| Computational model of aortic valve surgical repair using grafted pericardium. | |
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MedLine Citation:
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PMID: 22341628 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Aortic valve reconstruction using leaflet grafts made from autologous pericardium is an effective surgical treatment for some forms of aortic regurgitation. Despite favorable outcomes in the hands of skilled surgeons, the procedure is underutilized because of the difficulty of sizing grafts to effectively seal with the native leaflets. Difficulty is largely due to the complex geometry and function of the valve and the lower distensibility of the graft material relative to native leaflet tissue. We used a structural finite element model to explore how a pericardial leaflet graft of various sizes interacts with two native leaflets when the valve is closed and loaded. Native leaflets and pericardium are described by anisotropic, hyperelastic constitutive laws, and we model all three leaflets explicitly and resolve leaflet contact in order to simulate repair strategies that are asymmetrical with respect to valve geometry and leaflet properties. We ran simulations with pericardial leaflet grafts of various widths (increase of 0%, 7%, 14%, 21% and 27%) and heights (increase of 0%, 13%, 27% and 40%) relative to the native leaflets. Effectiveness of valve closure was quantified based on the overlap between coapting leaflets. Results showed that graft width and height must both be increased to achieve proper valve closure, and that a graft 21% wider and 27% higher than the native leaflet creates a seal similar to a valve with three normal leaflets. Experimental validation in excised porcine aortas (n=9) corroborates the results of simulations. |
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Authors:
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Peter E Hammer; Peter C Chen; Pedro J del Nido; Robert D Howe |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2012-02-16 |
Journal Detail:
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Title: Journal of biomechanics Volume: 45 ISSN: 1873-2380 ISO Abbreviation: J Biomech Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-04-16 Completed Date: 2012-08-09 Revised Date: 2013-05-20 |
Medline Journal Info:
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Nlm Unique ID: 0157375 Medline TA: J Biomech Country: United States |
Other Details:
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Languages: eng Pagination: 1199-204 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 Elsevier Ltd. All rights reserved. |
Affiliation:
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Department of Cardiac Surgery, Children's Hospital, Boston, MA, USA. peter.hammer@childrens.harvard.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Aortic Valve / pathology, physiopathology, surgery* Aortic Valve Insufficiency / pathology, physiopathology, surgery* Biomechanics Computer Simulation Elasticity Finite Element Analysis Humans Models, Anatomic Models, Cardiovascular* Pericardium / transplantation* Sus scrofa Transplantation, Autologous |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL073647-09/HL/NHLBI NIH HHS; R01HL073647/HL/NHLBI NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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