Three-Dimensional Transesophageal Echocardiography-Based Virtual Modeling and Biomechanical Evaluation of the Mitral Valve

Abstract

In this study, we proposed a novel valid computational strategy to simulate mitral valve (MV) function for the entire cardiac cycle using a virtual MV model created from in-vivo 3D transesophageal echocardiography (TEE) data. The geometric parameters of the actual MVs (i.e., harvested and photographed) were compared with those of the corresponding virtual MVs (i.e., modeled from 3D TEE data). The difference in five geometric parameters between the actual MVs and virtual MV models ranged between 10.8% and 19.7%. This geometric difference between the harvested MVs and the virtual in-vivo MVs corresponds to the well-known fact that soft tissue is exposed to a shrinkage of 15–33% after harvesting. Dynamic finite element evaluation of MV function displayed morphologic alteration, stress distribution, and coaptation of the MVs in individual cases and the outcomes were well corresponded to the echo data. This 3D TEE data-based computational modeling and simulation protocol to investigate the biomechanical characteristics of MV function can be easily transitioned to clinical application. It is anticipated that this computational MV evaluation strategy can help us better understand, better quantitate, and better visualize the progress of pathophysiologic development in the MV apparatus.