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

Abstract

Paravalvular aortic regurgitation (AR) significantly influences the outcome of transcatheter aortic valve implantation (TAVI). This study deals with the effect of stent design on AR after TAVI was evaluated by numerical simulations. Three different stents were implanted into the representative calcified human aortic root models. The excessively dense or a sparse outflow end would result in larger stent deformation indexes, higher stress of calcified plaques and aortic root, and larger gap between stent and aortic wall, and lead to serious paravalvular regurgitation. This study provides the guidance for design of transcatheter aortic valve.

Patient-specific simulation of transcatheter aortic valve replacement: impact of deployment options on paravalvular leakage

“…Recent studies quantified the interaction between the device and the implantation site, as a surrogate measure of PVL, by measuring the gap between the stent (Bosi et al 2018; Morganti et al 2014) or the skirt (Schultz et al 2016) from the native tissue in patient-specific and idealized aortic root (AR) anatomies (Chang et al 2018). Similarly, a max-flow algorithm was proposed (Bosmans et al 2016), which creates a one-dimensional connected graph to represent the flow network based on the size of the gap between the stent and AR.…”

“…Computational models have been employed to study the interaction between TAVR stent and aortic native tissue and predict post-procedural device performance from a structural dynamics standpoint (Bianchi et al 2016; McGee et al 2018; Morganti et al 2016; Sturla et al 2016; Wang et al 2014). Recent studies quantified the interaction between the device and the implantation site, as a surrogate measure of PVL, by measuring the gap between the stent (Bosi et al 2018; Morganti et al 2014) or the skirt (Schultz et al 2016) from the native tissue in patient-specific and idealized aortic root (AR) anatomies (Chang et al 2018). Similarly, a max-flow algorithm was proposed (Bosmans et al 2016), which creates a one-dimensional connected graph to represent the flow network based on the size of the gap between the stent and AR.…”