness, diversity). Overall, water quality assessment based on diatom assemblages and diatom-based metrics had a good fit with the available physico-chemical data and agreed on the most impacted sites. However, additional sites showed signs of degradation based on the diatom metrics used. This suggests that the use of biotic indicators provides useful complementary information on the health status at the selected sites.

Characterization of mechanical properties of pericardium tissue using planar biaxial tension and flexural deformation.

Flexure is an important mode of deformation for native and bioprosthetic heart valves. However, mechanical characterization of bioprosthetic leaflet materials has been done primarily through planar tensile testing. In this study, an integrated experimental and computational cantilever beam bending test was performed to characterize the flexural properties of glutaraldehyde-treated bovine and porcine pericardium of different thicknesses. A strain-invariant based structural constitutive model was used to model the pericardial mechanical behavior quantified through the bending tests of this study and the planar biaxial tests previously performed. The model parameters were optimized through an inverse finite element (FE) procedure in order to describe both sets of experimental data. The optimized material properties were implemented in FE simulations of transcatheter aortic valve (TAV) deformation. It was observed that porcine pericardium TAV leaflets experienced significantly more flexure than bovine when subjected to opening pressurization, and that the flexure may be overestimated using a constitutive model derived from purely planar tensile experimental data. Thus, modeling of a combination of flexural and biaxial tensile testing data may be necessary to more accurately describe the mechanical properties of pericardium, and to computationally investigate bioprosthetic leaflet function and design.

Assessment of deformation of the mitral valve complex during off-pump coronary artery bypass surgery using three-dimensional echocardiography in a porcine model

BackgroundThis study aimed to assess the deformation of the mitral valve complex during the displacement of the beating heart by using three-dimensional echocardiography in a porcine off-pump coronary artery bypass grafting (OPCAB) model. MethodsIn nine healthy swine, we positioned the beating heart as an OPCAB model, i.e. control, left anterior descending artery (LAD), right coronary artery (RCA), and left circumflex artery (LCX) positions. In each position, three-dimensional echocardiography was performed to assess the mitral valve complex with hemodynamic parameters. We analyzed the deformation of the mitral valve and the three-dimensional coordinates of the papillary muscles. ResultsThere was a significant increase in maximum tenting length and tenting volume (control 0.70±0.30, LAD 0.65±0.27, RCA 0.79±0.23, LCX 0.95±0.34cm3, p<0.05) in the LCX position compared with the other positions. The posterior papillary muscle (PPM) angle had a significant relationship with the tenting volume (r=−0.643, p<0.001). The PPM was displaced to the medial side in the LAD and LCX positions (p<0.01). ConclusionsThe prime cause of the deformation of the mitral leaflets is suggested to be the displacement of the PPM associated with the change in geometry of the left ventricle in a porcine model.

Shone’s Syndrome and Patent Ductus Arteriosus: A Rare Case Report

Introduction: Shone syndrome is a rare congenital anomaly consisting of multiple levels of obstruction in the left side of the heart and aorta. In its complete form it comprises four types of lesions: (1) parachute mitral valve; (2) supravalvular ring of left atrium; (3) subaortic stenosis of either the muscular or membranous type; or (4) coarctation of the aorta. Shone complex is rarely associated with patent ductus arteriosus. Only two other cases of such association has previously been reported. Case Presentation: We report an 18 year old male referred to our center for aortic and mitral valve replacement who was a near complete case of Shone syndrome associated with a history of repaired coarctation and patent ductus arteriosus during infancy and subsequently repair of aortic valve at 3 years of age. Now he became symptomatic due to the progression of aortic stenosis and congenital mitral valve stenosis. Echocardiography revealed unicuspid aortic valve with severe stenosis and parachute mitral valve deformity with supravalvular ring resulting in severe mitral stenosis. The patient had undergone aortic and mitral valve replacements. Conclusions: This rare case is a near complete form of Shone complex associated with patent ductus arteriosus.It is emphasized that when any form of left heart obstruction is encountered we should meticulously look for other associated lesions.

Exploring the effects of acid mine drainage on diatom teratology using geometric morphometry.

Metal pollution of aquatic habitats is a major and persistent environmental problem. Acid mine drainage (AMD) affects lotic systems in numerous and interactive ways. In the present work, a mining area (Roșia Montană) was chosen as study site, and we focused on two aims: (i) to find the set of environmental predictors leading to the appearance of the abnormal diatom individuals in the study area and (ii) to assess the relationship between the degree of valve outline deformation and AMD-derived pollution. In this context, morphological differences between populations of Achnanthidium minutissimum and A. macrocephalum, including normal and abnormal individuals, were evidenced by means of valve shape analysis. Geometric morphometry managed to capture and discriminate normal and abnormal individuals. Multivariate analyses (NMDS, PLS) separated the four populations of the two species mentioned and revealed the main physico-chemical parameters that influenced valve deformation in this context, namely conductivity, Zn, and Cu. ANOSIM test evidenced the presence of statistically significant differences between normal and abnormal individuals within both chosen Achnanthidium taxa. In order to determine the relative contribution of each of the measured physico-chemical parameters in the observed valve outline deformations, a PLS was conducted, confirming the results of the NMDS. The presence of deformed individuals in the study area can be attributed to the fact that the diatom communities were strongly affected by AMD released from old mining works and waste rock deposits.

