Repair of Mitral Valve Prolapse Through ePTFE Neochordae: A Finite Element Approach From CMR

Patient-specific finite element (FE) modeling is largely used to quantify mitral valve (MV) biomechanics associated to pathological and post-surgical conditions. We used this approach, integrated with non-invasive cardiac magnetic resonance (CMR) imaging data, to numerically perform the repair of the isolated mitral valve leaflet prolapse through expanded-polytetrafluoroethylene (ePTFE) sutures and quantitatively compare the effects of different techniques of neochordal implantation (NCI). CMR-derived FE models well reproduced MVP-related alterations and were able to assess the efficacy of each repairing technique and its biomechanical effects on MV apparatus; the quantification of biomechanical differences between NCI techniques, especially in terms of both chordal tensions and leaflet stresses redistribution, may impact on the short- and long-term the clinical outcome, potentially opening the way to patient-specific optimization of NCIs and, if extensively and successfully tested, improve surgical planning.