Numerical models of valve-in-valve implantation: effect of intentional leaflet laceration on the anchorage

Yaakobovich, Halit; Mayo, Romina Plitman; Zaretsky, Uri; Finkelstein, Ariel; Marom, Gil

doi:10.1007/s10237-019-01218-1

Cited by 11 publications

(9 citation statements)

References 34 publications

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“…For example, in patients with single-ventricle defects scheduled for Fontan surgery (Box 1), computational simulations of blood flow have been used to assess preoperative flow conditions and to predict the outcomes of various surgical options (Trusty et al, 2018). Fluid-structure interaction simulations have also been (Gao et al, 2018) deployed to evaluate transcatheter aortic valve replacement, to identify potentials to optimize device design (Wu et al, 2016), whereas FEM simulations have been used to evaluate the effectiveness of novel procedures, such as leaflet laceration after valve-in-valve procedures (Yaakobovich et al, 2020). Application of the same techniques to fetal CVS and CHD research can have similar translational potential.…”

Section: Sheepmentioning

confidence: 99%

Mending a broken heart: In vitro, in vivo and in silico models of congenital heart disease

Rufaihah

Chen

Yap

et al. 2021

Disease Models &Amp; Mechanisms

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Birth defects contribute to ∼0.3% of global infant mortality in the first month of life, and congenital heart disease (CHD) is the most common birth defect among newborns worldwide. Despite the significant impact on human health, most treatments available for this heterogenous group of disorders are palliative at best. For this reason, the complex process of cardiogenesis, governed by multiple interlinked and dose-dependent pathways, is well investigated. Tissue, animal and, more recently, computerized models of the developing heart have facilitated important discoveries that are helping us to understand the genetic, epigenetic and mechanobiological contributors to CHD aetiology. In this Review, we discuss the strengths and limitations of different models of normal and abnormal cardiogenesis, ranging from single-cell systems and 3D cardiac organoids, to small and large animals and organ-level computational models. These investigative tools have revealed a diversity of pathogenic mechanisms that contribute to CHD, including genetic pathways, epigenetic regulators and shear wall stresses, paving the way for new strategies for screening and non-surgical treatment of CHD. As we discuss in this Review, one of the most-valuable advances in recent years has been the creation of highly personalized platforms with which to study individual diseases in clinically relevant settings.

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Section: Sheepmentioning

confidence: 99%

Mending a broken heart: In vitro, in vivo and in silico models of congenital heart disease

Rufaihah

Chen

Yap

et al. 2021

Disease Models &Amp; Mechanisms

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show abstract

“…The blood flow models post-ViV are based on geometries from our previous finite-element analysis studies of the ViV implantation [32]. Briefly, implantations of two TAVI devices-Medtronic Evolut royalsocietypublishing.org/journal/rsos R. Soc.…”

Section: Computational Modelsmentioning

confidence: 99%

“…Thereafter, the different thrombosis risk estimations were analysed and compared. In all the models, the results were calculated using the tenth cycle data and plotted in a spread view of the TAVI device leaflets [32]. The colour contours indicate the thrombogenic risk, with red being the higher risk locations and blue the lower risk ones.…”

Section: Comparison Between the Evolut And Sapien Modelsmentioning

confidence: 99%

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Numerical models for assessing the risk of leaflet thrombosis post-transcatheter aortic valve-in-valve implantation

Mayo

Yaakobovich

Finkelstein³

et al. 2020

R. Soc. open sci.

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Leaflet thrombosis has been suggested as the reason for the reduced leaflet motion in cases of hypoattenuated leaflet thickening of bioprosthetic aortic valves. This work aimed to estimate the risk of leaflet thrombosis in two post-valve-in-valve (ViV) configurations, using five different numerical approaches. Realistic ViV configurations were calculated by modelling the deployments of the latest version of transcatheter aortic valve devices (Medtronic Evolut PRO, Edwards SAPIEN 3) in the surgical Sorin Mitroflow. Computational fluid dynamics simulations of blood flow followed the dry models. Lagrangian and Eulerian measures of near-wall stagnation were implemented by particle and concentration tracking, respectively, to estimate the thrombogenicity and to predict the risk locations. Most of the numerical approaches indicate a higher leaflet thrombosis risk in the Edwards SAPIEN 3 device because of its intra-annular implantation. The Eulerian approaches estimated high-risk locations in agreement with the wall sheer stress (WSS) separation points. On the other hand, the Lagrangian approaches predicted high-risk locations at the proximal regions of the leaflets matching the low WSS magnitude regions of both transcatheter aortic valve implantation models and reported clinical and experimental data. The proposed methods can help optimizing future designs of transcatheter aortic valves with minimal thrombotic risks.

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“…Recently, we suggested that BASILICA can weaken anchorage forces, although our study did not indicate that it was weakened enough to cause migration. 68 Stronger anchoring forces, for example by over-inflating the balloon-expandable device, can obviously help prevent migration. Nevertheless, these approaches can cause additional nonhemodynamic complications such as conduction abnormalities (necessitating permanent pacemaker implantation) or even aortic root rupture.…”

Section: Hemodynamics Of Structural Complicationsmentioning

confidence: 99%

New Insights into Valve Hemodynamics

Marom¹,

Einav²

2020

Rambam Maimonides Med J

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Heart valve diseases are common disorders with five million annual diagnoses being made in the United States alone. All heart valve disorders alter cardiac hemodynamic performance; therefore, treatments aim to restore normal flow. This paper reviews the state-of-the-art clinical and engineering advancements in heart valve treatments with a focus on hemodynamics. We review engineering studies and clinical literature on the experience with devices for aortic valve treatment, as well as the latest advancements in mitral valve treatments and the pulmonic and tricuspid valves on the right side of the heart. Upcoming innovations will potentially revolutionize treatment of heart valve disorders. These advancements, and more gradual enhancements in the procedural techniques and imaging modalities, could improve the quality of life of patients suffering from valvular disease who currently cannot be treated.

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Numerical models of valve-in-valve implantation: effect of intentional leaflet laceration on the anchorage

Cited by 11 publications

References 34 publications

Mending a broken heart: In vitro, in vivo and in silico models of congenital heart disease

Mending a broken heart: In vitro, in vivo and in silico models of congenital heart disease

Numerical models for assessing the risk of leaflet thrombosis post-transcatheter aortic valve-in-valve implantation

New Insights into Valve Hemodynamics

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