Mitral valve (MV) regurgitation (MR) is a condition in which the valve between the heart’s left atrium and left ventricle fails to close properly, causing backflow of blood into the atrium. MV transcatheter edge-to-edge repair (TEER) is a minimally invasive procedure for treating MR. During the TEER procedure, the MV leaflet flaps are clipped together to improve closure and reduce leakage without the need for open heart surgery. However, the effects of TEER configuration on MV function, hemodynamics, and long-term outcomes remain largely uncharacterized. To better understand post-TEER hemodynamic responses, we develop a computational fluid-structure interaction model that demonstrates the interaction between blood flow behavior and a patient-specific MV in the left heart. The developed model evaluates post-operative hemodynamics, such as a significant reduction in the effective orifice area and an increase in transvalvular gradients. This study provides a better understanding of how pre- and post-operative MV conditions, geometry, mechanical behaviors, and flow influence the post-TEER functional state.

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Diastolic Hemodynamics of the Human Mitral Valve Following Transcatheter Edge-to-Edge Repair

  • Keon Ho Kim,
  • Ashton M. Corpuz,
  • Natalie T. Somonian,
  • Ming-Chen Hsu,
  • Michael S. Sacks

摘要

Mitral valve (MV) regurgitation (MR) is a condition in which the valve between the heart’s left atrium and left ventricle fails to close properly, causing backflow of blood into the atrium. MV transcatheter edge-to-edge repair (TEER) is a minimally invasive procedure for treating MR. During the TEER procedure, the MV leaflet flaps are clipped together to improve closure and reduce leakage without the need for open heart surgery. However, the effects of TEER configuration on MV function, hemodynamics, and long-term outcomes remain largely uncharacterized. To better understand post-TEER hemodynamic responses, we develop a computational fluid-structure interaction model that demonstrates the interaction between blood flow behavior and a patient-specific MV in the left heart. The developed model evaluates post-operative hemodynamics, such as a significant reduction in the effective orifice area and an increase in transvalvular gradients. This study provides a better understanding of how pre- and post-operative MV conditions, geometry, mechanical behaviors, and flow influence the post-TEER functional state.