# Numerical Simulation of the Mitral Valve Repair: A Pilot Model

Pigeon Tévy Julie, Pascale Kulisa, Benyebka Bousaïd

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

## To cite this version:

Pigeon Tévy Julie, Pascale Kulisa, Benyebka Bousaïd. Numerical Simulation of the Mitral Valve Repair: A Pilot Model. African Conference of Tribology, Apr 2025, Tunis, Tunisia. hal-05362456

HAL Id: hal-05362456

https://hal.science/hal-05362456v1

Submitted on 24 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_2.png" /></figure>

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

Julie Tévy 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.

## Biological context

The mitral valve is clinically described as a fibrous ring on which leaflets open and close, alternately allowing blood to circulate and stop between the atrium and the ventricle. The prosthetic ring is anchored in the cardiac tissues in the native annular zone. From a surgical point of view, it designates the atrioventricular junction and the boundary between the atrial tissue and the leaflets. Its structure is complex, composed of a mixture of fibrous, muscular and adipose tissues, of variable composition along the ring [1].

## 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 appropriate tangential friction coefficient 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.

## Results

<figure><img src="image_3.png" /><figcaption>Figure 1a: Designed prosthesis based on Carpentier patent. Figure 1b: Simulation of a biofaithfull mitral valve under ventricular contraction simulation.</figcaption></figure>

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, European Heart Journal - Cardiovascular Imaging, 30:100-107, 2019.

2. Purser et al., Ann of Biomed Eng, 39 367-377, 2011.

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).