Despite the advancement of cardiac imaging technologies, these have traditionally been limited to global geometrical measurements. Computational fluid dynamics (CFD) has emerged as a reliable tool that provides flow field information and other variables essential for the assessment of the cardiac function. Extensive studies have shown that vortex formation and propagation during the filling phase acts as a promising indicator for the diagnosis of the cardiac health condition. Proper setting of the boundary conditions is crucial in a CFD study as they are important determinants, that affect the simulation results. In this article, the effect of different transmitral velocity profiles (parabolic and uniform profile) on the vortex formation patterns during diastole was studied in a ventricle with dilated cardiomyopathy (DCM). The resulting vortex evolution pattern using the uniform inlet velocity profile agreed with that reported in the literature, which revealed an increase in thrombus risk in a ventricle with DCM. However the application of a parabolic velocity profile at the inlet yields a deviated vortical flow pattern and overestimates the propagation velocity of the vortex ring towards the apex of the ventricle. This study highlighted that uniform inlet velocity profile should be applied in the study of the filling dynamics in a left ventricle because it produces results closer to that observed experimentally.
Repair of the mitral valve is defined (loosely) as a procedure that alters the valve structure, without replacement, enabling the natural valve itself to continue to perform under the physical conditions to which it is exposed. As the mitral valve is driven by flow and pressure, it should be feasible to analyse and assess its function, failure and repair as a mechanical system. This article reviews the current state of mechanical evaluation of surgical repairs of the failed mitral valve of the heart. This review describes the anatomy and physiology of the mitral valve, followed by the failure of the mitral valve from a mechanical point of view. The surgical methods used to repair failed valves are introduced, while the use of engineering analysis to aid understanding of mitral valve repair is also reviewed. Finally, a section on recommendations for development and future uses of engineering techniques to surgical repair are presented.
Mitral valve repair is perceived to be of limited durability for advanced rheumatic disease in adults. We aim to examine the long-term outcomes of repair for rheumatic disease, identify predictors of durability, and compare with repair for degenerative disease.