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Related Concept Videos

Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular tachycardia.
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...

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Related Experiment Video

Updated: Jun 19, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
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Image-Based Computational Fluid Dynamics to Compare Two Repair Techniques for Mitral Valve Prolapse.

Lorenzo Bennati1, Giovanni Puppini2, Vincenzo Giambruno3

  • 1Department of Surgery, Dentistry, Pediatrics, and Obstetrics/Gynecology, University of Verona, Piazzale Ludovico Antonio Scuro 10, Verona, 37134, Italy.

Annals of Biomedical Engineering
|August 9, 2024
PubMed
Summary

The Neochordae technique for mitral valve prolapse offers more physiological blood flow than the Resection technique. While Resection improves washout, it increases turbulence and hemolysis risk.

Keywords:
Computational fluid dynamicsHemolysisMitral valve prolapseNeochordae techniqueResection techniqueTurbulence

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Area of Science:

  • Cardiovascular Surgery
  • Biomedical Engineering
  • Fluid Dynamics

Background:

  • Mitral valve prolapse (MVP) repair involves chordal replacement (Neochordae) or leaflet resection (Resection).
  • Optimal surgical technique for MVP remains debated.
  • Computational fluid dynamics (CFD) can model blood flow dynamics post-surgery.

Purpose of the Study:

  • To compare blood flow dynamics between Neochordae and Resection techniques for MVP repair using CFD.
  • To evaluate the impact of each technique on ventricular blood flow patterns, turbulence, and thrombus formation risk.

Main Methods:

  • CFD simulations of the left heart were performed using cine-MRI data from a healthy subject and two MVP patients (Neochordae and Resection).
  • Large Eddy Simulation modeled turbulence, and a resistive method managed valve dynamics.
  • Three virtual scenarios (healthy, Neochordae, Resection) were created in the same heart geometry.

Main Results:

  • The Resection technique showed significantly higher turbulent forces (up to 640 Pa) compared to Neochordae and healthy cases (max 240 Pa), indicating increased hemolysis risk.
  • Resection reduced low-velocity areas at the ventricular apex to 15%, compared to 30% (healthy) and 48% (Neochordae).
  • Neochordae technique resulted in more physiological ventricular blood flow patterns.

Conclusions:

  • The Neochordae technique promotes more physiological blood flow compared to the Resection technique.
  • The Resection technique enhances ventricular apex washout, potentially reducing thrombus formation risk.
  • However, the Resection technique increases turbulence, leading to higher ventricular effort and hemolysis risk.