scholarly journals Development of a fluid-structure interaction model to simulate mitral valve malcoaptation

Perfusion ◽  
2018 ◽  
Vol 34 (3) ◽  
pp. 225-230 ◽  
Author(s):  
Kamran Hassani ◽  
Alireza Karimi ◽  
Ali Dehghani ◽  
Ali Tavakoli Golpaygani ◽  
Hamed Abdi ◽  
...  
Keyword(s):  
Blood Flow ◽  
Mitral Valve ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Computational Model ◽  
Left Atrium ◽  
Interaction Model ◽  
Structure Interaction ◽  
Normal Mitral Valve ◽  
Leaflet Coaptation

Object: Mitral regurgitation (MR) is a condition in which the mitral valve does not prevent the reversal of blood flow from the left ventricle into the left atrium. This study aimed at numerically developing a model to mimic MR and poor leaflet coaptation and also comparing the performance of a normal mitral valve to that of the MR conditions at different gap junctions of 1, 3 and 5 mm between the anterior and posterior leaflets. Results: The results revealed no blood flow to the left ventricle when a gap between the leaflets was 0 mm. However, MR increased this blood flow, with increases in the velocity and pressure within the atrium. However, the pressure within the aorta did not vary meaningfully (ranging from 22 kPa for a ‘healthy’ model to 25 kPa for severe MR). Conclusions: The findings from this study have implications not only for understanding the changes in pressure and velocity as a result of MR in the ventricle, atrium or aorta, but also for the development of a computational model suitable for clinical translation when diagnosing and determining treatment for MR.

Biomechanics of the Mitral Valve in Ischemic Heart Disease: Translating From the Bench to the Operating Room

2010 ◽  
Author(s):  
Muralidhar Padala ◽  
Ajit P. Yoganathan
Keyword(s):  
Blood Flow ◽  
Mitral Valve ◽  
Left Ventricle ◽  
Left Atrium ◽  
Mitral Annulus ◽  
Normal Function ◽  
Force Balance ◽  
Papillary Muscles ◽  
Atrioventricular Valve ◽  
Main Components

The Mitral Valve (MV) is the left atrioventricular valve that controls blood flow between the left atrium and the left ventricle (Fig 1A-B). It has four main components: (i) the mitral annulus — a fibromuscular ring at the base of the left atrium and the ventricle; (ii) two collagenous planar leaflets — anterior and posterior; (iii) web of chordae and (iv) two papillary muscles (PM) that are part of the left ventricle (LV). Normal function of the mitral valve involves a delicate force balance between different components of the valve.

Biaxial Compliance Changes of Mitral Valve Leaflets Following Radiofrequency Ablation

2009 ◽  
Author(s):  
Carolyn G. Norwood ◽  
W. David Merryman
Keyword(s):  
Blood Flow ◽  
Radiofrequency Ablation ◽  
Mitral Valve ◽  
Left Ventricle ◽  
Left Atrium ◽  
Posterior Leaflet ◽  
Anterior Leaflet ◽  
Retrograde Blood Flow

The mitral valve (MV), located between the left atrium and left ventricle of the heart, is responsible for preventing retrograde blood flow by closing during systole. There are two MV leaflets, anterior and posterior. The anterior is the larger of the two and semicircular; the posterior leaflet is more rectangular and can be subdivided into three scallops, the middle scallop being the largest in most human hearts. The two leaflets are anchored to the wall of the left ventricle by the chordae tendinae. The MV annulus forms a complete fibrous ring anchored along the anterior leaflet (1).

Biatrial Approach for Bicameral Myxoma with Mitral Regurgitation

2000 ◽  
Vol 8 (2) ◽  
pp. 167-168 ◽  
Author(s):  
Pankaj Goel ◽  
Nainar Madhu Sankar ◽  
Sethurathinam Rajan ◽  
Kotturathu Mammen Cherian
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Left Atrium ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Severe Mitral Regurgitation ◽  
Two Dimensional ◽  
Dimensional Echocardiography ◽  
Two Dimensional Echocardiography

A 16-year-old girl presented with an episode of syncope. Two-dimensional echocardiography revealed masses in the left atrium and left ventricle with severe mitral regurgitation. She underwent removal of myxomas and mitral valve replacement using an extended biatrial approach.

