A pilot in silico modeling‐based study of the pathological effects on the biomechanical function of tricuspid valves

Date
2020-05-03
Authors
Laurence, Devin
Hsu, Ming-Chen
Johnson, Emily
Hsu, Ming-Chen
Baumwart, Ryan
Mir, Arshid
Burkhart, Harold
Holzapfel, Gerhard
Wu, Yi
Lee, Chung-Hao
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Altmetrics
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Research Projects
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Mechanical Engineering
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Abstract

Current clinical assessment of functional tricuspid valve regurgitation relies on metrics quantified from medical imaging modalities. Although these clinical methodologies are generally successful, the lack of detailed information about the mechanical environment of the valve presents inherent challenges for assessing tricuspid valve regurgitation. In the present study, we have developed a finite element‐based in silico model of one porcine tricuspid valve (TV) geometry to investigate how various pathological conditions affect the overall biomechanical function of the TV. There were three primary observations from our results. Firstly, the results of the papillary muscle (PM) displacement study scenario indicated more pronounced changes in the TV biomechanical function. Secondly, compared to uniform annulus dilation, nonuniform dilation scenario induced more evident changes in the von Mises stresses (83.8‐125.3 kPa vs 65.1‐84.0 kPa) and the Green‐Lagrange strains (0.52‐0.58 vs 0.47‐0.53) for the three TV leaflets. Finally, results from the pulmonary hypertension study scenario showed opposite trends compared to the PM displacement and annulus dilation scenarios. Furthermore, various chordae rupture scenarios were simulated, and the results showed that the chordae tendineae attached to the TV anterior and septal leaflets may be more critical to proper TV function. This in silico modeling‐based study has provided a deeper insight into the tricuspid valve pathologies that may be useful, with moderate extensions, for guiding clinical decisions.

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<p>This is the peer-reviewed version of the following article: Laurence, Devin W., Emily L. Johnson, Ming‐Chen Hsu, Ryan Baumwart, Arshid Mir, Harold M. Burkhart, Gerhard A. Holzapfel, Yi Wu, and Chung‐Hao Lee. "A pilot in‐silico modeling‐based study of the pathological effects on the biomechanical function of tricuspid valves." <em>International Journal for Numerical Methods in Biomedical Engineering</em> (2020), which has been published in final form at DOI:<a href="https://doi.org/10.1002/cnm.3346" target="_blank">10.1002/cnm.3346</a>.This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. Posted with permission.</p>
Keywords
chordae tendineae, coaptation height, finite element simulations, functional tricuspid regurgitation, tenting area, tenting height
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