Fluid-Structure Interaction Analysis of Ruptured Mitral Chordae Tendineae

• Type of Material: Article
• Authors: Milan Toma, Georgia Institute of Technology; Charles H. Bloodworth, Georgia Institute of Technology; Eric L. Pierce, Georgia Institute of Technology; Daniel R. Einstein, St Martins University; Richard P. Cochran, University of Maine; Ajit Yoganathan, Emory University; Karyn S. Kunzelman, University of Maine
• Language: English
• Date: 2017-03-01
• Publisher: Springer Verlag (Germany)
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2016, Biomedical Engineering Society.
• Final Published Version (URL): http://dx.doi.org/10.1007/s10439-016-1727-y
• Title of Journal or Parent Work: Annals of Biomedical Engineering
• ISSN: 0090-6964
• Volume: 45
• Issue: 3
• Start Page: 619
• End Page: 631
• Grant/Funding Information: This study was supported by a grant from the National Heart Lung and Blood Institute (R01-HL092926) and by a grant from the National Science Foundation Graduate Research Fellowship (DGE-1148903).
• Keywords: Chordae tendineae; REPLACEMENT; Technology; DILATATION; Engineering, Biomedical; Chordal rupture; REGURGITATION; Mitral valve; IN-VITRO; ULTRASOUND; Engineering; Comprehensive model; PAPILLARY-MUSCLE; SUTURE; STRESSES; Computer simulation; Science & Technology; Fluid-structure interaction; FINITE-ELEMENT MODEL; VALVE FUNCTION
• Research Categories: Engineering, Biomedical

Abstract

The chordal structure is a part of mitral valve geometry that has been commonly neglected or simplified in computational modeling due to its complexity. However, these simplifications cannot be used when investigating the roles of individual chordae tendineae in mitral valve closure. For the first time, advancements in imaging, computational techniques, and hardware technology make it possible to create models of the mitral valve without simplifications to its complex geometry, and to quickly run validated computer simulations that more realistically capture its function. Such simulations can then be used for a detailed analysis of chordae-related diseases. In this work, a comprehensive model of a subject-specific mitral valve with detailed chordal structure is used to analyze the distinct role played by individual chordae in closure of the mitral valve leaflets. Mitral closure was simulated for 51 possible chordal rupture points. Resultant regurgitant orifice area and strain change in the chordae at the papillary muscle tips were then calculated to examine the role of each ruptured chorda in the mitral valve closure. For certain subclassifications of chordae, regurgitant orifice area was found to trend positively with ruptured chordal diameter, and strain changes correlated negatively with regurgitant orifice area. Further advancements in clinical imaging modalities, coupled with the next generation of computational techniques will enable more physiologically realistic simulations.