Many surgeons have come to view mitral valve (MV) repair as the treatment of choice in patients with mitral regurgitation (MR) [1]. However, recent long-term studies have indicated that the recurrence of significant MR after repair may be much higher than previously believed, particularly in patients with (ischemic mitral regurgitation) IMR [2]. Since a significant number of these failures result from chordal, leaflet and suture line disruption, it has been suggested that excessive tissue stress and the resulting strain-induced tissue damage are important etiologic factors. We thus hypothesize that the restoration of homeostatic normal MV leaflet tissue stress levels in IMR repair techniques ultimately leads to improved repair durability through restoration of normal MV responses. Therefore, the objective of this study is to develop a novel high-fidelity and micro-anatomically accurate 3D finite element (FE) model that incorporates detailed collagen fiber architecture, realistic constitutive models, and micro-anatomically accurate valvular geometry to connect the cellular function of the MV tissues with the organ level mechanical responses, and to aid in the design of MV repair procedures.

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