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Euler’s Elastica-Based Biomechanics of the Papillary Muscle Approximation in Ischemic Mitral Valve Regurgitation: A Simple 2D Analytical Model
Ischemic mitral regurgitation (IMR) occurs as an adverse consequence of left ventricle remodeling post-myocardial infarction. A change in mitral valve configuration with an imbalance between closing and tethering forces underlie this pathological condition. These abnormalities lead to impaired leafl...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6539350/ https://www.ncbi.nlm.nih.gov/pubmed/31075914 http://dx.doi.org/10.3390/ma12091518 |
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author | Nappi, Francesco Carotenuto, Angelo Rosario Avtaar Singh, Sanjeet Singh Mihos, Christos Fraldi, Massimiliano |
author_facet | Nappi, Francesco Carotenuto, Angelo Rosario Avtaar Singh, Sanjeet Singh Mihos, Christos Fraldi, Massimiliano |
author_sort | Nappi, Francesco |
collection | PubMed |
description | Ischemic mitral regurgitation (IMR) occurs as an adverse consequence of left ventricle remodeling post-myocardial infarction. A change in mitral valve configuration with an imbalance between closing and tethering forces underlie this pathological condition. These abnormalities lead to impaired leaflet coaptation and a variable degree of mitral regurgitation, which can in turn influence the ventricular filling status, the heart rhythm and the afterload regardless of the residual ischemic insult. The IMR correction can be pursued through under-sizing mitral annuloplasty and papillary muscle approximation to restore the mitral valve and left ventricle physiological geometry to, consequently, achieve normalization of the engaged physical forces. Because the structures involved undergo extremely large deformations, a biomechanics model based on the Euler’s Elastica –the mitral leaflet– interlaced with nonlinear chordae tendineae anchored on papillary muscles has been constructed to elucidate the interactions between closing and tethering forces. The model takes into account the actual updated geometrical and mechanical features of the valvular and subvalvular apparatuses in physiological and IMR conditions, as well as in case of papillary muscle approximation, finally furnishing ad hoc geometry-based mathematical relations that could be utilised to support—and optimize—the relevant choices in cardiac surgery. |
format | Online Article Text |
id | pubmed-6539350 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-65393502019-06-05 Euler’s Elastica-Based Biomechanics of the Papillary Muscle Approximation in Ischemic Mitral Valve Regurgitation: A Simple 2D Analytical Model Nappi, Francesco Carotenuto, Angelo Rosario Avtaar Singh, Sanjeet Singh Mihos, Christos Fraldi, Massimiliano Materials (Basel) Article Ischemic mitral regurgitation (IMR) occurs as an adverse consequence of left ventricle remodeling post-myocardial infarction. A change in mitral valve configuration with an imbalance between closing and tethering forces underlie this pathological condition. These abnormalities lead to impaired leaflet coaptation and a variable degree of mitral regurgitation, which can in turn influence the ventricular filling status, the heart rhythm and the afterload regardless of the residual ischemic insult. The IMR correction can be pursued through under-sizing mitral annuloplasty and papillary muscle approximation to restore the mitral valve and left ventricle physiological geometry to, consequently, achieve normalization of the engaged physical forces. Because the structures involved undergo extremely large deformations, a biomechanics model based on the Euler’s Elastica –the mitral leaflet– interlaced with nonlinear chordae tendineae anchored on papillary muscles has been constructed to elucidate the interactions between closing and tethering forces. The model takes into account the actual updated geometrical and mechanical features of the valvular and subvalvular apparatuses in physiological and IMR conditions, as well as in case of papillary muscle approximation, finally furnishing ad hoc geometry-based mathematical relations that could be utilised to support—and optimize—the relevant choices in cardiac surgery. MDPI 2019-05-09 /pmc/articles/PMC6539350/ /pubmed/31075914 http://dx.doi.org/10.3390/ma12091518 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Nappi, Francesco Carotenuto, Angelo Rosario Avtaar Singh, Sanjeet Singh Mihos, Christos Fraldi, Massimiliano Euler’s Elastica-Based Biomechanics of the Papillary Muscle Approximation in Ischemic Mitral Valve Regurgitation: A Simple 2D Analytical Model |
title | Euler’s Elastica-Based Biomechanics of the Papillary Muscle Approximation in Ischemic Mitral Valve Regurgitation: A Simple 2D Analytical Model |
title_full | Euler’s Elastica-Based Biomechanics of the Papillary Muscle Approximation in Ischemic Mitral Valve Regurgitation: A Simple 2D Analytical Model |
title_fullStr | Euler’s Elastica-Based Biomechanics of the Papillary Muscle Approximation in Ischemic Mitral Valve Regurgitation: A Simple 2D Analytical Model |
title_full_unstemmed | Euler’s Elastica-Based Biomechanics of the Papillary Muscle Approximation in Ischemic Mitral Valve Regurgitation: A Simple 2D Analytical Model |
title_short | Euler’s Elastica-Based Biomechanics of the Papillary Muscle Approximation in Ischemic Mitral Valve Regurgitation: A Simple 2D Analytical Model |
title_sort | euler’s elastica-based biomechanics of the papillary muscle approximation in ischemic mitral valve regurgitation: a simple 2d analytical model |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6539350/ https://www.ncbi.nlm.nih.gov/pubmed/31075914 http://dx.doi.org/10.3390/ma12091518 |
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