Biomechanical Optimization of Mitral Valve Repair Operations

PROJECT SUMMARY Mitral valve disease is a significant cause of global morbidity and mortality. Evolving treatment guidelines support earlier intervention and valve repair when possible. Advances in repair techniques have progressed in the clinical arena primarily based upon anatomic and physiologic premises as well as surgeon experience. Yet, the biomechanical engineering fundamentals and principles underlying mitral valve interventions are rarely investigated. A more robust understanding of such principles and incorporation into surgical procedures may enhance valve reparability and durability and thus ultimately translate into less thromboembolic and hemorrhagic sequelae of long-term anticoagulation for mechanical valve replacement and less perioperative risks of reintervention for bioprosthetic valve deterioration. We have designed and produced a novel 3D-printed heart simulator into which mitral valve specimens can be mounted and studied throughout the cardiac cycle. Complex disease states such as primary (degenerative) mitral regurgitation can be reproduced, allowing the investigation of the biomechanical characteristics of various repair operations and novel devices. Innovative biomechanical sensors within this simulator and state-of-the-art imaging modalities facilitate the detailed analysis of the engineering principles behind these operations. We propose to study primary mitral valve regurgitation and engineer novel minimally invasive devices and platforms to improve the treatment of this disease. We will then validate these findings and devices in pre-clinical large animal models. We are optimistic that the proposed experiments and devices will yield important knowledge on current and potential future clinical therapies for mitral valve disease and can be rapidly translated to intraoperative patient care.