大動脈弁の変形に応じた応力分布の可視化( 教育・訓練・協調)

大動脈弁の変形に応じた応力分布の可視化( 教育・訓練・協調)

Ascending to descending aorta extraanatomic bypass for coarctation of aorta

Objective To summarize the treatment of 10 aortic coarctation cases , who receive the surgery from ascending aorta to thoracic descending aorta with the prosthetic graft, discuss the valuable and appliable of this method. Methods Cardiac surgery, Chinese Acdemy of Medical Sciences, Peking Union Medical College Hospital department treated 10 patients who got the aortic coarctation from Jan. 2006 to Dec. 2015 Seven male patients and 3 cases of female patients consist of the sample, aged from 14 to 35 years old, the median age was 27. One cases consolidated aortic valve deformity and aortic root expansion, the others were simple aortic coarctation.Their upper limbs blood pressure was 20 mmHg higher compared with the low limb. Meanwhile, there was no sign of surgery contraindication. Ten cases received this operation under cardiopulmonary bypass situation.And the patient who consolidate aortic valve deformity and aortic root expansion receive the Bentall surgery at the same time. Results There was no death during perioperative time, no spinal cord ischemic and other serious complications. Those patients went back to outpatient department after discharging from hospital 3 to 6 months.The differential pressure between upperlimbs and low limbs were less than 20 mmHg, and the CTA results indicated no aneurysms. Conclusion Using artificial blood vessels to make a graft from the ascending aorta to the descending aorta is an effective method for treatment of thoracic aorta. Key words: Aortic coarctation; Bypass; Cardiovascular abnormalities; Surgical procedures, operative

Surface Strains of Porcine Tricuspid Valve Septal Leaflets Measured in Ex Vivo Beating Hearts.

Quantification of the tricuspid valve (TV) leaflets mechanical strain is important in order to understand valve pathophysiology and to develop effective treatment strategies. Many of the traditional methods used to dynamically open and close the cardiac valves in vitro via flow simulators require valve dissection. Recent studies, however, have shown that restriction of the atrioventricular valve annuli could significantly change their in vivo deformation. For the first time, the porcine valve leaflets deformation was measured in a passive ex vivo beating heart without isolating and remounting the valve annuli. In particular, the right ventricular apexes of porcine hearts (n = 8) were connected to a pulse-duplicator pump that maintained a pulsatile flow from and to a reservoir connected to the right atrium and the pulmonary arteries. This pump provided a right ventricular pressure (RVP) waveform that closely matched physiological values, leading to opening and closure of the tricuspid and pulmonary valves (PVs). At the midsection of the valve leaflets, the peak areal strain was 9.8 ± 2.0% (mean±standard error). The peak strain was 5.6 ± 1.1% and 4.3 ± 1.0% in the circumferential and radial directions, respectively. Although the right ventricle was beating passively, the leaflet peak areal strains closely matched the values measured in other atrioventricular valves (i.e., the mitral valve (MV)) in vivo. This technique can be used to measure leaflet strains with and without the presence of valve lesions to help develop/evaluate treatment strategies to restore normal valve deformation.

Machine learning-based 3-D geometry reconstruction and modeling of aortic valve deformation using 3-D computed tomography images.

To conduct a patient-specific computational modeling of the aortic valve, 3-D aortic valve anatomic geometries of an individual patient need to be reconstructed from clinical 3-D cardiac images. Currently, most of computational studies involve manual heart valve geometry reconstruction and manual finite element (FE) model generation, which is both time-consuming and prone to human errors. A seamless computational modeling framework, which can automate this process based on machine learning algorithms, is desirable, as it can not only eliminate human errors and ensure the consistency of the modeling results but also allow fast feedback to clinicians and permits a future population-based probabilistic analysis of large patient cohorts. In this study, we developed a novel computational modeling method to automatically reconstruct the 3-D geometries of the aortic valve from computed tomographic images. The reconstructed valve geometries have built-in mesh correspondence, which bridges harmonically for the consequent FE modeling. The proposed method was evaluated by comparing the reconstructed geometries from 10 patients with those manually created by human experts, and a mean discrepancy of 0.69mm was obtained. Based on these reconstructed geometries, FE models of valve leaflets were developed, and aortic valve closure from end systole to middiastole was simulated for 7 patients and validated by comparing the deformed geometries with those manually created by human experts, and a mean discrepancy of 1.57mm was obtained. The proposed method offers great potential to streamline the computational modeling process and enables the development of a preoperative planning system for aortic valve disease diagnosis and treatment.