Detailed anatomical study supported the concept of mediocranial MU repositioning during corrective surgery, although the impact is minor to the levator muscle's action. Future mathematical models describing effects of such a maneuver should integrate surrounding structures.

Purpose Decision support systems for mitral valve disease are an important step toward personalized surgery planning. A simulation of the mitral valve apparatus is required for decision support. Building a model of the chordae tendineae is an essential component of a mitral valve simulation. Due to image quality and artifacts, the chordae tendineae cannot be reliably detected in medical imaging. Methods Using the position-based dynamics framework, we are able to realistically simulate the opening and closing of the mitral valve. Here, we present a heuristic method for building an initial chordae model needed for a successful simulation. In addition to the heuristic, we present an interactive editor to refine the chordae model and to further improve pathology reproduction as well as geometric approximation of the closed valve. Results For evaluation, five mitral valves were reconstructed based on image sequences of patients scheduled for mitral valve surgery. We evaluated the approximation of the closed valves using either just the heuristic chordae model or a manually refined model. Using the manually refined models, prolapse was correctly reproduced in four of the five cases compared to two of the five cases when using the heuristic. In addition, using the editor improved the approximation in four cases. Conclusions Our approach is suitable to create realistically parameterized mitral valve apparatus reconstructions for the simulation of normally and abnormally closing valves in a decision support system.

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Cleft lip and palate reconstruction should reasonably use the uvular muscle to augment the velar midline bulk. Uvular muscle deformation calculation was successful, permitting functional insight on the basis of microanatomical specimens, so far a bigger complete velar model can be ventured.

The occlusional performance of sole endoluminal stenting of intracranial aneurysms is controversially discussed in the literature. Simulation of blood flow has been studied to shed light on possible causal attributions. The outcome, however, largely depends on the numerical method and various free parameters. The present study is therefore conducted to find ways to define parameters and efficiently explore the huge parameter space with finite element methods (FEMs) and lattice Boltzmann methods (LBMs). The goal is to identify both the impact of different parameters on the results of computational fluid dynamics (CFD) and their advantages and disadvantages. CFD is applied to assess flow and aneurysmal vorticity in 2D and 3D models. To assess and compare initial simulation results, simplified 2D and 3D models based on key features of real geometries and medical expert knowledge were used. A result obtained from this analysis indicates that a combined use of the different numerical methods, LBM for fast exploration and FEM for a more in-depth look, may result in a better understanding of blood flow and may also lead to more accurate information about factors that influence conditions for stenting of intracranial aneurysms.

To achieve the best treatment of mitral valve disease in a patient, surgeons aim to optimally combine complementary surgical techniques. Image‐based in silico simulation as well as visualization of the mitral valve dynamics can support the visual analysis of the patient‐specific valvular dynamics and enable an exploration of different therapy options. The usage in a time‐constrained clinical environment requires a mitral valve model that is cost‐effective, easy to set up, parameterize and evaluate. Working towards this goal, we develop a simplified model of the mitral valve and analyse its applicability for the sketched use‐case. We propose a novel approach to simulate the mitral valve with position‐based dynamics. The resulting mitral valve model can be deformed to simulate the closing and opening, and incorporate changes caused by virtual interventions in the simulation. Ten mitral valves were reconstructed from transesophageal echocardiogram sequences of patients with normal and abnormal physiology for evaluation. Simulation results showed good agreements with expert annotations of the original image data and reproduced valve closure in all cases. In four of five pathological cases, abnormal closing behaviour was correctly reproduced. In future research, we aim to improve the parameterization of the model in terms of biomechanical correctness and perform a more extensive validation.

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We present a novel approach to simulate deformation in aortic valve replacement scenarios with applications in operation planning and batch domain creation for large computational fluid dynamics studies of the aortic arch.