The geometric properties of the mitral valve (MV), the valve controlling the inflow of blood to the left ventricle (LV), is a primary subject of study in clinical cardiology since its movements represent central points for differentiating physiological from pathological conditions. The ability of describing and modeling MV-LV dynamics is fundamental for improving MV repair surgical procedure. The realistic MV modeling is challenging for each individual patient because the mechanical properties of tissues are not accessible noninvasively, making a rigorous fluid-structure interaction approach not easily applicable in a clinical scenario. This study reformulates and extends a dynamic MV model for numerical simulation of LV flow based on diagnostic images recorded during clinical routine and compared it with in vivo recordings of the original valve obtained by highly accurate echocardiography which allowed the MV frame-by-frame recording. Results validate the model for clinical application and indicate that the dynamic of the MV during its opening and closure is primarily driven by the flow with negligible contribution from elastic resistance. The numerical model is then employed to provide preliminary analysis of the implications in terms of fluid dynamics of the corrective MV repair surgery. Results confirm that after mitral valve repair the regurgitant volume is drastically reduced, the intracavitary kinematic flow transit across the LV is restored to near-normal pattern but with substantial differences in terms of energetic terms and time course of hemodynamic forces. This study confirms the feasibility of integrating numerical models and clinical imaging technologies for clinical evaluation.
