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Patient-Specific Finite Element Analysis of Heart Failure and the Impact of Surgical Intervention in Pulmonary Hypertension Secondary to Mitral Valve Disease Publisher Pubmed



Heidari A1, 2 ; Elkhodary KI3 ; Pop C4 ; Badran M5 ; Vali H2 ; Abdelraouf YMA3 ; Torbati S6 ; Asgharian M7 ; Steele RJ7 ; Mahmoudzadeh Kani I8 ; Sheibani S2 ; Pouraliakbar H9 ; Sadeghian H10, 11 ; Cecere R1, 12 Show All Authors
Authors
  1. Heidari A1, 2
  2. Elkhodary KI3
  3. Pop C4
  4. Badran M5
  5. Vali H2
  6. Abdelraouf YMA3
  7. Torbati S6
  8. Asgharian M7
  9. Steele RJ7
  10. Mahmoudzadeh Kani I8
  11. Sheibani S2
  12. Pouraliakbar H9
  13. Sadeghian H10, 11
  14. Cecere R1, 12
  15. Friedrich MGW13
  16. Tafti HA10, 11
Show Affiliations
Authors Affiliations
  1. 1. Department of Mechanical Engineering, McGill University, 817 Sherbrooke Street West, Montreal, H3A 0C3, QC, Canada
  2. 2. Department of Anatomy & Cell Biology, McGill University, Montreal, QC, Canada
  3. 3. Department of Mechanical Engineering, American University in Cairo, New Cairo, 11835, Egypt
  4. 4. Faculty of Medicine, McGill University, Montreal, QC, Canada
  5. 5. Department of Mechanical Engineering, Future University in Egypt, New Cairo, Egypt
  6. 6. School of Mechanical Engineering, College of Engineering, University of Tehran, Tehran, Iran
  7. 7. Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada
  8. 8. School of Civil Engineering, College of Engineering, University of Tehran, Tehran, Iran
  9. 9. Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
  10. 10. Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran
  11. 11. Department of Surgery, Tehran Heart Center, Tehran, Iran
  12. 12. Department of Surgery, Royal Victoria Hospital, McGill University Health Centre, Montreal, QC, Canada
  13. 13. Departments of Medicine and Diagnostic Radiology, McGill University, Montreal, QC, Canada

Source: Medical and Biological Engineering and Computing Published:2022


Abstract

Pulmonary hypertension (PH), a chronic and complex medical condition affecting 1% of the global population, requires clinical evaluation of right ventricular maladaptation patterns under various conditions. A particular challenge for clinicians is a proper quantitative assessment of the right ventricle (RV) owing to its intimate coupling to the left ventricle (LV). We, thus, proposed a patient-specific computational approach to simulate PH caused by left heart disease and its main adverse functional and structural effects on the whole heart. Information obtained from both prospective and retrospective studies of two patients with severe PH, a 72-year-old female and a 61-year-old male, is used to present patient-specific versions of the Living Heart Human Model (LHHM) for the pre-operative and post-operative cardiac surgery. Our findings suggest that before mitral and tricuspid valve repair, the patients were at risk of right ventricular dilatation which may progress to right ventricular failure secondary to their mitral valve disease and left ventricular dysfunction. Our analysis provides detailed evidence that mitral valve replacement and subsequent chamber pressure unloading are associated with a significant decrease in failure risk post-operatively in the context of pulmonary hypertension. In particular, right-sided strain markers, such as tricuspid annular plane systolic excursion (TAPSE) and circumferential and longitudinal strains, indicate a transition from a range representative of disease to within typical values after surgery. Furthermore, the wall stresses across the RV and the interventricular septum showed a notable decrease during the systolic phase after surgery, lessening the drive for further RV maladaptation and significantly reducing the risk of RV failure. Graphical abstract: [Figure not available: see fulltext.] © 2022, International Federation for Medical and Biological Engineering.
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