NUMERICAL SIMULATION OF THE MITRAL
VALVE REPAIR

Pigeon Tévy Julie, Aline Bel-Brunon, Benyebka Bousaïd

► To cite this version:

Pigeon Tévy Julie, Aline Bel-Brunon, Benyebka Bousaïd. NUMERICAL SIMULATION OF THE MITRAL VALVE REPAIR. African Congress of Tribology, Apr 2023, Yamoussoukro, Côte d'Ivoire. hal-05362499

HAL Id: hal-05362499

https://hal.science/hal-05362499v1

Submitted on 13 Nov 2025

HAL is a multi-disciplinary open access
archive for the deposit and dissemination of sci-
entific research documents, whether they are pub-
lished or not. The documents may come from
teaching and research institutions in France or
abroad, or from public or private research centers.

L'archive ouverte pluridisciplinaire HAL, est
destinée au dépôt et à la diffusion de documents
scientifiques de niveau recherche, publiés ou non,
émanant des établissements d'enseignement et de
recherche français ou étrangers, des laboratoires
publics ou privés.

<figure><img src="image_1.png" /></figure>

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

Tévy Julie PIGEON, Benyebka BOU-SAÏD, Aline BEL-BRUNON (LaMCoS)

## ABSTRACT

Mitral regurgitation is the second most common valve disease in Europe [1]. This pathology is characterized by a leak in the mitral valve leading to retrograde blood leakage from the left ventricle to the left atrium during systole. Ring prosthetic annuloplasty is a surgical operation that seals the valve and stabilizes the repair, preventing recurrence of mitral regurgitation [2]. In this context, a model of cardiac tissue healing after anchoring surgical staples is sought. In three key steps: 1. Numerical modeling of the geometry of the mitral valve and its environment with computer-aided design (CAD) software. 2. Finite element (FE) simulations of the valve under hemodynamic loads and ventricular contractions. 3. Identification of the mechanical properties and behavior laws of the valve components. One perspective is to provide patient-specific staple geometries based on specific anatomical and pathological criteria.

## INTRODUCTION

From a clinical point of view, the mitral valve is described as a fibrous ring on which leaflets are located. These leaflets open and close, alternately allowing blood to circulate and stop between the atrium and the ventricle. The movement of the valve is determined by ventricular contractions transmitted to the leaflets by means of cords inserted into the papillary muscles of the myocardium.

Annuloplasty consists of reducing the diameter of the native mitral annulus and restoring its shape using a prosthetic ring – rigid on the anterior part and flexible on the posterior part of the ring [3]. The prosthetic ring is anchored in the cardiac tissues in the native annular zone.

The native annulus is a key structure for mitral valve repair. From a surgical point of view, it designates the atrioventricular junction and the boundary between the atrial tissue and the leaflets. Moreover, it does not represent any continuous histological reality because it is a complex structure composed of a mixture of fibrous, muscular and adipose tissues, of variable composition along the ring [2].

## METHODS

An anatomical scale mitral valve geometry (native annulus, leaflets, choardae) and its surroundings (myocardial tissue) are designed using computer-aided design (CAD)

software. Simultaneously, a macroscale geometry of the system {prosthetic ring sample, staple, myocardial sample} is designed. Numerical simulations with hemodynamic loads and loads due to ventricular contractions are carried out with the Abaqus software. The maximum pressure is felt in the aorta when the heart contracts and ejects blood into the aorta from the left ventricle (about 120 mmHg) [4]. We assume that the aortic valve surface is fixed at the maximum systolic pressure as the boundary condition. Two types of simulation are performed: static, with maximum loads and pressures applied to the system, and dynamic, with pulsatile loads.

The mechanical properties of the tissues in the area of the anchors are deduced from the stress state of the system obtained by numerical simulations. From the chosen damaged tissue model and the growth and remodeling model, we assess the loss of tissue integrity around the anchors.

## OVERVIEW

The weaker the mechanical properties of the tissue (Young's modulus, maximum tensile and compressive stress, density, elasticity), the more easily the anchors and the prosthetic ring will be released from the cardiac tissues and in particular from the native mitral ring.

From the chosen growth and remodeling model, we will evaluate the degradation of the mechanical properties of the tissues for a set of different anchorage geometries. A geometry adapted to the patient will depend on the characteristics of the patient (age, pathology, anatomical configuration of the mitral valve).

## REFERENCES

[1] Alexandrino, Cécile. « L'insuffisance mitrale fonctionnelle: analyse descriptive avec un logiciel de modélisation valvulaire en échocardiographie transoesophagienne tridimensionnelle », s. d., 80.

[2] Faletra, Francesco F, Laura Anna Leo, Vera Lucia Paiocchi, Alessandro Caretta, Giacomo Maria Viani, Susanne Anna Schlossbauer, Stefanos Demertzis, et Siew Yen Ho. « Anatomy of Mitral Annulus Insights from Non-Invasive Imaging Techniques ». European Heart Journal - Cardiovascular Imaging 20, nº 8 (1 août 2019): 843-57. https://doi.org/10.1093/ehjci/jez153.

[3] Carpentier, Alain. « Cardiac valve surgery - the “French correction” », 1983.

[4] Homan, Travis D., Stephen J. Bordes, et Erica Cichowski. « Physiology, Pulse Pressure ». In StatPearls. Treasure Island (FL): StatPearls Publishing, 2022. http://www.ncbi.nlm.nih.gov/books/NBK482408/.