Immersogeometric fluid-structure interaction modeling of the human mitral valve and transcatheter edge-to-edge repair
Abstract
Transcatheter edge-to-edge repair (TEER) treats mitral regurgitation with a clip that grasps and coapts the mitral valve (MV) leaflets. Predicting its outcome requires resolving the interaction between the blood flow and the complete MV apparatus, in which highly deformable leaflets and chordae tendineae undergo large deformation and complex contact. In this work, we introduce an immersogeometric fluid-structure interaction (FSI) formulation in which the coupling among the valvular components, the surrounding flow, and the repair is enforced weakly, without requiring conforming discretizations. A fully parameterized reconstruction pipeline is developed to convert segmented images into analysis-ready isogeometric meshes. The leaflets and chordae are modeled as Kirchhoff-Love shells and cables, and the shell formulation is modified to include an in-vivo prestrain tensor that accounts for the loading already present in the imaged geometry. We propose a subcell approach that improves the quadrature for the interfacial constraint and eliminates the over-refinement otherwise needed to prevent unphysical leakage through the leaflets. The MV repair is modeled by a penalty formulation that enforces leaflet coaptation over a prescribed region, allowing clip number and placement to be varied without remeshing or modeling the device. A lumped-parameter model at the outflow tract of the left heart imposes a flow-dependent pressure rather than a prescribed waveform, so that the split between forward and regurgitant flow matches physiological behavior. We validate the reconstruction against the segmented imaging data, demonstrate mesh convergence of the proposed formulations, and apply the framework to a prolapsed MV and its single- and double-clip repairs to quantify pre- and post-operative changes in valve dynamics and left-heart hemodynamics.
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BibTeX
@misc{kim2026immersogeometric,
title = {{Immersogeometric fluid-structure interaction modeling of the human mitral valve and transcatheter edge-to-edge repair}},
author = {Keon Ho Kim and Ashton M. Corpuz and Monu Jaiswal and Michael S. Sacks and Ming-Chen Hsu},
howpublished = {arXiv},
year = {2026},
month = sep,
doi = {10.48550/arxiv.2609.34209},
eprint = {2609.34209},
archivePrefix = {arXiv},
url = {https://arxiv.org/abs/2609.34209},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - UNPB
TI - Immersogeometric fluid-structure interaction modeling of the human mitral valve and transcatheter edge-to-edge repair
AU - Keon Ho Kim
AU - Ashton M. Corpuz
AU - Monu Jaiswal
AU - Michael S. Sacks
AU - Ming-Chen Hsu
PY - 2026
DA - 2026/09/28
PB - arXiv
DO - 10.48550/arxiv.2609.34209
UR - https://arxiv.org/abs/2609.34209
AB - Transcatheter edge-to-edge repair (TEER) treats mitral regurgitation with a clip that grasps and coapts the mitral valve (MV) leaflets. Predicting its outcome requires resolving the interaction between the blood flow and the complete MV apparatus, in which highly deformable leaflets and chordae tendineae undergo large deformation and complex contact. In this work, we introduce an immersogeometric fluid-structure interaction (FSI) formulation in which the coupling among the valvular components, the surrounding flow, and the repair is enforced weakly, without requiring conforming discretizations. A fully parameterized reconstruction pipeline is developed to convert segmented images into analysis-ready isogeometric meshes. The leaflets and chordae are modeled as Kirchhoff-Love shells and cables, and the shell formulation is modified to include an in-vivo prestrain tensor that accounts for the loading already present in the imaged geometry. We propose a subcell approach that improves the quadrature for the interfacial constraint and eliminates the over-refinement otherwise needed to prevent unphysical leakage through the leaflets. The MV repair is modeled by a penalty formulation that enforces leaflet coaptation over a prescribed region, allowing clip number and placement to be varied without remeshing or modeling the device. A lumped-parameter model at the outflow tract of the left heart imposes a flow-dependent pressure rather than a prescribed waveform, so that the split between forward and regurgitant flow matches physiological behavior. We validate the reconstruction against the segmented imaging data, demonstrate mesh convergence of the proposed formulations, and apply the framework to a prolapsed MV and its single- and double-clip repairs to quantify pre- and post-operative changes in valve dynamics and left-heart hemodynamics.
ER -