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Wu W, Ching S, Sabin P, Laurence DW, Maas SA, Lasso A, Weiss JA, Jolley MA. The effects of leaflet material properties on the simulated function of regurgitant mitral valves. J Mech Behav Biomed Mater 2023; 142:105858. [PMID: 37099920 PMCID: PMC10199327 DOI: 10.1016/j.jmbbm.2023.105858] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/30/2023] [Accepted: 04/12/2023] [Indexed: 04/28/2023]
Abstract
Advances in three-dimensional imaging provide the ability to construct and analyze finite element (FE) models to evaluate the biomechanical behavior and function of atrioventricular valves. However, while obtaining patient-specific valve geometry is now possible, non-invasive measurement of patient-specific leaflet material properties remains nearly impossible. Both valve geometry and tissue properties play a significant role in governing valve dynamics, leading to the central question of whether clinically relevant insights can be attained from FE analysis of atrioventricular valves without precise knowledge of tissue properties. As such we investigated (1) the influence of tissue extensibility and (2) the effects of constitutive model parameters and leaflet thickness on simulated valve function and mechanics. We compared metrics of valve function (e.g., leaflet coaptation and regurgitant orifice area) and mechanics (e.g., stress and strain) across one normal and three regurgitant mitral valve (MV) models with common mechanisms of regurgitation (annular dilation, leaflet prolapse, leaflet tethering) of both moderate and severe degree. We developed a novel fully-automated approach to accurately quantify regurgitant orifice areas of complex valve geometries. We found that the relative ordering of the mechanical and functional metrics was maintained across a group of valves using material properties up to 15% softer than the representative adult mitral constitutive model. Our findings suggest that FE simulations can be used to qualitatively compare how differences and alterations in valve structure affect relative atrioventricular valve function even in populations where material properties are not precisely known.
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Affiliation(s)
- Wensi Wu
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, 19104, PA, USA; Division of Pediatric Cardiology, Children's Hospital of Philadelphia, Philadelphia, 19104, PA, USA
| | - Stephen Ching
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, 19104, PA, USA
| | - Patricia Sabin
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, 19104, PA, USA
| | - Devin W Laurence
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, 19104, PA, USA; Division of Pediatric Cardiology, Children's Hospital of Philadelphia, Philadelphia, 19104, PA, USA
| | - Steve A Maas
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, UT, USA; Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT 84112, UT, USA
| | - Andras Lasso
- Laboratory for Percutaneous Surgery, Queen's University, Kingston, ON, Canada
| | - Jeffrey A Weiss
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, UT, USA; Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT 84112, UT, USA
| | - Matthew A Jolley
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, 19104, PA, USA; Division of Pediatric Cardiology, Children's Hospital of Philadelphia, Philadelphia, 19104, PA, USA.
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