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S. Jeong(정수환),M. Ko(고민성),S. M. Kim(김성민),H. Kim(김형건) Korean Society for Precision Engineering 2021 한국정밀공학회 학술발표대회 논문집 Vol.2021 No.11월
Posterior leaflet prolapse of the mitral valve (MV) occurs with ruptured posterior chordae or enlarged posterior leaflet tissue. MV repair for posterior leaflet prolapse usually involves resection or neochordoplasty. An important surgical procedure in quadrangular resection, which requires a larger incision than triangular resection, is to determine the optimal incision size for the recovery of normal MV function. We created a virtual MV model containing chordal rupture and P2 leaflet prolapse, and virtually repaired the pathologic MV with quadrangular resection in terms of three different incision sizes using our previously-validated finite element-based MV simulation protocol. We compared the biomechanical and physiologic characteristics of the pre-repair MV and three different post-resection MVs. The normal MV revealed full leaflet coaptation at peak systole, whereas the P2 prolapse MV showed incomplete leaflet coaptation directly related to the occurrence of mitral regurgitation. Both post-resection MVs with a clinically appropriate incision size and with excessive tissue incision restored complete leaflet coaptation at peak systole. However, the post-resection MV with a small incision revealed incomplete leaflet coaptation. This virtual MV repair technique can provide a valuable pre-surgical evaluation tool to determine the optimal incision size for quadrangular resection to best recover normal MV function.