Computational Simulations of Ventricular Outflow Tract Obstructions Associated With Varied Replacement Valve Geometries

Abstract

Transcatheter replacement therapies for the atrioventricular (AV) valves are considered as the next frontier for the treatment of valvular regurgitation. The AV valves, tricuspid and mitral, are the regulators of blood flow from the atria into the ventricles. During diastole, blood flows through the open tricuspid and mitral valves to fill the right and left ventricles, respectively. During systole, the ventricles contract, closing the AV valves, and forcing the blood to exit through their respective ventricular outflow tracts (VOTs) to the arterial circulations. Although the current gold standard for the treatment of valvular regurgitation is surgical replacement or repair, the field of transcatheter therapies is rapidly expanding as new treatment options for patients; especially for those individuals considered to be at greater risks for surgical complications. Market released bioprosthetic devices for replacing the aortic and pulmonary valves have shown great promise and success. However, the advancement of similar therapies for either the mitral and tricuspid valves remain in the early stages of development. This slower progress is attributed to the high complexities and variabilities of the AV valves, which present challenges for both device design and post-implantation functions.