Investigation of the Blood Flow and Mitral-Septal Opposition in the Left Ventricle With the Obstructive Hyperthrophic Cardiomyopathy During Systole Using Fluid-Structure Interaction Technique

2010 ◽  
Author(s):  
Ahmad Moghaddaszade Kermani ◽  
Afzal Suleman
Keyword(s):  
Blood Flow ◽  
Mitral Valve ◽  
Left Ventricle ◽  
Fluid Structure Interaction ◽  
Left Ventricular ◽  
Anterior Leaflet ◽  
Fluid Structure ◽  
Structure Interaction ◽  
Narrow Passage ◽  
Aortic Orifice

In this article, fluid-structure interaction methodology was used to analyze the blood flow and Mitral-Septal opposition in the Left ventricle with the Obstructive Hyperthrophic Cardiomyopathy (OHCM). The geometry of the computational model includes the diseased left ventricle with thickened septum and Mitral valve. A semi-ellipsoidal geometry was developed with the dimensions, extracted from MR images of the diseased left ventricle. Also, the geometry of the Mitral valve was created using anatomical data provided in literature [1]. The three element Windkessel model and atrial pressure [2, 3] were used to introduce mass flow and pressure boundary conditions to the aortic orifice and left atrium respectively. Effect of the fibers was taken into account by varying the Young’s modulus of the mitral valve tissue with circumferential and radial coordinates. The fluid-structure interaction algorithm started at the beginning of the systole (when the mitral valve is fully open with zero stress) by applying the left ventricular pressure on the left ventricular wall and aortic mass flow outlet on the aortic orifice. The Navier-Stokes equations were solved with SIMPLE algorithm and finite volume method to calculate the blood flow inside the diseased left ventricle. The calculated pressure was applied to the surface of the mitral valve and the structural model of the tissue was solved using non-linear finite element. The deformation of the mitral valve was transferred to the blood by moving the fluid mesh. In the next time step, the same procedure was repeated with the new mesh. This algorithm was followed up to the end of the systole. The thickened septum creates a narrow passage for the blood flowing out of the left ventricle, thus a jet of blood flow is developed in this narrow passage which applies high shear stress on the anterior leaflet of the mitral valve. The drag force deforms the anterior leaflet toward the septum, obstructing the blood flow rushing toward the aortic orifice.

Mitral regurgitation

2018 ◽  
Author(s):  
Kazem Rahimi
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Left Atrium ◽  
Papillary Muscles ◽  
Chordae Tendineae

Mitral regurgitation (MR) is the reflux of blood from the left ventricle into the left atrium as a result of dysfunction of the mitral valve. MR can result from abnormalities of any part of the mitral valve apparatus (valve leaflets, annulus, chordae tendineae, and papillary muscles), or dilatation/disease of the left ventricle.

Extended Myectomy for Hypertrophic Obstructive Cardiomyopathy

2012 ◽  
Vol 15 (5) ◽  
pp. 251
Author(s):  
Changqing Gao ◽  
Chonglei Ren ◽  
Cangsong Xiao ◽  
Yang Wu ◽  
Gang Wang ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Ventricle ◽  
Mitral Regurgitation ◽  
Surgical Procedures ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Systolic Anterior Motion ◽  
Anterior Leaflet ◽  
Septal Myectomy ◽  
The Mean

