Dynamic, patient-specific mitral valve modelling for planning transcatheter repairs.

PURPOSE: Transcatheter, beating heart repair techniques for mitral valve regurgitation is a very active area of development. However, it is difficult to both simulate and predict the clinical outcomes of mitral repairs, owing to the complexity of mitral valve geometry and the influence of hemodynamics. We aim to produce a workflow for manufacturing dynamic patient-specific models to simulate the mitral valve for transcatheter repair applications.

METHODS

In this paper, we present technology and associated workflow, for using transesophageal echocardiography to generate dynamic physical replicas of patient valves. We validate our workflow using six patient datasets representing patients with unique or particularly challenging pathologies as selected by a cardiologist. The dynamic component of the models and their resultant potential as procedure planning tools is due to a dynamic pulse duplicator that permits the evaluation of the valve models experiencing realistic hemodynamics.

RESULTS

Early results indicate the workflow has excellent anatomical accuracy and the ability to replicate regurgitation pathologies, as shown by colour Doppler ultrasound and anatomical measurements comparing patients and models. Analysis of all measurements successfully resulted in t critical two-tail > t stat and p values > 0.05, thus demonstrating no statistical difference between the patients and models, owing to high fidelity morphological replication.

CONCLUSIONS

Due to the combination of a dynamic environment and patient-specific modelling, this workflow demonstrates a promising technology for simulating the complete morphology of mitral valves undergoing transcatheter repairs.