Mitral valve function and chordal force distribution using a flexible annulus model: An in vitro study

Jorge Hernan Jimenez, Dennis Dam Soerensen, Zhaoming He, Jennifer Ritchie, Ajit P. Yoganathan

Research output: Contribution to journalArticlepeer-review

56 Scopus citations


Since variations in annular motion/shape and papillary muscle displacement have been observed in studies of dilated cardiomyopathy and ischemic mitral regurgitation, the objective of this study was to investigate the effects of annular motion/flexibility and papillary muscle displacement on chordal force and mitral valve function. Six human mitral valves were studied in a left heart simulator using a flexible annular model. Mitral flow, trans-mitral pressure and chordae tendineae tension were monitored online in normal and pathophysiologic papillary muscle positions. The flexible annulus model showed a significant increase in mitral regurgitation volume (p < 0.05) when compared to static annuli models. Furthermore, there was a significant increase of force on the basal chords compared to the force present with the static annuli models. Utilizing the flexible annulus model, papillary muscle displacement significantly increased the force on the anterior strut, posterior intermediate and commissural chords. (1) Papillary muscle displacement increases the tension on the intermediate chords inducing tenting of the leaflets and subsequent regurgitation. (2) The tension on the intermediate and marginal chords is relatively insensitive to annular motion, whereas tension on the basal chords is directly affected by annular motion.

Original languageEnglish
Pages (from-to)557-566
Number of pages10
JournalAnnals of Biomedical Engineering
Issue number5
StatePublished - May 2005


  • Annular motion
  • Chordal force
  • Mitral regurgitation


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