13th International Conference on Fracture June 16–21, 2013, Beijing, China -9- Acknowledgments The authors wish to express their gratitude to the Instituto de Formación e Investigación Marqués de Valdecilla (IFIMAV) for their funding of the research. Moreover, the participation of J.M. Icardo was supported by grant CGL2008-04559/BOS from the Ministerio de Educación y Ciencia. References [1] Anyanwu, A.C., Bridgewater, B., Adams, D.H. 2010. The lottery of mitral valve repair surgery. Heart 96, 1964-1967. [2] Carpentier, A., Chauvaud, S., Fabiani, J.N., et al., 1980. Reconstructive surgery of mitral valve incompetence: ten-year appraisal. J Thorac Cardiovasc Surg. 79, 338-348. [3] David, T.E., Burns, R.J., Bacchus, C.M., Druck, M.N., 1984. Mitral valve replacement for mitral regurgitation with and without preservation of chordae tendineae. J Thorac Cardiovasc Surg, 88 (5 Pt 1): 718-25. [4] Edmunds, L.H. Jr., 1997. Cardiac surgery in the adult. McGraw-Hill. New York. [5] Fratzl, P., Misof, K., Zizak, I., Rapp, G., Amenitsch, H., Bernstorff, S.,1998. Fibrillar structure and mechanical properties of collagen. J. Struct.Biol. 122, 119-122. [6] Fulkerson, P.K., Beaver, B.M., Auseon, J.C., Graber, H.L.,1979. Calcification of the mitral annulus: etiology, clinical associations, complications and therapy. Am J Med. 66, 967. [7] Fung, Y.C., 1993. Biomechanics. Mechanical properties of living tissues. Springer. [8] He, S., Weston, M.W., Lemmon, J., Jensen, M., Levine, R.A., Yoganathan, A.P., 2000. Geometric distribution of chordae tendineae: an important anatomic feature in mitral valve function. Journal of Heart Valve Disease 9. 4, 495–503. [9] ISO 7980:1986. Water quality. Determination of calcium and magnesium. Atomic absorption spectrometric method. [10] Jimenez, J.H., He, S., Soerensen, D.D., He, Z., Yoganathan, A.P., 2003. Effects of a Saddle Shaped Annulus on Mitral Valve Function and Chordal Force Distribution: An In Vitro Study. Annals of Biomedical Engineering. 31(10), 1171-1181. [11] Jimenez, J.H., Soerensen, D.D., He, Z., Ritchie, J., Yoganathan, A.P, 2005. Mitral valve function and chordal force distribution using a flexible annulus model: an in vitro study. Annals of Biomedical Engineering. 33, 557-566. [12] Kunzelman, K.S., Cochran, R.P., 1990. Mechanical properties of basal and marginal mitral valve chordae tendineae. ASAIO Transactions 36 (3), M405–408. [13] Lam, J.H.C., Ranganathan, N., Wigle, E.D., Silver, M.D., 1970. Morphology of the human mitral valve chordae tendineae: a new classification. Circulation XLI, 449-458. [14] Lim, K.O., Boughner, D.R., 1975. Mechanical properties of human mitral valve chordae tendineae: variation with size and strain rate. Canadian Journal of Physiology. 53, 330–339. [15] Lim, K.O., Boughner, D.R., 1976. Morphology and relationship to extensibility curves of human mitral valve chordae tendineae. Circulation Research 39, 580–585. [16] Lomholt, M., Nielsen, S.L., Hansen, S.B., Andersen, N.T., Hasenkam, J.M., 2002. Differential tension between secondary and primary mitral chordae in an acute in-vivo porcine model. Journal of Heart Valve Disease. 11 (3), 337–345. [17] Millington-Sanders, C., Meir, A., Lawrence, L., Stolinski, C., 1998. Structure of chordae tendineae in the left ventricle of the human heart. Journal of Anatomy. 192, 573-581. [18] Nair, C.K., Aronow, W.S., Stokke, K., Mohiuddin, S.M., Thomson, W., Sketch, M.H., 1984. Cardiac conduction defects in patients older than 60 years with aortic stenosis with and without mitral anular calcium. Am J Cardiol. 53, 169–172. [19] Nair, C.K., Sketch, M.H., Ahmed, I., Thomson, W., Ryschon, K., Woodruff, M.P., et al., 1987. Calcific valvular aortic stenosis with and without mitral annular calcium. Am J Cardiol. 60,
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