Advanced biomechanical assessment of mitral valve prosthesis using fluid-structure interaction modeling

Mitral valve disease, particularly mitral regurgitation (MR), is among the most common valvular heart diseases, often requiring prosthetic valve replacement to restore normal hemodynamics and preserve myocardial function. Despite advances in prosthetic technologies, predicting patient-informed biomechanical performance remains challenging due to complex blood-structure interactions. This study aimed to develop a patient-informed fluid-structure interaction (FSI) model to evaluate the biomechanical and hemodynamic performance of a mechanical mitral valve prosthesis.

A patient-informed FSI model of the left ventricle (LV) and mitral valve prosthesis was developed and validated using echocardiographic data and numerical simulations. The model analyzed the behavior of a St. Jude mechanical mitral valve implanted in a 46-year-old male patient and compared it with a healthy LV model. Hemodynamic and mechanical parameters, including flow velocity, shear stress, pressure gradient, and von Mises stress, were quantified.

The prosthetic valve restored global flow direction, stroke volume, and ventricular wall displacement, consistent with echocardiographic data. In the healthy LV, peak inflow velocities reached 0.6-0.7 m/s during early diastole with transient shear stress (∼0.08 s). The prosthetic valve produced higher inflow velocities (up to 6.5 m/s) and prolonged shear stress (∼0.08-0.18 s), indicating potential hemolysis risk. Pressure gradients peaked at ∼13 mmHg, and stress analysis showed preserved central motion with localized stress near the prosthesis.

Patient-informed FSI modeling enables accurate, noninvasive assessment of post-operative hemodynamics and mechanical performance, identifying risks such as elevated shear stress and hemolysis while supporting optimized prosthetic design and personalized surgical planning.