Impact of Secondary Chordal Cutting on Mitral Valve Closure and Chordal Force Distribution in an Ischemic Dilated Ventricle: Engineering Insight and Clinical Implications

The Mitral Valve (MV) is the left atrioventricular valve that controls blood flow between the left atrium and the left ventricle (Fig 1A-B). It has four main components: (i) the mitral annulus – a fibromuscular ring at the base of the left atrium and the ventricle; (ii) two collagenous planar leaflets – anterior and posterior; (iii) web of chordae tendineae – classified into primary (inserting at the free edge of the leaflet), secondary (inserting into the base of the leaflet), tertiary (inserting into the annulus); and (iv) two papillary muscles that are part of the left ventricle. Normal function of the mitral valve involves a delicate force balance between different components of the valve.