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Tricuspid Chordae Tendineae Mechanics: Insertion Site, Leaflet, and Size-Specific Analysis and Constitutive Modelling

  • Sp Iss: Experimental Advances in Cardiovascular Biomechanics
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Abstract

Background: Tricuspid valve chordae tendineae play a vital role in our cardiovascular system. They function as “parachute cords” to the tricuspid leaflets to prevent prolapse during systole. However, in contrast to the tricuspid annulus and leaflets, the tricuspid chordae tendineae have received little attention. Few previous studies have described their mechanics and their structure-function relationship. Objective: In this study, we aimed to quantify the mechanics of tricuspid chordae tendineae based on their leaflet of origin, insertion site, and size. Methods: Specifically, we uniaxially stretched 53 tricuspid chordae tendineae from sheep and recorded their stress-strain behavior. We also analyzed the microstructure of the tricuspid chordae tendineae based on two-photon microscopy and histology. Finally, we compared eight different hyperelastic constitutive models and their ability to fit our data. Results: We found that tricuspid chordae tendineae are highly organized collageneous tissues, which are populated with cells throughout their thickness. In uniaxial stretching, this microstructure causes the classic J-shaped nonlinear stress-strain response known from other collageneous tissues. We found differences in stiffness between tricuspid chordae tendineae from the anterior, posterior, or septal leaflets only at small strains. Similarly, we found significant differences based on their insertion site or size also only at small strains. Of the models we fit to our data, we recommend the Ogden two-parameter model. This model fit the data excellently and required a minimal number of parameters. For future use, we identified and reported the Ogden material parameters for an average data set. Conclusion: The data presented in this study help to explain the mechanics and structure-function relationship of tricuspid chordae tendineae and provide a model recommendation (with parameters) for use in computational simulations of the tricuspid valve.

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Acknowledgments

This work was supported by the American Heart Association under Award 18CDA34120028 and the National Institutes of Health under Award 1 F31 HL145976-01A1. Dr. Rausch has a speaking agreement with Edwards Lifesciences. No other author has any conflicts to report. We performed all experimental and animal procedures in congruence with the Guide for Care and Use of Laboratory Animals prepared by the National Academy of Science and published by the National Institutes of Health, and the Principles of Laboratory Animal Care, formulated by the National Society for Medical Research. The study protocol was approved by our local Institutional Animal Care and Use Committee (Spectrum Health IACUC No.: 18-01).

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Authors and Affiliations

  1. Department of Aerospace Engineering & Engineering Mechanics, University of Texas at Austin, Austin, TX, USA

    K. J. Smith & M. K. Rausch

  2. Department of Mechanical Engineering, University of Texas at Austin, Austin, TX, USA

    M. Mathur

  3. Department of Biomedical Engineering, University of Texas at Austin, Austin, TX, USA

    W. D. Meador, G. P. Sugerman, A. K. Menta & M. K. Rausch

  4. Department of Biological Sciences, University of Texas at Austin, Austin, TX, USA

    B. Phillips-Garcia

  5. Division of Cardiothoracic Surgery, Spectrum Health, Grand Rapids, MI, USA

    T. Jazwiec, M. Malinowski & T. A. Timek

  6. Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland

    T. Jazwiec

  7. Department of Cardiac Surgery, Medical University of Silesia School of Medicine in Katowice, Katowice, Poland

    M. Malinowski

  8. Oden Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, TX, USA

    M. K. Rausch

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  1. K. J. Smith
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Correspondence to M. K. Rausch.

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Appendix

Appendix

Table 4 Classification of tricuspid chordae tendineae samples (n = 53) by leaflet, insertion site, and size
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Smith, K.J., Mathur, M., Meador, W.D. et al. Tricuspid Chordae Tendineae Mechanics: Insertion Site, Leaflet, and Size-Specific Analysis and Constitutive Modelling. Exp Mech 61, 19–29 (2021). https://doi.org/10.1007/s11340-020-00594-5

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