A metric for the stiffness of calcified aortic valves using a combined computational and experimental approach

Maleki, Hoda; Shahriari, Shahrokh; Durand, Louis-Gilles; Labrosse, Michel R.; Kadem, Lyes

doi:10.1007/s11517-013-1113-y

Cited by 28 publications

(22 citation statements)

References 19 publications

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“…The original non-stenotic Computer-Aided Design (CAD) model of the stenotic aortic valve was based on a previously published model [5,6]. The model is symmetric and includes three leaflets, three commissures, three sinuses, and three interleaflet triangles, which is consistent with Sutton et al's description of the normal aortic valve [7].…”

Section: Methodsmentioning

confidence: 78%

An In Vitro Model of Aortic Stenosis for the Assessment of Transcatheter Aortic Valve Implantation

Maleki

Shahriari

Labrosse

et al. 2014

Journal of Biomechanical Engineering

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A significant number of elderly patients with severe symptomatic aortic stenosis are denied surgical aortic valve replacement (SAVR) because of high operative risk. Transcatheter aortic valve implantation (TAVI) has emerged as a valid alternative to SAVR in these patients. One of the main characteristics of TAVI, when compared to SAVR, is that the diseased native aortic valve remains in place. For hemodynamic testing of new percutaneous valves and clinical training, one should rely on animal models. However, the development of an appropriate animal model of severe aortic stenosis is not straightforward. This work aims at developing and testing an elastic model of the ascending aorta including a severe aortic stenosis. The physical model was built based on a previous silicone model and tested experimentally in this study. Experimental results showed that the error between the computer-aided design (CAD) file and the physical elastic model was <5%, the compliance of the ascending aorta was 1.15 ml/mm Hg, the effective orifice area (EOA) of the stenotic valve was 0.86 cm 2 , the peak jet velocity was 4.9 m/s and mean transvalvular pressure gradient was 50 mm Hg, consistent with as severe. An EDWARDS-SAPIEN 26 mm valve was then implanted in the model leading to a significant increase in EOA (2.22 cm 2 ) and a significant decrease in both peak jet velocity (1.29 m/s) and mean transvalvular pressure gradient (3.1 mm Hg). This model can be useful for preliminary in vitro testing of percutaneous valves before more extensive animal and in vivo tests.

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Section: Methodsmentioning

confidence: 78%

An In Vitro Model of Aortic Stenosis for the Assessment of Transcatheter Aortic Valve Implantation

Maleki

Shahriari

Labrosse

et al. 2014

Journal of Biomechanical Engineering

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“…Moreover, as mentioned above several recent cross-sectional biomechanical studies have demonstrated relationships between lumbopelvic control, kinematics and muscle activations to both increased pitch velocity and higher shoulder/elbow loads 1, 2, 21, 25-28, 30 . A lack of lumbopelvic control may lead to an inability of the pitcher to efficiently transfer energy from the legs to the hand, leading to excessive use of the shoulder, arm and wrist muscles to generate ball velocity.…”

Section: Discussionmentioning

confidence: 85%

Lumbopelvic Control and Days Missed Because of Injury in Professional Baseball Pitchers

Chaudhari

McKenzie²,

Pan

et al. 2014

Am J Sports Med

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Background Recently lumbopelvic control has been linked to pitching performance, kinematics and loading; however, poor lumbopelvic control has not been prospectively investigated as a risk factor for injury in baseball pitchers. Hypothesis Pitchers with poor lumbopelvic control during spring training are more likely to miss 30 or more days due to injury through an entire baseball season than pitchers with good lumbopelvic control. Study design Cohort study. Methods Three hundred forty-seven professional baseball pitchers were enrolled into the study during the last 2 weeks of spring training and stayed with the same team for the entire season. Lumbopelvic control was quantified by peak anterior-posterior deviation of the pelvis relative to starting position during a single leg raise test (APScore). Days missed due to injury through the entire season were recorded by each team's medical staff. Results Higher APScore was significantly associated with a higher likelihood of missing 30 days or more (Chi-Square, p=0.023). When divided into tertiles based on their APScore, participants in the highest tertile were 3.0 times and 2.2 times more likely to miss at least 30 days throughout the course of a baseball season relative to those in the lowest or middle tertiles, respectively. Higher APScore was also significantly associated with missing more days due to injury within participants who missed at least one day to injury (ANOVA, p=0.018), with the highest tertile missing significantly more days (mean=98.6 d) than the middle tertile (mean=45.8d, p=0.017) or the lowest tertile (mean=43.8, p=0.017). Conclusion This study found that poor lumbopelvic control in professional pitchers was associated with increased risk of missing significant time due to injury.

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“…We have recently published clinical case studies to accurately simulate MV dynamics of various pathologic conditions using our dynamic finite element protocol [37, 38]. It is anticipated that incorporation of realistic fluid-induced loading conditions on the valve cusps (e.g., physiologic 3D fluid-structure interaction simulation) will provide more accurate information pertaining to valvular dynamics [8, 19, 25, 27]. …”

Section: Discussionmentioning

confidence: 99%

Biomechanical evaluation of the pathophysiologic developmental mechanisms of mitral valve prolapse: effect of valvular morphologic alteration

Choi

McPherson

Kim

2015

Med Biol Eng Comput

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Mitral valve prolapse (MVP) refers to an excessive billowing of the mitral valve (MV) leaflets across the mitral annular plane into the left atrium during the systolic portion of the cardiac cycle. The underlying mechanisms for the development of MVP and mitral regurgitation (MR) in association with MV tissue remodeling is still unclear. We performed computational MV simulations to investigate the pathophysiologic developmental mechanisms of MVP. A parametric MV geometry model was utilized for this study. Posterior leaflet enlargement and posterior chordal elongation models were created by adjusting the geometry of the posterior leaflet and chordae, respectively. Dynamic finite element simulations of MV function were performed over the complete cardiac cycle. Computational simulations demonstrated that enlarging posterior leaflet area increased large stress concentration in the posterior leaflets and chordae, and posterior chordal elongation decreased leaflet coaptation. When MVP was accompanied by both posterior leaflet enlargement and chordal elongation simultaneously, the posterior leaflet was exposed to extremely large prolapse with a substantial lack of leaflet coaptation. These data indicate that MVP development is closely related to tissue alterations of the leaflets and chordae. This biomechanical evaluation strategy can help us better understand the pathophysiologic developmental mechanisms of MVP.

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A metric for the stiffness of calcified aortic valves using a combined computational and experimental approach

Cited by 28 publications

References 19 publications

An In Vitro Model of Aortic Stenosis for the Assessment of Transcatheter Aortic Valve Implantation

An In Vitro Model of Aortic Stenosis for the Assessment of Transcatheter Aortic Valve Implantation

Lumbopelvic Control and Days Missed Because of Injury in Professional Baseball Pitchers

Biomechanical evaluation of the pathophysiologic developmental mechanisms of mitral valve prolapse: effect of valvular morphologic alteration

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