Fatigue exhaustion of the mitral valve tissue
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Sudden failure and rupture of the tissue is a rare but serious short-term complication after the mitral valve surgical repair. Excessive cyclic loading on the suture line of the repair can progressively damage the surrounding tissue and finally cause tissue rupture. Moreover, mechanical over-tension, which occurs in a diseased mitral valve, gradually leads to tissue floppiness, mitral annular dilation, and leaflet rupture. In this work, the rupture mechanics of mitral valve is studied by characterizing the fracture toughness exhaustion of healthy tissue. Results of this study show that fracture toughness of the posterior mitral valve is lower than its anterior counterpart, indicating that posterior tissue is more prone to failure. Moreover, the decrease in fracture toughness by increasing the number of fatigue cycles shows that excessive mechanical loading leads to progressive failure and rupture of mitral valve tissue within a damage accumulative process.
KeywordsFracture toughness Tissue rupture Mitral valve Suture failure Percutaneous annuloplasty
We wish to thank Mr. Boby Chu for the design and fabrication of the fatigue and the fracture toughness devices and Dr. Amir K. Miri Ramsheh for helping us to set up and to calibrate the devices. We also thank NSERC, Canada’s Natural Sciences and Engineering Research Council, and FRQNT, Quebec’s Fonds de recherche du Québec Nature et Technologies, for their financial support.
Compliance with ethical standards
Conflict of interest
There is no conflict of interest for any author related to this article.
- Agricola E, Oppizzi M, Maisano F, De Bonis M, Schinkel AF, Torracca L, Margonato A, Melisurgo G, Alfieri O (2004) Echocardiographic classification of chronic ischemic mitral regurgitation caused by restricted motion according to tethering pattern. Circulation 5:326Google Scholar
- Alfieri O, De Bonis M (2012) Repair options for mitral regurgitation. Interv Cardiol (London) 7(2):131Google Scholar
- Azar T, Hayward V (2008) Estimation of the fracture toughness of soft tissue from needle insertion. In: Bello F, Edwards E (eds) Biomedical simulation. Lecture notes in computer science, vol 5104. Springer, Phoenix, AZ, pp 166–175Google Scholar
- Bellucci G, Seedhom BB (2002) Tensile fatigue behavior of articular cartilage. Biorheology 39(1–2):193Google Scholar
- Boron W, Boulpaen E (2005) Medical physiology: a cellular and molecular approach. Elsevier Saunders, PhiladelphiaGoogle Scholar
- Chanthasopeephan T, Desai J, Lau A (2006) Determining fracture characteristics in scalpel cutting of soft tissue. In: The first IEEE/RAS-EMBS international conference on biomedical robotics and biomechatronics, BioRob 2006, pp 899–904Google Scholar
- Chin-Purcell MV, Lewis JL (1996) Fracture of articular cartilage. J Biomech Eng 118:545556Google Scholar
- Cohen R, Zimber M, Hansbrough JF, Fung YC, Debes J, Skalak R (1991) Tear strength properties of a novel cultured dermal tissue model. Ann Biomed Eng 19(5):600–601Google Scholar
- Gilpin C (2005) Cyclic loading of porcine coronary arteries. Master’s Thesis, Georgia Institute of Technology, AtlantaGoogle Scholar
- Paris PC, Gomez MP, Anderson WE (1961) A rational analytic theory of fatigue. Trend Eng 13(1):9Google Scholar
- Quick DW, Kunzelman KS, Kneebone JM, Cochran RP (1997) Collagen synthesis is upregulated in mitral valves subjected to altered stress. ASAIO J (American Society for Artificial Internal Organs: 1992) 43(3):181Google Scholar