Simulation of transcatheter aortic valve implantation through patient-specific finite element analysis: Two clinical cases

Patient-specific image-based computer simulation for theprediction of valve morphology and calcium displacement after TAVI with the Medtronic CoreValve and the Edwards SAPIEN valve

“…As mentioned above, There is growing interest in the development of software which is able to construct detailed geometric anatomic models from patient-specific diagnostic images and software that allows computer simulation of TAVI in order to predict valve configuration in the patient-specific anatomy, thereby helping the physician to select the valve (type and size) that best fits the individual patient [14][15][16][17][18][19][20][21][22] . A number of studies have employed finite element computer modelling to deploy a transcatheter aortic valve virtually into a patient-specific aortic root model [14][15][16]19,21,22 . While all of these studies have definitely contributed to proving the feasibility of patient-specific TAVI simulations, the validation of the modelling results has been limited so far.…”

“…The increasing number and spectrum of patients referred for TAVI as well as the increasing valve types available necessitate patient-specific tools predicting device-host interaction for both patient selection and procedure planning (i.e., selection of the valve that best fits the individual patient). Finite element computer simulation of a TAVI procedure based upon the integration of the patient-specific anatomy, the physical and mechanical properties of the valve and the biomechanical properties of the aortic root, may help to define in vivo device-host interactions, thereby enhancing the safety of TAVI [14][15][16][17][18][19][20][21][22] .…”

Effect of Stent Designs on the Paravalvular Regurgitation of Transcatheter Aortic Valve Implantation

“…This was a simple but an effective method to use the gap between the stent and the aortic wall to evaluate the extent of paravalvular regurgitation. This method was used in many papers to evaluate the paravalvular regurgitation after TAVI, and the proof was identical to experimental observation [Morganti et al (2014); Morganti et al (2016)]. So, we adopt the gap to evaluate the regurgitation.…”

“…Stent apposition and deformation, stress on valve leaflets, stent, and calcified plaque were studied to evaluate the ability of anchoring by finite element analysis [Morganti et al (2014); Auricchio et al (2014); Sturla et al (2016)]. It was indicated that larger calcified spot stress will lead to risk of stroke [Sturla et al (2016)].…”

“…Aortic rupture location had been investigated and got the same outcome in clinic [Wang et al (2015)]. It also simulated the influence of the asymmetric coaptation, anchoring position and angle, calcification position, pattern and size to paravalvular regurgitation and clinical outcome in previous studies [Morganti et al (2014); Morganti et al (2016); Sturla et al (2016); Russ et al (2013)]. Recently, a workflow had been developed to simulate the potential leakage prior to the implantation to help decide the best implant type, size and position [Bart et al (2016)].…”