On the Modeling of Patient-Specific Transcatheter Aortic Valve Replacement: A Fluid-Structure Interaction Approach.
Cardiovasc Eng Technol
; 10(3): 437-455, 2019 09.
Article
em En
| MEDLINE
| ID: mdl-31309527
ABSTRACT
PURPOSE:
Transcatheter aortic valve replacement (TAVR) is a minimally invasive treatment for high-risk patients with aortic diseases. Despite its increasing use, many influential factors are still to be understood and require continuous investigation. The best numerical approach capable of reproducing both the valves mechanics and the hemodynamics is the fluid-structure interaction (FSI) modeling. The aim of this work is the development of a patient-specific FSI methodology able to model the implantation phase as well as the valve working conditions during cardiac cycles.METHODS:
The patient-specific domain, which included the aortic root, native valve and calcifications, was reconstructed from CT images, while the CAD model of the device, metallic frame and pericardium, was drawn from literature data. Ventricular and aortic pressure waveforms, derived from the patient's data, were used as boundary conditions. The proposed method was applied to two real clinical cases, which presented different outcomes in terms of paravalvular leakage (PVL), the main complication after TAVR.RESULTS:
The results confirmed the clinical prognosis of mild and moderate PVL with coherent values of regurgitant volume and effective regurgitant orifice area. Moreover, the final release configuration of the device and the velocity field were compared with postoperative CT scans and Doppler traces showing a good qualitative and quantitative matching.CONCLUSION:
In conclusion, the development of realistic and accurate FSI patient-specific models can be used as a support for clinical decisions before the implantation.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Valva Aórtica
/
Estenose da Valva Aórtica
/
Substituição da Valva Aórtica Transcateter
/
Modelagem Computacional Específica para o Paciente
/
Hemodinâmica
/
Modelos Cardiovasculares
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Cardiovasc Eng Technol
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Itália