Finite Element Analysis of Tricuspid Valve Deformation from Multi-slice Computed Tomography Images
- 392 Downloads
Despite the growing clinical interest in the tricuspid valve (TV), there is an incomplete understanding of TV biomechanics which is important in normal TV function and successful TV repair techniques. Computational models with patient-specific human TV geometries can provide a quantitative understanding of TV biomechanic. Therefore, this study aimed to develop finite element (FE) models of human TVs from multi-slice computed tomography (MSCT) images to investigate chordal forces and leaflet stresses and strains. Three FE models were constructed for human subjects with healthy TVs from MSCT images and incorporated detailed leaflet geometries, realistic nonlinear anisotropic hyperelastic material properties of human TV, and physiological boundary conditions tracked from MSCT images. TV closure from diastole to systole was simulated. Chordal lengths were iteratively adjusted until the simulated TV geometries were in good agreement with the “true” geometries reconstructed from MSCT images at systole. Larger chordal forces were found on the strut (or basal) chords than on the rough zone chords and the total forces applied on the anterior papillary muscles by the strut chords were higher than those on the posterior or septal papillary muscles. At peak systolic pressure, the average maximum stress on the middle sections of the leaflets ranged from 30 to 90 kPa, while the average maximum principal strain values ranged from 0.16 to 0.30. The results from healthy TVs can serve as baseline biomechanical metrics of TV mechanics and may be used to inform TV repair device design. The computational approach developed could be one step towards developing computational models that may support pre-operative planning in complex TV repair procedures in the future.
KeywordsMulti-slice computed tomography Tricuspid valve Finite element analysis Patient-specific geometries Biomechanics
Research for this project was funded in part by NIH HL104080 and HL127570 Grants. The authors would like to thank Erica Shin for tissue mechanical testing of TV tissues.
The authors declare that they have no conflict of interest.
- 3.Campelo-Parada, F., G. Perlman, F. Philippon, J. Ye, C. Thompson, E. Bédard, O. Abdul-Jawad Altisent, M. Del Trigo, J. Leipsic, P. Blanke, D. Dvir, R. Puri, J. G. Webb, and J. Rodés-Cabau. First-in-man experience of a novel transcatheter repair system for treating severe tricuspid regurgitation. J. Am. Coll. Cardiol. 66:2475–2483, 2015.CrossRefPubMedGoogle Scholar
- 4.Fukuda, S., G. Saracino, Y. Matsumura, M. Daimon, H. Tran, N. L. Greenberg, T. Hozumi, J. Yoshikawa, J. D. Thomas, and T. Shiota. Three-dimensional geometry of the tricuspid annulus in healthy subjects and in patients with functional tricuspid regurgitation. Circulation 114:I-492–I-498, 2006.CrossRefGoogle Scholar
- 12.Latib, A., E. Agricola, A. Pozzoli, P. Denti, M. Taramasso, P. Spagnolo, J.-M. Juliard, E. Brochet, P. Ou, M. Enriquez-Sarano, F. Grigioni, O. Alfieri, A. Vahanian, A. Colombo, and F. Maisano. First-in-man implantation of a tricuspid annular remodeling device for functional tricuspid regurgitation. JACC 8:e211–e214, 2015.PubMedGoogle Scholar
- 17.Mansi, T., I. Voigt, B. Georgescu, X. Zheng, E. A. Mengue, M. Hackl, R. I. Ionasec, T. Noack, J. Seeburger, and D. Comaniciu. An integrated framework for finite-element modeling of mitral valve biomechanics from medical images: application to MitralClip intervention planning. Med. Image Anal. 16:1330–1346, 2012.CrossRefPubMedGoogle Scholar
- 19.Meduri, C. U., V. Rajagopal, M. A. Vannan, K. Feldt, and A. Latib. Transcatheter tricuspid valve therapies. Card. Interv. Today 11:48–53, 2017.Google Scholar
- 28.Shiran, A., and A. Sagie. Tricuspid regurgitation in mitral valve disease. Incid. Progn. Implic. Mech. Manage. 53:401–408, 2009.Google Scholar
- 39.Xanthos, T., I. Dalivigkas, and K. A. Ekmektzoglou. Anatomic variations of the cardiac valves and papillary muscles of the right heart. Italian J. Anat. Embryol. 116:111–126, 2011.Google Scholar