Left Ventricular Remodelling
Research type
Research Study
Full title
Left Ventricular Remodelling Following Mitral Valve Implantation
IRAS ID
304202
Contact name
Sotirios Korossis
Contact email
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
0 years, 5 months, 1 days
Research summary
Any of the heart valves may become either so stenotic or regurgitant that needs to be replaced. Regardless of the nature and underlying cause of valvular dysfunction, surgeons are confronted with a difficult decision regarding the choice of the optimum replacement prosthesis for the individual patient. Current prostheses are imperfect and subject patients to risks, including thrombosis, calcification, abnormal haemodynamics, prosthesis mismatch, and cardiac remodelling, which can only be realised postoperatively. These complications vary between patients and lead to dangerous re-operations. More personalised interventions could significantly improve clinical outcomes by prolonging prosthesis survival and alleviating reoperations. Currently, the post-operative phase is largely unpredictable, whilst current practices are based on “one-size-fits-all” and “trial-and-error”, mainly due to the lack of cost-effective, realistic, and multi-parameter preoperative models that can reliably predict post-operative performance of valve prostheses.
This project will develop a computational modelling platform for interrogating post-operative mitral valve (MV) prosthesis performance and left ventricular remodelling and adaptation, using computational fluid dynamics (CFD), finite element analysis (FEA), fluid-solid interaction (FSI) and electrophysiological modelling. The project will develop a novel prognostic/forecasting tool that will enable cardiac surgeons to make patient-specific preoperative decisions for optimising valve replacement. The optimisation will be based on patient-specific parameters, whilst the prognosis will be based on forecasted postoperative haemodynamics biomechanics and ventricular adaptation/remodelling of the left heart. Using the validated database of patients at Royal Brompton and Harefield hospitals, this project will utilise the pre- and post-operative computed tomography (CT) angiography images of patients who have undergone MV replacement. The 3D patient-specific geometries of the left heart will be reconstructed from the 3D angiography images and will be coupled with the patient’s blood pressure/flow parameters to produce clinically relevant simulations that will enable to assess and compare the left heart anatomy and haemodynamic performance prior and after MV replacement.REC name
West Midlands - Black Country Research Ethics Committee
REC reference
24/WM/0123
Date of REC Opinion
11 Jun 2024
REC opinion
Further Information Favourable Opinion