Euler's elastica–based biomechanical assessment for neochordal insertion in the treatment of degenerative mitral valve repair Francesco Nappi, MD, Cristiano.

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Presentation transcript:

Euler's elastica–based biomechanical assessment for neochordal insertion in the treatment of degenerative mitral valve repair Francesco Nappi, MD, Cristiano Spadaccio, MD, PhD, Christos G. Mihos, DO, Massimiliano Fraldi, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 155, Issue 2, Pages 603-605 (February 2018) DOI: 10.1016/j.jtcvs.2017.09.002 Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Three-dimensional echocardiographic reconstruction exemplifying the relationship between the papillary muscles and leaflets (left) is shown with reference to a sketch of the in-plane mechanical modeling of the mitral valve nonlinear bending and tethering due to the interaction with hyperelastic chordae anchored to a moving papillary muscle site (right). Equations and assumptions at the basis of this model are as follows: [1] θ'(s)=M(s)B,s∈[0,l), in which B represents bending stiffness, which establishes a linear relationship between the bending movement M and the curvature θ′; that is, the derivative of the angle θ representing the slope of the tangent to the elastica at each curvilinear abscissa, s. Bisshop method: [2] Θ(s)=arcsin[2K2sin2φ(s)−1]. Cauchy stress: [3] σ=∂ψc∂ε=C1(ec2ε−1)=Τλ, where T = P/Aref denotes the Piola-Kirchhoff nominal stress; that is, the edge load per unit reference cross-sectional area of the tendon. A, Anterior; AL, anterior leaflet; PM, posterior mitral leaflet; P (left figure), posterior; alpha, leaflet angle; lc, chordae tendinae length clamped on a side; P (right figure), oriented force or load; theta(s), curvature or slope of the tangent to the elastica at each curvilinear abscissa, s (see equation [1]); x(s) y(s), reference for position in space; u, interpapillary distance. The Journal of Thoracic and Cardiovascular Surgery 2018 155, 603-605DOI: (10.1016/j.jtcvs.2017.09.002) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

The Journal of Thoracic and Cardiovascular Surgery 2018 155, 603-605DOI: (10.1016/j.jtcvs.2017.09.002) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions