NDLI: Aortic Valve Repair via Neo-Chordae Technique: Mechanistic Insight Through Numerical Modelling

Content Provider	Springer Nature Link
Author	Votta, Emilia Paroni, Luca Conti, Carlo A. Pelosi, Alessandra Mangini, Andrea D’Alesio, Paolo Vismara, Riccardo Antona, Carlo Redaelli, Alberto
Copyright Year	2011
Abstract	Recently, the neo-chordae technique (NCT) was proposed to stabilize the surgical correction of isolated aortic valve (AV) prolapse. Neo-chordae are inserted into the corrected leaflet to drive its closure by minimal tensions and prevent relapses. In a previous in vitro study we analysed the NCT effects on healthy aortic roots (ARs). Here we extend that analysis via finite element models (FEMs). After successfully replicating the experimental conditions for validation purposes, we modified our AR FEM, obtaining a continent AV with minor isolated prolapse, thus representing a realistic clinical scenario. We then simulated the NCT, and systematically assessed the acute effects of changing neo-chordae length, opening angle, asymmetry and insertion on the aorta. In the baseline configuration the NCT restored physiological AV dynamics and coaptation, without inducing abnormal leaflet stresses. This outcome was notably sensitive only to neo-chordae length, suggesting that the NCT is a potentially easy-to-standardize technique. However, this parameter is crucial: major shortenings (6 mm) prevent coaptation and increase leaflet stresses by 359 kPa, beyond the yield limit. Minor shortenings (2–4 mm) only induce a negligible stress increase and mild leaflet tethering, which however may hamper the long-term surgical outcome.
Starting Page	1039
Ending Page	1051
Page Count	13
File Format	PDF
ISSN	00906964
Journal	Annals of Biomedical Engineering
Volume Number	40
Issue Number	5
e-ISSN	15739686
Language	English
Publisher	Springer US
Publisher Date	2011-12-25
Publisher Place	Boston
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Aortic valve Surgical correction ePTFE chordae Finite element modeling Mechanics Biomedical Engineering Biochemistry Biophysics and Biological Physics Biomedicine general
Content Type	Text
Resource Type	Article
Subject	Biomedical Engineering

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