Comparison of hemodynamics in biological surgical aortic valve replacement and transcatheter aortic valve implantation: An in‐silico study

Franke, Benedikt; Schlief, Adriano; Walczak, Lars; Sündermann, Simon H.; Unbehaun, Axel; Kempfert, Jörg; Solowjowa, Natalia; Kühne, Titus; Goubergrits, Leonid

doi:10.1111/aor.14405

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References 31 publications

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“…In-silico studies are common in research of pathologies affecting the pulmonary artery, such as pulmonary stenosis and pulmonary hypertension ( 20 – 22 ). Numerical assessment of medical devices, either by investigating implantation procedures using finite element modelling or hemodynamic device efficacy using CFD is also common ( 23 – 25 ). However, so far no studies investigating the effects of PAPS devices on the intra-arterial hemodynamics were published for either of the existing systems as indicated by a literature research in PubMed using the terms “pulmonary artery pressure sensor,” “in-silico,” “Cordella,” “CardioMEMS,” “CFD,” “hemodynamics” on 1st of March 2023.…”

Section: Discussionmentioning

confidence: 99%

In-silico enhanced animal study of pulmonary artery pressure sensors: assessing hemodynamics using computational fluid dynamics

Brüning,

Yevtushenko,

Schlief

et al. 2023

Front. Cardiovasc. Med.

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To assess whether in-silico models can be used to predict the risk of thrombus formation in pulmonary artery pressure sensors (PAPS), a chronic animal study using pigs was conducted. Computed tomography (CT) data was acquired before and immediately after implantation, as well as one and three months after the implantation. Devices were implanted into 10 pigs, each one in the left and right pulmonary artery (PA), to reduce the required number of animal experiments. The implantation procedure aimed at facilitating optimal and non-optimal positioning of the devices to increase chances of thrombus formation. Eight devices were positioned non-optimally. Three devices were positioned in the main PA instead of the left and right PA. Pre-interventional PA geometries were reconstructed from the respective CT images, and the devices were virtually implanted at the exact sites and orientations indicated by the follow-up CT after one month. Transient intra-arterial hemodynamics were calculated using computational fluid dynamics. Volume flow rates were modelled specifically matching the animals body weights. Wall shear stresses (WSS) and oscillatory shear indices (OSI) before and after device implantation were compared. Simulations revealed no relevant changes in any investigated hemodynamic parameters due to device implantation. Even in cases, where devices were implanted in a non-optimal manner, no marked differences in hemodynamic parameters compared to devices implanted in an optimal position were found. Before implantation time and surface-averaged WSS was 2.35±0.47 Pa, whereas OSI was 0.08±0.17, respectively. Areas affected by low WSS magnitudes were 2.5±2.7 cm2, whereas the areas affected by high OSI were 18.1±6.3 cm2. After device implantation, WSS and OSI were 2.45±0.49 Pa and 0.08±0.16, respectively. Surface areas affected by low WSS and high OSI were 2.9±2.7 cm2, and 18.4±6.1 cm2, respectively. This in-silico study indicates that no clinically relevant differences in intra-arterial hemodynamics are occurring after device implantation, even at non-optimal positioning of the sensor. Simultaneously, no embolic events were observed, suggesting that the risk for thrombus formation after device implantation is low and independent of the sensor position.

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Section: Discussionmentioning

confidence: 99%

In-silico enhanced animal study of pulmonary artery pressure sensors: assessing hemodynamics using computational fluid dynamics

Brüning,

Yevtushenko,

Schlief

et al. 2023

Front. Cardiovasc. Med.

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Comparison of hemodynamics in biological surgical aortic valve replacement and transcatheter aortic valve implantation: An in‐silico study

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 1 publication

References 31 publications

In-silico enhanced animal study of pulmonary artery pressure sensors: assessing hemodynamics using computational fluid dynamics

In-silico enhanced animal study of pulmonary artery pressure sensors: assessing hemodynamics using computational fluid dynamics

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