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Influence of Annular Dynamics and Material Behavior in Finite Element Analysis of Barlow’s Mitral Valve Disease
Journal of Elasticity ( IF 1.8 ) Pub Date : 2021-05-21 , DOI: 10.1007/s10659-021-09829-5
Hans Martin Aguilera , Stig Urheim , Bjørn Skallerud , Victorien Prot

Barlow’s disease affects the entire mitral valve apparatus, by altering several of the fundamental mechanisms in the mitral valve which ensures unidirectional blood flow between the left atrium and the left ventricle. In this paper, a finite element model of a patient diagnosed with Barlow’s disease with patient-specific geometry and boundary conditions is presented. The geometry and boundary conditions are extracted from the echocardiographic assessment of the patient prior to surgery. Material properties representing myxomatous, healthy human and animal mitral valves are implemented and computed response are compared with each other and the echocardiographic images of the patient. This study shows that the annular dilation observed in Barlow’s patients controls several aspects of the mitral valve behavior during ventricular systole. The coaptation of the leaflets is observed to be highly dependent on annular dilation, and the coaptation area reduces rapidly at the onset of mitral regurgitation. Furthermore, the leaflet material implementation is important to predict lack of closure in the FE model correctly. It was observed that using healthy human material parameters in the Barlow’s diseased FE geometry gave severe lack of closure from the onset of mitral regurgitation, while myxomatous material properties showed a more physiological leakage.



中文翻译:

环形动力学和材料行为对Barlow二尖瓣疾病的有限元分析的影响

巴洛氏病通过改变二尖瓣中的几个基本机制来影响整个二尖瓣装置,以确保左心房和左心室之间的单向血流。在本文中,提出了诊断为Barlow病的患者的有限元模型,具有特定于患者的几何形状和边界条件。在手术前从患者的超声心动图评估中提取几何形状和边界条件。实现代表粘液样,健康的人和动物二尖瓣的物质特性,并将计算的响应相互比较,并比较患者的超声心动图图像。这项研究表明,在Barlow的患者中观察到的环形扩张可控制心室收缩期间二尖瓣行为的多个方面。观察到小叶的接合高度依赖于环形扩张,并且接合区域在二尖瓣反流开始时迅速减小。此外,宣传单页材料的实现对于正确预测有限元模型的闭合性很重要。据观察,在Barlow患病的FE几何体中使用健康的人类材料参数会导致二尖瓣反流开始时严重缺乏闭合性,而粘液性物质的特性显示出更多的生理渗漏。

更新日期:2021-05-22
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