The role of chordal apparatus and coaptation length in the progression towards mitral valve prolapse: biomechanical insight through FE modeling

Degenerative mitral valve prolapse (MVP) affects up to 3% of the population and may lead to serious complications and alterations in MV biomechanics. In the case of severe MVP, leaflet coaptation is restored by surgical or transcatheter repair; even if coaptation is restored, a reduced coaptation length correlates with subsequent recurrent mitral regurgitation. Here, we used high-fidelity finite element models based on cardiac magnetic resonance imaging to systematically test if stress overloads on the MV, possibly driving MV remodeling, are induced by a reduction in coaptation or chordae tendineae support.