Image-based simulation of mitral valve dynamic closure including anisotropy.

Simulation of the dynamic behavior of mitral valve closure could improve clinical treatment by predicting surgical procedures outcome. We propose here a method to achieve this goal by using the immersed boundary method. In order to go towards patient-based simulation, we tailor our method to be adapted to a valve extracted from medical image data. It includes investigating segmentation process, smoothness of geometry, case setup and the shape of the left ventricle. We also study the influence of leaflet tissue anisotropy on the quality of the valve closure by comparing with an isotropic model. As part of the anisotropy analysis, we study the influence of the principal material direction by comparing methods to obtain them without dissection. Results show that our method can be scaled to various image-based data. We evaluate the mitral valve closure quality based on measuring bulging area, contact map, and flow rate. The results show also that the anisotropic material model more precisely represents the physiological characteristics of the valve tissue. Furthermore, results indicate that the orientation of the principal material direction plays a role in the effectiveness of the valve seal.