title: Mass-spring systems for simulating mitral valve repair using 3D ultrasound images.
abstract: Mitral valve (MV) diseases are among the most common types of heart diseases, while heart diseases are the most common cause of death worldwide. MV repair surgery is connected to higher survival rates and fewer complications than the total replacement of the MV, but MV repair requires extensive patient-specific therapy planning. The simulation of MV repair with a patient-specific model could help to optimize surgery results and make MV repair available to more patients. However, current patient-specific simulations are difficult to transfer to clinical application because of time-constraints or prohibitive requirements on the resolution of the image data. As one possible solution to the problem of patient-specific MV modeling, we present a mass-spring MV model based on 3D transesophageal echocardiographic (TEE) images already routinely acquired for MV repair therapy planning. Our novel approach to the rest-length estimation of springs allows us to model the global support of the MV leaflets through the chordae tendinae without the need for high-resolution image data. The model is used to simulate MV annuloplasty for five patients undergoing MV repair, and the simulated results are compared to post-surgical TEE images. The comparison shows that our model is able to provide a qualitative estimate of annuloplasty surgery. In addition, the data suggests that the model might also be applied to simulating the implantation of artificial chordae.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany; TomTec Imaging Systems GmbH, Unterschleißheim, Germany. Electronic address: Stephan.Skornitzke@med.uni-heidelberg.de.
authors.forename: Stephan
authors.initials: S
authors.lastname: Skornitzke
authors.affiliation: TomTec Imaging Systems GmbH, Unterschleißheim, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Schummers
authors.affiliation: TomTec Imaging Systems GmbH, Unterschleißheim, Germany.
authors.forename: Marcus
authors.initials: M
authors.lastname: Schreckenberg
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine II, Leipzig Heart Center, University of Leipzig, Leipzig, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Ender
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine II, Leipzig Heart Center, University of Leipzig, Leipzig, Germany.
authors.forename: Sarah
authors.initials: S
authors.lastname: Eibel
authors.affiliation: Chair of Scientific Computing, Technische Universität München, Munich, Germany.
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Bungartz
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Kauczor
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Stiller
mesh_terms: D002815:Chordae Tendineae; D003198:Computer Simulation; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D055119:Elastic Modulus; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D058386:Mitral Valve Annuloplasty / Q000379:methods*; D008955:Models, Cardiovascular; D066230:Patient-Specific Modeling; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014783:Viscosity
keywords: Image-based therapy planning; Mass-spring model; Mitral valve annuloplasty; Patient-specific anatomy