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Article

Effect of Edge-to-Edge Mitral Valve Repair on Chordal Strain: Fluid-Structure Interaction Simulations

1
Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury Campus, Northern Boulevard, Old Westbury, NY 11568-8000, USA
2
Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Technology Enterprise Park, 387 Technology Circle, Atlanta, GA 30313-2412, USA
3
Department of Mechanical Engineering, St. Martin’s University, 5000 Abbey Way SE, Lacey, WA 98503, USA
4
Department of Mechanical Engineering, University of Maine, 219 Boardman Hall, Orono, ME 04469-5711, USA
*
Author to whom correspondence should be addressed.
Biology 2020, 9(7), 173; https://doi.org/10.3390/biology9070173
Received: 10 May 2020 / Revised: 13 July 2020 / Accepted: 16 July 2020 / Published: 18 July 2020
(This article belongs to the Special Issue Computational Biology)
Edge-to-edge repair for mitral valve regurgitation is being increasingly performed in high-surgical risk patients using minimally invasive mitral clipping devices. Known procedural complications include chordal rupture and mitral leaflet perforation. Hence, it is important to quantitatively evaluate the effect of edge-to-edge repair on chordal integrity. in this study, we employ a computational mitral valve model to simulate functional mitral regurgitation (FMR) by creating papillary muscle displacement. Edge-to-edge repair is then modeled by simulated coaptation of the mid portion of the mitral leaflets. in the setting of simulated FMR, edge-to-edge repair was shown to sustain low regurgitant orifice area, until a two fold increase in the inter-papillary muscle distance as compared to the normal mitral valve. Strain in the chordae was evaluated near the papillary muscles and the leaflets. Following edge-to-edge repair, strain near the papillary muscles did not significantly change relative to the unrepaired valve, while strain near the leaflets increased significantly relative to the unrepaired valve. These data demonstrate the potential for computational simulations to aid in the pre-procedural evaluation of possible complications such as chordal rupture and leaflet perforation following percutaneous edge-to-edge repair. View Full-Text
Keywords: mitral valve; edge-to-edge repair; chordae tendineae; comprehensive model; fluid-structure interaction; computer simulation; chordal strain mitral valve; edge-to-edge repair; chordae tendineae; comprehensive model; fluid-structure interaction; computer simulation; chordal strain
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MDPI and ACS Style

Toma, M.; Einstein, D.R.; Kohli, K.; Caroll, S.L.; Bloodworth, C.H., IV; Cochran, R.P.; Kunzelman, K.S.; Yoganathan, A.P. Effect of Edge-to-Edge Mitral Valve Repair on Chordal Strain: Fluid-Structure Interaction Simulations. Biology 2020, 9, 173. https://doi.org/10.3390/biology9070173

AMA Style

Toma M, Einstein DR, Kohli K, Caroll SL, Bloodworth CH IV, Cochran RP, Kunzelman KS, Yoganathan AP. Effect of Edge-to-Edge Mitral Valve Repair on Chordal Strain: Fluid-Structure Interaction Simulations. Biology. 2020; 9(7):173. https://doi.org/10.3390/biology9070173

Chicago/Turabian Style

Toma, Milan, Daniel R. Einstein, Keshav Kohli, Sheridan L. Caroll, Charles H. Bloodworth IV, Richard P. Cochran, Karyn S. Kunzelman, and Ajit P. Yoganathan 2020. "Effect of Edge-to-Edge Mitral Valve Repair on Chordal Strain: Fluid-Structure Interaction Simulations" Biology 9, no. 7: 173. https://doi.org/10.3390/biology9070173

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