  Atrioventricular valve regurgitation is a significant cause of morbidity and
mortality in patients with acquired and congenital cardiac valve disease.
Image-derived computational modeling of atrioventricular valves has advanced
substantially over the last decade and holds particular promise to inform valve
repair in small and heterogeneous populations which are less likely to be
optimized through empiric clinical application. While an abundance of
computational biomechanics studies have investigated mitral and tricuspid valve
disease in adults, few studies have investigated application to vulnerable
pediatric and congenital heart populations. Further, to date, investigators
have primarily relied upon a series of commercial applications that are neither
designed for image-derived modeling of cardiac valves, nor freely available to
facilitate transparent and reproducible valve science. To address this
deficiency, we aimed to build an open-source computational framework for the
image-derived biomechanical analysis of atrioventricular valves. In the present
work, we integrated an open-source valve modeling platform, SlicerHeart, and an
open-source biomechanics finite element modeling software, FEBio, to facilitate
image-derived atrioventricular valve model creation and finite element
analysis. We present a detailed verification and sensitivity analysis to
demonstrate the fidelity of this modeling in application to 3D
echocardiography-derived pediatric mitral and tricuspid valve models. Our
analyses achieved excellent agreement with those reported in the literature. As
such, this evolving computational framework offers a promising initial
foundation for future development and investigation of valve mechanics, in
particular collaborative efforts targeting the development of improved repairs
for children with congenital heart disease.
