Mitral and tricuspid valve mechanics
The Mitral Valve (MV) and the Tricuspid Valve (TV) are the two atrioventricular valves of the heart that control blood flow between the atria and the ventricles. During fetal growth, the valves form as a common atrioventricular valve from the endocardial cushions of the heart and separate in MV and TV as the septum starts growing at the atrial and ventricular levels.
Fig 1: Anatomy and Function of the Mitral and Tricuspid Valves
More than 3 million patients suffer from mitral and tricuspid valve regurgitation, due to primary causes such as degenerative valve disease or secondary etiologies such as ischemic heart disease and dilated cardiomyopathy. These different pathologies lead to abnormal closure of the valve and hence leakage, resulting in serious health problems leading to congestive heart failure.
Fig 2: Leakage Flows through the mitral valve as seen on color doppler imaging
Surgical repair is the procedure of choice over valve replacement, for such valvular failure. Mitral annuloplasty is the main procedure that is adopted for such valve repairs and is conducted with the patient on a cardio-pulmonary bypass. However, the durability of these repairs remains less than optimal with recurrence of valve leakage. This lack of durability is attributed to lack of understanding of the physiological and pathological mitral and tricuspid valve mechanics.
Fig 3: (a) Surgically repaired mitral valve (b) Replacement mechanical valve in the mitral position
To understand the native valve mechanics under normal, diseased and post surgical condition, we developed a novel in-vitro system called the " Georgia Tech Heart Simulator". Native mitral valves from different animals and humans can be mounted into this simulator and the valves can be tested under different hemodynamic conditions both normal and diseased. Several surgical procedures can be simulated and different clinically relevant parameters can be studied.