<p><b>Background:</b> The purpose of this study was to summarize our experience of extended ventricular septal myectomy in patients with hypertrophic obstructive cardiomyopathy (HOCM).</p><p><b>Methods:</b> Thirty-eight patients (26 men, 12 women) with HOCM underwent extended ventricular septal myectomy. The mean age was 36.3 years (range, 18-64 years). Diagnosis was made by echocardiography. The mean (mean � SE) systolic gradient between the left ventricle (LV) and the aorta was 89.3 � 31.1 mm Hg (range, 50-184 mm Hg) according to echocardiographic assessments before the operations. Moderate or severe systolic anterior motion (SAM) of the anterior leaflet of the mitral valve was found in 38 cases, and mitral regurgitation was present in 29 cases. Extended ventricular septal myectomy was performed in all 38 cases. The results of the surgical procedures were evaluated intraoperatively with transesophageal echocardiography (TEE) and with transthoracic echocardiography (TTE) at 1 to 2 weeks after the operation. All patients were followed up with TTE after their operation.</p><p><b>Results:</b> All patients were discharged without complications. The TEE evaluations showed that the mean systolic gradient between the LV and the aorta decreased from 94.8 � 35.6 mm Hg preoperatively to 13.6 � 10.8 mm Hg postoperatively (<i>P</i> = .0000) and that the mean thickness of the ventricular septum decreased from 28.3 � 7.9 mm to 11.8 � 3.2 mm (<i>P</i> = .0000). Mitral regurgitation and SAM were significantly reduced or eliminated. During the follow-up, all patients promptly became completely asymptomatic or complained of mild effort dyspnea only, and syncope was abolished. TTE examinations showed that the postoperative pressure gradient either remained the same or diminished.</p><p><b>Conclusions:</b> Extended ventricular septal myectomy is mostly an effective method for patients with HOCM, and good surgical exposure and thorough excision of the hypertrophic septum are of paramount importance for a successful surgery.</p>

scholarly journals Fluid–structure interaction in a fully coupled three-dimensional mitral–atrium–pulmonary model

2021 ◽  
Author(s):  
Liuyang Feng ◽  
Hao Gao ◽  
Nan Qi ◽  
Mark Danton ◽  
Nicholas A. Hill ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Left Atrium ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Pulmonary Veins ◽  
Three Dimensional ◽  
Left Heart ◽  
Structure Interaction ◽  
Acute Mitral Regurgitation ◽  
Reversal Flow

AbstractThis paper aims to investigate detailed mechanical interactions between the pulmonary haemodynamics and left heart function in pathophysiological situations (e.g. atrial fibrillation and acute mitral regurgitation). This is achieved by developing a complex computational framework for a coupled pulmonary circulation, left atrium and mitral valve model. The left atrium and mitral valve are modelled with physiologically realistic three-dimensional geometries, fibre-reinforced hyperelastic materials and fluid–structure interaction, and the pulmonary vessels are modelled as one-dimensional network ended with structured trees, with specified vessel geometries and wall material properties. This new coupled model reveals some interesting results which could be of diagnostic values. For example, the wave propagation through the pulmonary vasculature can lead to different arrival times for the second systolic flow wave (S2 wave) among the pulmonary veins, forming vortex rings inside the left atrium. In the case of acute mitral regurgitation, the left atrium experiences an increased energy dissipation and pressure elevation. The pulmonary veins can experience increased wave intensities, reversal flow during systole and increased early-diastolic flow wave (D wave), which in turn causes an additional flow wave across the mitral valve (L wave), as well as a reversal flow at the left atrial appendage orifice. In the case of atrial fibrillation, we show that the loss of active contraction is associated with a slower flow inside the left atrial appendage and disappearances of the late-diastole atrial reversal wave (AR wave) and the first systolic wave (S1 wave) in pulmonary veins. The haemodynamic changes along the pulmonary vessel trees on different scales from microscopic vessels to the main pulmonary artery can all be captured in this model. The work promises a potential in quantifying disease progression and medical treatments of various pulmonary diseases such as the pulmonary hypertension due to a left heart dysfunction.

Sign in / Sign up

Export Citation Format

Share Document