Image-based framework for the tricuspid valve biomechanical FEA: initial application to RV free wall approximation

This study presents a finite element modeling framework, based on real-time 3D echocardiography, to evaluate tricuspid valve biomechanics in regurgitant conditions and predict surgical outcomes of free wall approximation. Two chordae tendineae templates were compared: uniformly distributed unbranched chordae (KCT) and parametrically distributed branched chordae (LCT). Results show that KCT more accurately replicates baseline regurgitant conditions after length tuning, while LCT better captures post-surgical biomechanical effects. A hybrid approach combining features of both templates may yield optimal fidelity for both baseline reproduction and surgical prediction.