Annals of Biomedical Engineering

, Volume 39, Issue 6, pp 1690–1702

Characterization of Mitral Valve Annular Dynamics in the Beating Heart

  • Manuel K. Rausch
  • Wolfgang Bothe
  • John-Peder Escobar Kvitting
  • Julia C. Swanson
  • Neil B. IngelsJr.
  • D. Craig Miller
  • Ellen Kuhl
Article

DOI: 10.1007/s10439-011-0272-y

Cite this article as:
Rausch, M.K., Bothe, W., Kvitting, J.E. et al. Ann Biomed Eng (2011) 39: 1690. doi:10.1007/s10439-011-0272-y

Abstract

The objective of this study is to establish a mathematical characterization of the mitral valve annulus that allows a precise qualitative and quantitative assessment of annular dynamics in the beating heart. We define annular geometry through 16 miniature markers sewn onto the annuli of 55 sheep. Using biplane videofluoroscopy, we record marker coordinates in vivo. By approximating these 16 marker coordinates through piecewise cubic splines, we generate a smooth mathematical representation of the 55 mitral annuli. We time-align these 55 annulus representations with respect to characteristic hemodynamic time points to generate an averaged baseline annulus representation. To characterize annular physiology, we extract classical clinical metrics of annular form and function throughout the cardiac cycle. To characterize annular dynamics, we calculate displacements, strains, and curvature from the discrete mathematical representations. To illustrate potential future applications of this approach, we create rapid prototypes of the averaged mitral annulus at characteristic hemodynamic time points. In summary, this study introduces a novel mathematical model that allows us to identify temporal, regional, and inter-subject variations of clinical and mechanical metrics that characterize mitral annular form and function. Ultimately, this model can serve as a valuable tool to optimize both surgical and interventional approaches that aim at restoring mitral valve competence.

Keywords

Mitral regurgitationMitral valveAnnulusDynamicsStrainCurvatureSplines

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Copyright information

© Biomedical Engineering Society 2011

Authors and Affiliations

  • Manuel K. Rausch
    • 1
  • Wolfgang Bothe
    • 3
  • John-Peder Escobar Kvitting
    • 3
  • Julia C. Swanson
    • 3
  • Neil B. IngelsJr.
    • 3
    • 4
  • D. Craig Miller
    • 3
  • Ellen Kuhl
    • 1
    • 2
    • 3
  1. 1.Department of Mechanical EngineeringStanford University School of EngineeringStanfordUSA
  2. 2.Department of BioengineeringStanford University School of EngineeringStanfordUSA
  3. 3.Department of Cardiothoracic SurgeryStanford University School of MedicineStanfordUSA
  4. 4.Department of Cardiovascular Physiology and BiophysicsPalo Alto Medical FoundationPalo AltoUSA