NUMERICAL SIMULATION OF THE MITRAL
VALVE REPAIR: A CUSTOMIZABLE MODEL

Pigeon Tévy Julie, Pascale Kulisa, Benyebka Bousaïd

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Pigeon Tévy Julie, Pascale Kulisa, Benyebka Bousaïd. NUMERICAL SIMULATION OF THE MITRAL VALVE REPAIR: A CUSTOMIZABLE MODEL. European Society of Biomechanics, Jul 2025, Zurich, Switzerland. [hal-05362479](https://hal.science/hal-05362479v1)

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Submitted on 13 Nov 2025

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Distributed under a Creative Commons Attribution 4.0 International License
# NUMERICAL SIMULATION OF THE MITRAL VALVE REPAIR: A CUSTOMIZABLE MODEL

Tévy Julie Pigeon (1), Pascale Kulisa (2), Benyebka Bou-Saïd (1)

1. INSA Lyon, CNRS, Ecole Centrale de Lyon, Universite Claude Bernard Lyon 1, LMFA, UMR5509, 69621, 69100 Villeurbanne, France

2. CNRS, Ecole Centrale de Lyon, INSA Lyon, Universite Claude Bernard Lyon 1, LMFA, UMR5509, 69621, Villeurbanne, France

## Introduction

Mitral regurgitation is the second most prevalent valvular disease in Europe. It is characterized by a leak in the mitral valve (MV), leading to retrograde blood flow from the left ventricle to the left atrium during systole. Annuloplasty is a surgical procedure that reduces the valve's diameter and stabilizes the repair, preventing the recurrence of mitral regurgitation through the use of a prosthetic ring. This ring is secured to the native mitral annulus with nitinol sewing threads or anchors. The long-term stability of these anchors after numerous cardiac cycles depends on mechanical and hemodynamic forces acting on the system, the healing process at anchor sites, and the material properties of both the tissue and the prosthesis. Our objective is to develop a customizable numerical model of the MV and its surrounding structures, enabling the design of a prosthetic ring tailored to each patient's unique physiology and pathology.

## Material and methods

The valve geometry is segmented from medical images and pre-processed using ANSYS SpaceClaim software. The prosthetic ring design is based on a Carpentier patent from 2009 and created using CAD software Creo Parametrics (Figure 1a). Predicting the mechanical properties of the native mitral annulus is challenging due to its heterogeneous nature and the limited presence of collagen fibers [1]. To address this, we consider the most critical scenario by assigning the mechanical properties of the myocardium to the mitral valve (MV), which increases its susceptibility to tearing under in-vivo stress. A Neo-Hookean constitutive law is employed, with coefficients derived from elastic parameters reported in the literature. The mechanical properties of the prosthetic ring were determined by replicating the compression test of a Carpentier-Edwards Physio ring in the commercial software Abaqus FEA [2].

The prosthetic ring is anchored to the MV at fixation points, with normal hard contact and tangential frictionless contact applied elsewhere. Ventricular contraction is simulated as a 3mm radial prescribed displacement on the lower side of the valve, corresponding to a 33% reduction in the MV opening area [3]. For meshing, the prosthesis and the biological tissue are modeled using quadratic tetrahedral elements. Abaqus is utilized to solve this solid mechanics problem via a Finite Element Model approach.

<figure><img src="image_2.png" /><figcaption>Figure 1a: Designed prosthesis based on Carpentier patent. Figure 1b: Simulation of a biofaithfull mitral valve under ventricular contraction simulation.</figcaption></figure>

## Results

During ventricular contraction, maximum stress is observed at the left commissure of the mitral valve (MV) and on the posterior leaflet (Figure 1b). With the prosthesis in place, stress concentrations occur around the anchors.

## Discussion

This model enhances a previous one that featured a geometrically simplified mitral valve (MV) and prosthetic ring. Our next step is to apply the findings from the prior study on anchor variations to this biofaithful model, evaluating the effects of anchoring width, number, and distribution on tissue response. In parallel, an experimental study is being conducted to analyze the mechanical property gradient at different locations of the native mitral annulus. The insights gained will help refine our model to better reflect physiological reality.

## References

1. Faletra et al., Eur Heart J Cardiovasc Imaging, 20(8):843-857, 2019

2. Purser et al., Ann Biomed Eng, 39(1):367-377, 2010

3. Owais et al., Ann Card Anaesth, 19:15-9, 2016

This work was performed within the framework of the ICELAND project (ANR-21-RHUS-0006) coordinated by the Hospices Civils de Lyon (HCL) within the program France 2030 operated by the French National Research Agency (ANR).

<figure><img src="image_3.png" /></figure>