Mitral valve (MV) asymmetry in the left ventricle causes a large anterior vortex during left ventricle (LV) filling which is considered to store kinematic energy. This vortex persists in the end of diastole and may facilitate early closure of the mitral valve and transfer kinetic energy in the anterior vortex to help blood ejection through the aortic valve. Washout effect from the anterior vortex may prevent thrombosis in the left ventricle. Recently one of the repair techniques, the mitral valve edge-to-edge repair (ETER) procedure, has been used for the correction of mitral regurgitation. According to this procedure, MV’s competence is restored by suturing the edges of the leaflets, at the central, lateral or commissural position, depending on the mechanism of the regurgitation and the site of valvular lesions. Changes in the mitral valve geometry, due to ETER, alter LV fluid mechanics. Our group has investigated suture length effect on LV fluid mechanics. MV ETER increased energy loss and lowered LV filling efficiency. The larger orifice area after ETER might prevent significant energy loss and transmitral pressure drop during diastole. However, suture position effect is unknown. In this study, we aim to investigate the effect of different MV suture position on LV fluid mechanics, especially the vortex, LV pumping efficiency.

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