Biomechanics and Modeling in Mechanobiology

, Volume 9, Issue 3, pp 281–293

Anterior mitral leaflet curvature in the beating ovine heart: a case study using videofluoroscopic markers and subdivision surfaces


  • S. Göktepe
    • Department of Mechanical EngineeringStanford University
  • W. Bothe
    • Department of Cardiothoracic SurgeryStanford University
  • J.-P. E. Kvitting
    • Department of Cardiothoracic SurgeryStanford University
  • J. C. Swanson
    • Department of Cardiothoracic SurgeryStanford University
  • N. B. Ingels
    • Department of Cardiothoracic SurgeryStanford University
    • Laboratory of Cardiovascular Physiology and BiophysicsPalo Alto Medical Foundation
  • D. C. Miller
    • Department of Cardiothoracic SurgeryStanford University
    • Departments of Mechanical Engineering, Bioengineering, and Cardiothoracic SurgeryStanford University
Original Paper

DOI: 10.1007/s10237-009-0176-z

Cite this article as:
Göktepe, S., Bothe, W., Kvitting, J.E. et al. Biomech Model Mechanobiol (2010) 9: 281. doi:10.1007/s10237-009-0176-z


The implantation of annuloplasty rings is a common surgical treatment targeted to re-establish mitral valve competence in patients with mitral regurgitation. It is hypothesized that annuloplasty ring implantation influences leaflet curvature, which in turn may considerably impair repair durability. This research is driven by the vision to design repair devices that optimize leaflet curvature to reduce valvular stress. In pursuit of this goal, the objective of this manuscript is to quantify leaflet curvature in ovine models with and without annuloplasty ring using in vivo animal data from videofluoroscopic marker analysis. We represent the surface of the anterior mitral leaflet based on 23 radiopaque markers using subdivision surfaces techniques. Quartic box-spline functions are applied to determine leaflet curvature on overlapping subdivision patches. We illustrate the virtual reconstruction of the leaflet surface for both interpolating and approximating algorithms. Different scalar-valued metrics are introduced to quantify leaflet curvature in the beating heart using the approximating subdivision scheme. To explore the impact of annuloplasty ring implantation, we analyze ring-induced curvature changes at characteristic instances throughout the cardiac cycle. The presented results demonstrate that the fully automated subdivision surface procedure can successfully reconstruct a smooth representation of the anterior mitral valve from a limited number of markers at a high temporal resolution of approximately 60 frames per minute.


Mitral valveMitral regurgitationAnnuloplasty ringCurvatureSubdivision surfacesContinuity

Copyright information

© Springer-Verlag 2009