Numerical Biomechanics Modeling of Surgical Treatment for Mitral Regurgitation
SCHOOL OF MECHANICAL ENGINEERING SEMINAR
Monday, January 11, 2021 at 14:00
Numerical Biomechanics Modeling of Surgical Treatment
for Mitral Regurgitation
Adi White Zeira
M.Sc. student of Dr. Gil Marom
Mitral valve regurgitation (MR) is a common valvular heart disorder causes by improper closure of the valve, with an estimated incidence of more than five million people worldwide. The current study focuses on primary MR that usually involves leaflet enlargement, chordae elongation or rupture, and annular perimeter dilation. Clinical evidences suggest that annular reduction by annuloplasty is significantly more effective than other treatments and that annuloplasty might obviate the need for chordae implantation. The aim of this study is to examine this hypothesis by finite element analyses. The implantations and heart function were modeled with the living heart human model (LHHM; Simulia, Dassault Systèmes), an electro-mechanically coupled simulator of the entire heart. First, the primary MR morphology was generated in the LHHM. The native chordae were extended and leaflets were enlarged by applying virtual thermal expansion, and the annulus perimeter was expanded by left atrial pressure. Then, this MR pathology was used to determine the effect of the disease on the valve closure and on the entire heart throughout the cardiac cycle. For the surgical treatment, flexible annuloplasty bands with varying lengths were implanted in the MR pathology. The results demonstrated how shorter band can seal the valve even without artificial chordae implantation and that the length of the band directly affects the severity of the regurgitation. These findings can help improving the guidelines for surgical annuloplasty for primary MR treatment by recommending the most appropriate band length and obviate the need for chordae implantation in some cases.
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