Computational evaluation of mitral valve repair with MitraClip

Abstract

Aim: This paper aims to evaluate the effectiveness of MitraClip implantation as a solution to severe mitral regurgitation (MR) in the case of posterior leaflet prolapse due to hypertrophic obstructive cardiomyopathy and chordae rupture.

Methods: NX CAD software was used to create a surface geometric model for the mitral valve (MV). A hyperelastic material model, calibrated against experimental results, was used to describe stress-strain responses of the MV leaflets, and a spring element approach was used to describe chordae response. Abaqus CAE was employed to create a finite element model for diseased MV suffering from MR. The effectiveness of MitraClip implantation on valve function was investigated by simulating the deformation of diseased valve, with and without MitraClip repair, during peak systole and diastole. Leaflet deformation and stress distributions were used to assess the effectiveness of the procedure.

Results: Overall, significant improvement was achieved for the diseased valve after MitraClip implantation. Prior to the introduction of the clip, the diseased valve was subjected to posterior leaflet prolapse which would induce a jet of MR. Once the MitraClip was included in the simulation, the valve leaflets were able to close and seal off, almost entirely at peak systolic condition without a significant impact on the stress distribution of the valve leaflets.

Conclusion: The results in this study provide further evidence to support MitraClip repair as a viable treatment for high-risk patients suffering from severe MR, and also highlight the need for further research into such an advanced, minimally invasive surgery technique.

Keywords

Finite element / mitral valve / MitraClip / mitral regurgitation / hypertrophic obstructive cardiomyopathy / hyperelastic model

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