Patient-specific finite element analysis of heart failure and the impact of surgical intervention in pulmonary hypertension secondary to mitral valve disease

Alireza Heidari, Department of Mechanical Engineering, McGill University, 817 Sherbrooke Street West, Montreal, QC, H3A 0C3, Canada. alireza.heidari@mcgill.ca.
Khalil I. Elkhodary, Department of Mechanical Engineering, American University in Cairo, New Cairo, 11835, Egypt.
Cristina Pop, Faculty of Medicine, McGill University, Montreal, QC, Canada.
Mohamed Badran, Department of Mechanical Engineering, Future University in Egypt, New Cairo, Egypt.
Hojatollah Vali, Department of Anatomy & Cell Biology, McGill University, Montreal, QC, Canada.
Yousof M. Abdel-Raouf, Department of Mechanical Engineering, American University in Cairo, New Cairo, 11835, Egypt.
Saeed Torbati, School of Mechanical Engineering, College of Engineering, University of Tehran, Tehran, Iran.
Masoud Asgharian, Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada.
Russell J. Steele, Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada.
Iradj Mahmoudzadeh Kani, School of Civil Engineering, College of Engineering, University of Tehran, Tehran, Iran.
Sara Sheibani, Department of Anatomy & Cell Biology, McGill University, Montreal, QC, Canada.
Hamidreza Pouraliakbar, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Hakimeh Sadeghian, Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran.
Renzo Cecere, Department of Mechanical Engineering, McGill University, 817 Sherbrooke Street West, Montreal, QC, H3A 0C3, Canada.
Matthias G. Friedrich, Departments of Medicine and Diagnostic Radiology, McGill University, Montreal, QC, Canada.
Hossein Ahmadi Tafti, Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran.

Second Author's Department

Mechanical Engineering Department

Fifth Author's Department

Mechanical Engineering Department

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https://doi.org/10.1007/s11517-022-02556-6

Document Type

Research Article

Publication Title

Medical & biological engineering & computing

Publication Date

6-1-2022

doi

10.1007/s11517-022-02556-6

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.

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1723

Last Page

1744

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