Investigate mitral valve regurgitation following myocardial infarction using cardiac in-silico models

Ischemic mitral valve regurgitation (IMR) affects over two million Americans with the occurrence expected to grow substantially over the next two decades as the population ages. IMR is induced by myocardial infarction (MI) and the subsequent loss of contractility within a region of the left ventricular wall. Further adverse remodeling of the left ventricle and mitral valve leaflets worsens the severity of IMR. There is now agreement that adjunctive procedures are required to treat IMR, but no consensus regarding the optimal procedure. MV repair such as undersized ring annuloplasty or MitraClip results in high recurrence of MR six month after surgery. On the other hand, MV replacement is not always a viable option due to the lifelong anticoagulants required by mechanical valves, and the relatively short lifespan of biological valves. There is thus an urgent need for quantitative assessments of mitral valve (MV) function to better design surgical solutions. Our first computational model which was developed using data collected for a single ovine heart aims to investigate the interaction between the left ventricle and the mitral valve in both healthy and diseased states. The decreased contractility of immediate MI with various infarct locations triggers different levels of MR severity. At the same time, the compressibility of myocardium and MV leaflet prestrain have been investigated and evaluated in the ovine heart model. Furthermore, patient-specific MV apparatus models were developed which rely on clinically obtainable pre-surgical imaging data and can thus be extended into a virtual surgery tool that provides surgeons with additional insight into the patient-specific valvular response to different treatment options.Biomedical Engineerin