Comparative mechanical, morphological, and microstructural characterization of porcine mitral and tricuspid leaflets and chordae tendineae

[Display omitted] Healthy function of tricuspid valve (TV) structures is essential to avoid tricuspid regurgitation (TR) and may significantly improve disease prognosis. Mitral valve (MV) structures have been extensively studied, but little is known about the TV and right-sided heart diseases. There...

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Bibliographic Details
Published in:Acta biomaterialia 2019-02, Vol.85, p.241-252
Main Authors: Pokutta-Paskaleva, Anastassia, Sulejmani, Fatiesa, DelRocini, Marissa, Sun, Wei
Format: Article
Language:English
Subjects:
Animals
Anisotropy
Biaxial testing
Biomechanical Phenomena
Cardiovascular diseases
Chordae tendineae
Chordae Tendineae - anatomy & histology
Chordae Tendineae - physiology
Computation
Computer applications
Computer simulation
Coronary artery disease
Decisions
Extensibility
Finite element method
Heart diseases
Heart valves
Mathematical models
Mechanical properties
Mechanics
Mechanics (physics)
Mitral valve
Mitral Valve - anatomy & histology
Mitral Valve - physiology
Model testing
Models, Biological
Morphology
Physiology
Regurgitation
Rheumatic heart disease
Second harmonic generation
Surgery
Swine
Tricuspid regurgitation
Tricuspid valve
Tricuspid Valve - anatomy & histology
Tricuspid Valve - physiology
Tricuspid valve mechanics
Uniaxial testing
Uniaxial tests
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Summary:[Display omitted] Healthy function of tricuspid valve (TV) structures is essential to avoid tricuspid regurgitation (TR) and may significantly improve disease prognosis. Mitral valve (MV) structures have been extensively studied, but little is known about the TV and right-sided heart diseases. Therefore, clinical decisions and finite element (FE) simulations often rely heavily on MV data for TV applications, despite fundamentally different mechanical and physiological environments. To bridge this gap, we performed a rigorous mechanical, morphological, and microstructural characterization of the MV and TV leaflets and chordae in a porcine model. Planar biaxial testing, uniaxial testing, second harmonic generation imaging and Verhoeff Van Gieson staining were performed. Morphological parameters, tissue moduli, extensibility, and anisotropy were quantified and compared. No major differences in leaflet mechanics or structure were found between TV and MV; chordal mechanics, morphology, and structure were found to compensate for anatomical and physiological loading differences between the valves. No differences in chordal mechanics were observed by insertion point within a leaflet; the septal tricuspid leaflet (STL) and posterior mitral leaflet (PML) did not have distinguishable strut chords, and the STL had the shortest chords. Within a valve, chords from septally-located leaflets were more extensible. MV chords were stiffer. This study presents the first rigorous comparative mechanical and structural dataset of MV and TV structures. Valve type and anatomical location may be stronger predictors of chordal mechanics. Chords from septally-located leaflets differ from each other and from their intravalvular counterparts; they merit special consideration in surgical and computational applications. A better understanding of the tricuspid valve (TV) and its associated structures is important for making advancements towards the repair of tricuspid regurgitation. Mitral valve structures have been extensively studied, but little is known about the TV and right-sided heart diseases. Clinical decisions and computational simulations often rely heavily on MV data for TV applications, despite fundamentally different environments. We therefore performed a rigorous mechanical, morphological, and microstructural characterization of atrioventricular leaflets and chordae tendineae in a porcine model. Finding that valve type and anatomical location may be strong predictors of chor
ISSN:1742-7061
1878-7568
DOI:10.1016/j.actbio.2018.12.029