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Chen S, Sari CR, Gao H, Lei Y, Segers P, De Beule M, Wang G, Ma X. Mechanical and morphometric study of mitral valve chordae tendineae and related papillary muscle. J Mech Behav Biomed Mater 2020; 111:104011. [PMID: 32835989 DOI: 10.1016/j.jmbbm.2020.104011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 07/07/2020] [Accepted: 07/21/2020] [Indexed: 01/21/2023]
Abstract
The mitral valve (MV) apparatus is a complex mechanical structure including annulus, valve leaflets, papillary muscles (PMs) and connected chordae tendineae. Chordae anchor to the papillary muscles to help the valve open and close properly during one cardiac cycle. It is of paramount importance to understand the functional, mechanical, and microstructural properties of mitral valve chordae and connecting PMs. In particular, little is known about the biomechanical properties of the anterior and posterior papillary muscle and corresponding chords. In this work, we performed uniaxial and biaxial tensile tests on the anterolateral (APM) and posteromedial papillary muscle (PPM), and their respective corresponding chordae tendineae, chordaeAPM and chordaePPM, in porcine hearts. Histology was carried out to link the microstructure and macro-mechanical behavior of the chordae and PMs. Our results demonstrate that chordaePPM are less in number, but significantly longer and stiffer than chordaeAPM. These different biomechanical properties may be partially explained by the higher collagen core ratio and larger collagen fibril density of chordaePPM. No significant mechanical or microstructural differences were observed along the circumferential and longitudinal directions of APM and PPM samples. Data measured on chordae and PMs were further fitted with the Ogden and reduced Holzapfel - Ogden strain energy functions, respectively. This study presents the first comparative anatomical, mechanical, and structural dataset of porcine mitral valve chordae and related PMs. Results indicate that a PM based classification of chordae will need to be considered in the analysis of the MV function or planning a surgical treatment, which will also help developing more precise computational models of MV.
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Affiliation(s)
- Shengda Chen
- College of Bioengineering, Chongqing University, Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, Chongqing, 400030, China; IBiTech - BioMMeda, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium; Numerical Simulation Center, Microport, Shanghai, China
| | - Candra Ratna Sari
- College of Bioengineering, Chongqing University, Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, Chongqing, 400030, China
| | - Hao Gao
- School of Mathematics & Statistics, University of Glasgow, Glasgow, UK
| | - Yang Lei
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu, China
| | - Patrick Segers
- IBiTech - BioMMeda, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium
| | - Matthieu De Beule
- IBiTech - BioMMeda, Department of Electronics and Information Systems, Ghent University, Ghent, Belgium; FEops NV, Ghent, Belgium
| | - Guixue Wang
- College of Bioengineering, Chongqing University, Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, Chongqing, 400030, China
| | - Xingshuang Ma
- College of Bioengineering, Chongqing University, Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, Chongqing, 400030, China.
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Morris L, Desai A, Akkus NI. Anterolateral papillary muscle rupture after intervention of the right coronary artery. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2015. [DOI: 10.1016/j.repce.2015.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Morris L, Desai A, Akkus NI. Anterolateral papillary muscle rupture after intervention of the right coronary artery. Rev Port Cardiol 2015; 34:693.e1-3. [PMID: 26507415 DOI: 10.1016/j.repc.2015.03.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 03/21/2015] [Indexed: 11/26/2022] Open
Abstract
Rupture of the anterolateral papillary muscle following a right coronary artery occlusion is extremely rare, and when complicated by a right ventricular infarction, can be fatal. The literature on optimal management of this complication is limited. We present an unusual case of anterolateral papillary muscle rupture following intervention of the right coronary artery.
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Affiliation(s)
- Liam Morris
- Division of Cardiology, LSU Health Sciences Center, Shreveport, LA, United States.
| | - Anand Desai
- Division of Cardiology, LSU Health Sciences Center, Shreveport, LA, United States
| | - Nuri Ilker Akkus
- Division of Cardiology, LSU Health Sciences Center, Shreveport, LA, United States
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Cherian PS, Clarke AJB, Burstow DJ. Unusual case of acute posteromedial papillary muscle rupture after acute anterior myocardial infarction. Heart Lung Circ 2013; 23:e16-9. [PMID: 23948290 DOI: 10.1016/j.hlc.2013.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 07/08/2013] [Accepted: 07/10/2013] [Indexed: 10/26/2022]
Abstract
Papillary muscle rupture is now a rare complication of acute myocardial infarction. Posteromedial papillary muscle rupture is more common than anterolateral papillary muscle rupture. The posteromedial papillary muscle is usually supplied from a branch of the right coronary artery. We present a case of posteromedial papillary muscle rupture due to an isolated left anterior descending artery lesion. This was diagnosed on the fifth day post infarction. The patient progressed to mitral valve replacement and coronary artery bypass grafting to the left anterior descending artery. We believe this unusual arterial supply to the posteromedial papillary muscle is due to an apex forming left anterior descending artery coupled with an apically located posteromedial papillary muscle.
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Affiliation(s)
- P S Cherian
- Department of Cardiothoracic Surgery, The Prince Charles Hospital, Australia; The University of Queensland, Australia.
| | - A J B Clarke
- Department of Cardiothoracic Surgery, The Prince Charles Hospital, Australia
| | - D J Burstow
- The University of Queensland, Australia; Department of Cardiology, The Prince Charles Hospital, Australia
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