+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Development of a modeling pipeline for the prediction of hemodynamic outcome after virtual mitral valve repair using image-based CFD

Development of a modeling pipeline for the prediction of hemodynamic outcome after virtual mitral valve repair using image-based CFD

International Journal of Computer Assisted Radiology and Surgery 2018

Severe mitral valve regurgitation can either be treated by a replacement or a repair of the valve. The latter is recommended due to lower perioperative mortality and better long-term survival. On the other hand, recurrence rates after mitral valve repair are high compared to those after replacements and the repair intervention can cause induced mitral valve stenosis. So far, there are no methods to predict the hemodynamic outcome of a chosen treatment or to compare different treatment options in advance. To overcome this, diastolic mitral valve hemodynamics are simulated using computational fluid dynamics after different virtual treatments of the valve. The left ventricular geometry of one patient was reconstructed using trans-esophageal echocardiography and computed tomography data. Pre-op hemodynamics are simulated using a referenced wall model to avoid expansive modeling of wall motion. Subsequently, the flow structures are compared to in vivo measurements. After manipulating the patient-specific geometry in order to mimic a restrictive mitral annuloplasty as well as a MitraClip intervention, hemodynamics results are calculated. Good agreements exist between calculated pre-op hemodynamics and in vivo measurements. The virtual annuloplasty did not result in any remarkable change of hemodynamics. Neither the pressure drop nor the velocity field showed strong differences. In contrast, the virtual MitraClip intervention led to a complete change in blood flow structures as well as an elevated pressure drop across the valve. The presented approach allows fast simulation of the diastolic hemodynamic situation before and after treatment of a mitral valve insufficiency. However, this approach is limited to the early diastolic phase of the cardiac cycle and needs to be validated using a larger sample size.

(PDF emailed within 0-6 h: $19.90)

Accession: 058078541

Download citation: RISBibTeXText

PMID: 30008058

DOI: 10.1007/s11548-018-1821-8

Related references

Early Clinical Outcome of Mitral Valve Replacement Using a Newly Designed Stentless Mitral Valve for Failure of Initial Mitral Valve Repair. Heart Surgery Forum 19(6): E306-E307, 2017

Meta-analysis of two different surgical treatments of ischaemic mitral regurgitation with the same outcome: mitral valve repair vs mitral valve replacement. Acta Cardiologica 71(5): 573-580, 2017

Mitral Valve Anatomic Predictors of Hemodynamic Success With Transcatheter Mitral Valve Repair. Journal of the American Heart Association 7(2), 2018

Is rheumatic aetiology a predictor of poor outcome in the current era of mitral valve repair? Contemporary long-term results of mitral valve repair in rheumatic heart disease. European Journal of Cardio-Thoracic Surgery 44(4): 673-681, 2014

A novel finite element-based patient-specific mitral valve repair: virtual ring annuloplasty. Bio-Medical Materials and Engineering 24(1): 341-347, 2014

Quantitative Modeling of the Mitral Valve by Three-Dimensional Transesophageal Echocardiography in Patients Undergoing Mitral Valve Repair: Correlation with Intraoperative Surgical Technique. Journal of the American Society of Echocardiography 28(9): 1083-1092, 2016

Echocardiographic prediction of left ventricular dysfunction after mitral valve repair for mitral regurgitation as an indicator to decide the optimal timing of repair. Journal of the American College of Cardiology 42(3): 458-463, 2003

Impact of the learning curve on outcome after transcatheter mitral valve repair: results from the German Mitral Valve Registry. Clinical Research in Cardiology 103(11): 930-937, 2015

One-year outcome of percutaneous mitral valve repair in patients with severe symptomatic mitral valve regurgitation. World Journal of Cardiology 9(1): 39-46, 2017

Early outcome of folding mitral valve repair technique without resection for mitral valve prolapse in 60 patients. Journal of Thoracic and Cardiovascular Surgery 145(1): 104-8; Discussion 108-9, 2013

Tricuspid Valve Repair for the Poor Right Ventricle: Tricuspid Valve Repair in Patients with Mild-to-Moderate Tricuspid Regurgitation Undergoing Mitral Valve Repair Improves In-Hospital Outcome. Thoracic and Cardiovascular Surgeon 65(8): 612-616, 2015

Residual mitral valve regurgitation after percutaneous mitral valve repair with the MitraClip® system is a risk factor for adverse one-year outcome. Catheterization and Cardiovascular Interventions 81(4): 609-617, 2013

Impact of failed mitral valve repair on hospital outcome of redo mitral valve procedures. European Journal of Cardio-Thoracic Surgery 51(5): 906-912, 2017

Influence of non-cardiac comorbidities on outcome after percutaneous mitral valve repair: results from the German transcatheter mitral valve interventions (TRAMI) registry. Clinical Research in Cardiology 104(12): 1044-1053, 2016

Neochordoplasty versus leaflet resection for ruptured mitral chordae treatment: Virtual mitral valve repair. Computers in Biology and Medicine 90: 50-58, 2017