Neochordoplasty versus leaflet resection for ruptured mitral chordae treatment: Virtual mitral valve repair
Neochordoplasty versus leaflet resection for ruptured mitral chordae treatment: Virtual mitral valve repair
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DOI：
10.1016/j.compbiomed.2017.09.006
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发表时间：
2017-11-01
影响因子：
7.7
通讯作者：
Kim, Hyunggun
中科院分区：
文献类型：
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作者：
Choi, Ahnryul;McPherson, David D.;Kim, Hyunggun
退行性二尖瓣病变(MV)是最常见的二尖瓣脱垂病变之一。四角叶切除和新生脉络膜成形术治疗后叶脱垂显示出良好的临床效果。我们评估了一个虚拟病理MV模型的功能和生物力学特征，进行了虚拟新脉络膜成形术和四角叶切除，并比较了修复后的两种MV功能。修复前的MV表现为严重的后叶脱垂，原因是P2脊索断裂和应力过度集中。两种修复技术均显示叶脱垂减少，应力集中减少，叶结合恢复。新脉络膜成形术显示出更好的叶结合和更好的后叶活动度，而叶切除显示出更均匀的叶应力分布。虚拟MV修复模拟能够预测和量化MV修复后的生物力学和功能改善。这一策略有可能帮助确定最有效的修复技术来恢复MV功能。
Degenerative mitral valve (MV) disease involving mitral prolapse is one of the most prevalent MV pathologies. Quadrangular leaflet resection and neochordoplasty demonstrate excellent clinical outcomes for the treatment of posterior leaflet prolapse. We evaluated the functional and biomechanical characteristics of a virtual pathologic MV model suffering from chordal rupture, performed virtual neochordoplasty and quadrangular leaflet resection, and compared the two post-repair MV functions. The pre-repair MV demonstrated severe posterior leaflet prolapse due to the ruptured P2 chordae and excessive stress concentration. Both repair techniques revealed reduced leaflet prolapse, decreased stress concentration, and restored leaflet coaptation. While neochordoplasty demonstrated further improved leaflet coaptation and superior posterior leaflet mobility, leaflet resection showed more uniform leaflet stress distributions. Virtual MV repair simulation has the ability to predict and quantitate biomechanical and functional improvement following MV repair. This strategy has the potential to help determine the most effective repair technique to restore MV function.