TY - JOUR
T1 - Mitral valve function and chordal force distribution using a flexible annulus model
T2 - An in vitro study
AU - Jimenez, Jorge Hernan
AU - Soerensen, Dennis Dam
AU - He, Zhaoming
AU - Ritchie, Jennifer
AU - Yoganathan, Ajit P.
N1 - Funding Information:
This work was supported by a grant from the National Heart Lung and Blood Institute (grant # HL52009).
PY - 2005/5
Y1 - 2005/5
N2 - 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.
AB - 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.
KW - Annular motion
KW - Chordal force
KW - Mitral regurgitation
UR - http://www.scopus.com/inward/record.url?scp=21244492346&partnerID=8YFLogxK
U2 - 10.1007/s10439-005-1512-9
DO - 10.1007/s10439-005-1512-9
M3 - Article
C2 - 15981857
AN - SCOPUS:21244492346
SN - 0090-6964
VL - 33
SP - 557
EP - 566
JO - Annals of Biomedical Engineering
JF - Annals of Biomedical Engineering
IS - 5
ER -