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Mitral Valve Repair Using ePTFE Sutures for Ruptured Mitral Chordae Tendineae: A Computational Simulation Study

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Abstract

Mitral valve (MV) repair using expanded polytetrafluoroethylene sutures is an established and preferred interventional method to resolve the complex pathophysiologic problems associated with chordal rupture. We developed a novel computational evaluation protocol to determine the effect of the artificial sutures on restoring MV function following valve repair. A virtual MV was created using three-dimensional echocardiographic data in a patient with ruptured mitral chordae tendineae (RMCT). Virtual repairs were designed by adding artificial sutures between the papillary muscles and the posterior leaflet where the native chordae were ruptured. Dynamic finite element simulations were performed to evaluate pre- and post-repair MV function. Abnormal posterior leaflet prolapse and mitral regurgitation was clearly demonstrated in the MV with ruptured chordae. Following virtual repair to reconstruct ruptured chordae, the severity of the posterior leaflet prolapse decreased and stress concentration was markedly reduced both in the leaflet tissue and the intact native chordae. Complete leaflet coaptation was restored when four or six sutures were utilized. Computational simulations provided quantitative information of functional improvement following MV repair. This novel simulation strategy may provide a powerful tool for evaluation and prediction of interventional treatment for RMCT.

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Acknowledgments

This work was in part supported by the National Institutes of Health (R01 HL109597, PI—Hyunggun Kim).

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Department of Internal Medicine, The University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 1.246, Houston, TX, 77030, USA

    Yonghoon Rim, Susan T. Laing, David D. McPherson & Hyunggun Kim

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  1. Yonghoon Rim
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  2. Susan T. Laing
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  3. David D. McPherson
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  4. Hyunggun Kim
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Correspondence to Hyunggun Kim.

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Associate Editor Jane Grande-Allen oversaw the review of this article.

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Rim, Y., Laing, S.T., McPherson, D.D. et al. Mitral Valve Repair Using ePTFE Sutures for Ruptured Mitral Chordae Tendineae: A Computational Simulation Study. Ann Biomed Eng 42, 139–148 (2014). https://doi.org/10.1007/s10439-013-0908-1

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  • DOI: https://doi.org/10.1007/s10439-013-0908-1

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