title: A novel finite element-based patient-specific mitral valve repair: virtual ring annuloplasty.
abstract: Alterations of normal mitral valve (MV) function lead to mitral insufficiency, i.e., mitral regurgitation (MR). Mitral repair is the most popular and most efficient surgical intervention for MR treatment. An annuloplasty ring is implanted following complex reconstructive MV repairs to prevent potential reoccurrence of MR. We have developed a novel finite element (FE)-based simulation protocol to perform patient-specific virtual ring annuloplasty following the standard clinical guideline procedure. A virtual MV was created using 3D echocardiographic data in a patient with mitral annular dilation. Proper type and size of the ring were determined in consideration of the MV apparatus geometry. The ring was positioned over the patient MV model and annuloplasty was simulated. Dynamic simulation of MV function across the complete cardiac cycle was performed. Virtual patient-specific annuloplasty simulation well demonstrated morphologic information of the MV apparatus before and after ring implantation. Dynamic simulation of MV function following ring annuloplasty demonstrated markedly reduced stress distribution across the MV leaflets and annulus as well as restored leaflet coaptation compared to pre-annuloplasty. This novel FE-based patient-specific MV repair simulation technique provides quantitative information of functional improvement following ring annuloplasty. Virtual MV repair strategy may effectively evaluate and predict interventional treatment for MV pathology.
authors.affiliation: Division of Cardiovascular Medicine, Department of Internal Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin St. MSB 1.246, Houston, Texas, USA.
authors.forename: Ahnryul
authors.initials: A
authors.lastname: Choi
authors.forename: Yonghoon
authors.initials: Y
authors.lastname: Rim
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Mun
authors.forename: Hyunggun
authors.initials: H
authors.lastname: Kim
mesh_terms: D001696:Biomechanical Phenomena; D006348:Cardiac Surgical Procedures / Q000379:methods*; D003198:Computer Simulation; D004452:Echocardiography; D020342:Finite Element Analysis; D006350:Heart Valve Prosthesis; D006801:Humans; D021621:Imaging, Three-Dimensional; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery*; D058386:Mitral Valve Annuloplasty / Q000379:methods*; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D008955:Models, Cardiovascular; D011474:Prosthesis Design; D015203:Reproducibility of Results; D013314:Stress, Mechanical; D013536:Suture Techniques; D013537:Sutures
keywords: Mitral valve; annuloplasty; finite element; mitral repair; patient-specific