First Finite Element Model of the Left Ventricle With Mitral Valve: Insights Into Ischemic Mitral Regurgitation

Jonathan F. Wenk, Zhihong Zhang, Guangming Cheng, Deepak Malhotra, Gabriel Acevedo-Bolton, Mike Burger, Takamaro Suzuki, David A. Saloner, Arthur W. Wallace, Julius M. Guccione, Mark B. Ratcliffe

Research output: Contribution to journalArticlepeer-review

101 Scopus citations

Abstract

Background: Left ventricular remodeling after posterobasal myocardial infarction can lead to ischemic mitral regurgitation. This occurs as a consequence of leaflet tethering due to posterior papillary muscle displacement. Methods: A finite element model of the left ventricle, mitral apparatus, and chordae tendineae was created from magnetic resonance images from a sheep that developed moderate mitral regurgitation after posterobasal myocardial infarction. Each region of the model was characterized by a specific constitutive law that captured the material response when subjected to physiologic pressure loading. Results: The model simulation produced a gap between the posterior and anterior leaflets, just above the infarcted posterior papillary muscle, which is indicative of mitral regurgitation. When the stiffness of the infarct region was reduced, this caused the wall to distend and the gap area between the leaflets to increase by 33%. Additionally, the stress in the leaflets increased around the chordal connection points near the gap. Conclusions: The methodology outlined in this work will allow a finite element model of both the left ventricle and mitral valve to be generated using noninvasive techniques.

Original languageEnglish
Pages (from-to)1546-1553
Number of pages8
JournalAnnals of Thoracic Surgery
Volume89
Issue number5
DOIs
StatePublished - May 2010

Bibliographical note

Funding Information:
This study was supported by National Institutes of Health grants R01-HL-84431 (Dr Ratcliffe), R01-HL-63348 (Dr Ratcliffe), R01-HL-77921 (Dr Guccione), and R01-HL-86400 (Dr Guccione). This support is gratefully acknowledged.

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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