ArticlePloS one2019
Mechanical effects of MitraClip on leaflet stress and myocardial strain in functional mitral regurgitation - A finite element modeling study.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
16 citing papers in PubMed, 24 citations in OpenAlex.
- Simulation of Transcatheter Therapies for Atrioventricular Valve Regurgitation in an Open-Source Finite Element Simulation Framework.Annals of biomedical engineering · 2026Article
- Tricuspid valve edge-to-edge repair simulations are highly sensitive to annular boundary conditions.Journal of the mechanical behavior of biomedical materials · 2025Article
- Simulated Effects of Acute Left Ventricular Myocardial Infarction on Mitral Regurgitation in an Ovine Model.Journal of biomechanical engineering · 2024Article
- Utilization of Engineering Advances for Detailed Biomechanical Characterization of the Mitral-Ventricular Relationship to Optimize Repair Strategies: A Comprehensive Review.Bioengineering (Basel, Switzerland) · 2023Review
- Looking towards the future: patient-specific computational modeling to optimize outcomes for transcatheter mitral valve repair.Frontiers in cardiovascular medicine · 2023Review
- Relative Impact of Surgical Mitral Repair and MitraClip on Annular Remodeling-A Potential Mechanism for Therapeutic Response to Mitral Repair for Degenerative Mitral Regurgitation.Journal of cardiothoracic and vascular anesthesia · 2022Observational
- Commentary: Mitral valve edge-to-edge repair is still a simple solution for complex diseases.JTCVS techniques · 2022Article
- Recurrent mitral regurgitation with haemolytic anaemia after MitraClip procedure: an autopsy case report.European heart journal. Case reports · 2022Article
- A Simulation Study of the Effects of Number and Location of MitraClips on Mitral Regurgitation.JACC. Advances · 2022Article
- State-of-the-art intra-procedural imaging for the mitral and tricuspid PASCAL Repair System.European heart journal. Cardiovascular Imaging · 2022Review
- Precision medicine in human heart modeling : Perspectives, challenges, and opportunities.Biomechanics and modeling in mechanobiology · 2021Review
- Mitral Valve Atlas for Artificial Intelligence Predictions of MitraClip Intervention Outcomes.Frontiers in cardiovascular medicine · 2021Article
- Leaflet Injuries After Percutaneous Edge-to-Edge Repair: A Challenge to Avoid.JACC. Case reports · 2021Article
- A Comprehensive Engineering Analysis of Left Heart Dynamics After MitraClip in a Functional Mitral Regurgitation Patient.Frontiers in physiology · 2020Article
- Transcatheter MitraClip repair alters mitral annular geometry - device induced annular remodeling on three-dimensional echocardiography predicts therapeutic response.Cardiovascular ultrasound · 2019Article
- Transcatheter Mitral Valve Repair to Treat Postmyocardial Infarction Papillary Muscle Rupture.Journal of cardiovascular echographyArticle
Corrections and comments
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Authors and funding
11 authors at 5 institutions in 1 country.
Funding
Abstract
purposeMitraClip is the sole percutaneous device approved for functional mitral regurgitation (MR; FMR) but MR recurs in over one third of patients. As device-induced mechanical effects are a potential cause for MR recurrence, we tested the hypothesis that MitraClip increases leaflet stress and procedure-related strain in sub-valvular left ventricular (LV) myocardium in FMR associated with coronary disease (FMR-CAD).
methodsSimulations were performed using finite element models of the LV + mitral valve based on MRI of 5 sheep with FMR-CAD. Models were modified to have a 20% increase in LV volume (↑LV_VOLUME) and MitraClip was simulated with contracting beam elements (virtual sutures) placed between nodes in the center edge of the anterior (AL) and posterior (PL) mitral leaflets. Effects of MitraClip on leaflet stress in the peri-MitraClip region of AL and PL, septo-lateral annular diameter (SLAD), and procedure-related radial strain (Err) in the sub-valvular myocardium were calculated.
resultsMitraClip increased peri-MitraClip leaflet stress at end-diastole (ED) by 22.3±7.1 kPa (p<0.0001) in AL and 14.8±1.2 kPa (p<0.0001) in PL. MitraClip decreased SLAD by 6.1±2.2 mm (p<0.0001) and increased Err in the sub-valvular lateral LV myocardium at ED by 0.09±0.04 (p<0.0001)). Furthermore, MitraClip in ↑LV_VOLUME was associated with persistent effects at ED but also at end-systole where peri-MitraClip leaflet stress was increased in AL by 31.9±14.4 kPa (p = 0.0268) and in PL by 22.5±23.7 kPa (p = 0.0101).
conclusionsMitraClip for FMR-CAD increases mitral leaflet stress and radial strain in LV sub-valvular myocardium. Mechanical effects of MitraClip are augmented by LV enlargement.
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