Patient–Specific Immersed Finite Element–Difference Model of Transcatheter Aortic Valve Replacement

Brown, Jordan; Lee, Jae H.; Smith, Margaret; Wells, David; Barrett, Aaron; Puelz, Charles; Vavalle, John P.; Griffith, Boyce E.

doi:10.1007/s10439-022-03047-3

Cited by 9 publications

(3 citation statements)

References 41 publications

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“…It should be noted that the printing parameters can still be subject to future optimizations and that NMP, considered as a class 2 solvent by the Food and Drug Administration (FDA), can be removed from the 3D-printed object postprinting by several washing steps or successive swelling/drying of the networks. These results therefore show the suitability of these NIPU formulations to be 3D-printed with sufficient resolution to foresee the precise design of small-sized devices such as implants or prostheses requiring high definition (i.e., heart valve leaflet) …”

Section: Results and Discussionmentioning

confidence: 72%

Design of 3D-Photoprintable, Bio-, and Hemocompatible Nonisocyanate Polyurethane Elastomers for Biomedical Implants

Pierrard,

Melo,

Thijssen

et al. 2024

Biomacromolecules

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Polyurethanes (PUs) have adjustable mechanical properties, making them suitable for a wide range of applications, including in the biomedical field. Historically, these PUs have been synthesized from isocyanates, which are toxic compounds to handle. This has encouraged the search for safer and more environmentally friendly synthetic routes, leading today to the production of nonisocyanate polyurethanes (NIPUs). Among these NIPUs, polyhydroxyurethanes (PHUs) bear additional hydroxyl groups, which are particularly attractive for derivatizing and adjusting their physicochemical properties. In this paper, polyether-based NIPU elastomers with variable stiffness are designed by functionalizing the hydroxyl groups of a poly-(propylene glycol)−PHU by a cyclic carbonate carrying a pendant unsaturation, enabling them to be post-photo-cross-linked with polythiols (thiol−ene). Elastomers with remarkable mechanical properties whose stiffness can be adjusted are obtained. Thanks to the unique viscous properties of these PHU derivatives and their short gel times observed by rheology experiments, formulations for light-based three-dimensional (3D) printing have been developed. Objects were 3D-printed by digital light processing with a resolution down to the micrometer scale, demonstrating their ability to target various designs of prime importance for personalized medicine. In vitro biocompatibility tests have confirmed the noncytotoxicity of these materials for human fibroblasts. In vitro hemocompatibility tests have revealed that they do not induce hemolytic effects, they do not increase platelet adhesion, nor activate coagulation, demonstrating their potential for future applications in the cardiovascular field.

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Section: Results and Discussionmentioning

confidence: 72%

Design of 3D-Photoprintable, Bio-, and Hemocompatible Nonisocyanate Polyurethane Elastomers for Biomedical Implants

Pierrard,

Melo,

Thijssen

et al. 2024

Biomacromolecules

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“…However, a comprehensive investigation of the “flap” motions will require a multidisciplinary approach involving fluid–structure interaction (FSI) methods. Although FSI has been widely employed to analyse the shear stress around aortic valves, it requires solving additional equations for the motion of the object of interest 20 , 21 . More importantly, this equation has to simultaneously handle the solid mechanic properties of the object of interest as well as the coupling effects between its motion and the transient haemodynamic environment.…”

Section: Discussionmentioning

confidence: 99%

An optical coherence tomography and endothelial shear stress study of a novel bioresorbable bypass graft

Poon

Ono

et al. 2023

Sci Rep

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Endothelial shear stress (ESS) plays a key role in the clinical outcomes in native and stented segments; however, their implications in bypass grafts and especially in a synthetic biorestorative coronary artery bypass graft are yet unclear. This report aims to examine the interplay between ESS and the morphological alterations of a biorestorative coronary bypass graft in an animal model. Computational fluid dynamics (CFD) simulation derived from the fusion of angiography and optical coherence tomography (OCT) imaging was used to reconstruct data on the luminal anatomy of a bioresorbable coronary bypass graft with an endoluminal “flap” identified during OCT acquisition. The “flap” compromised the smooth lumen surface and considerably disturbed the local flow, leading to abnormally low ESS and high oscillatory shear stress (OSI) in the vicinity of the “flap”. In the presence of the catheter, the flow is more stable (median OSI 0.02384 versus 0.02635, p < 0.0001; maximum OSI 0.4612 versus 0.4837). Conversely, OSI increased as the catheter was withdrawn which can potentially cause back-and-forth motions of the “flap”, triggering tissue fatigue failure. CFD analysis in this report provided sophisticated physiological information that complements the anatomic assessment from imaging enabling a complete understanding of biorestorative graft pathophysiology.

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“…Brown et al. ( 2023 ) developed a computational FSI model where they combined crimping and deployment simulations modeled using the immersed finite element-difference method. Furthermore, they modeled the device behavior across the cardiac cycle in a patient-specific aortic root geometry.…”

Section: Introductionmentioning

confidence: 99%

A fast in silico model for preoperative risk assessment of paravalvular leakage

Spanjaards,

Borowski,

Supp

et al. 2024

Biomech Model Mechanobiol

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In silico simulations can be used to evaluate and optimize the safety, quality, efficacy and applicability of medical devices. Furthermore, in silico modeling is a powerful tool in therapy planning to optimally tailor treatment for each patient. For this purpose, a workflow to perform fast preoperative risk assessment of paravalvular leakage (PVL) after transcatheter aortic valve replacement (TAVR) is presented in this paper. To this end, a novel, efficient method is introduced to calculate the regurgitant volume in a simplified, but sufficiently accurate manner. A proof of concept of the method is obtained by comparison of the calculated results with results obtained from in vitro experiments. Furthermore, computational fluid dynamics (CFD) simulations are used to validate more complex stenosis scenarios. Comparing the simplified leakage model to CFD simulations reveals its potential for procedure planning and qualitative preoperative risk assessment of PVL. Finally, a 3D device deployment model and the efficient leakage model are combined to showcase the application of the presented leakage model, by studying the effect of stent size and the degree of stenosis on the regurgitant volume. The presented leakage model is also used to visualize the leakage path. To generalize the leakage model to a wide range of clinical applications, further validation on a large cohort of patients is needed to validate the accuracy of the model’s prediction under various patient-specific conditions.

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Patient–Specific Immersed Finite Element–Difference Model of Transcatheter Aortic Valve Replacement

Cited by 9 publications

References 41 publications

Design of 3D-Photoprintable, Bio-, and Hemocompatible Nonisocyanate Polyurethane Elastomers for Biomedical Implants

Design of 3D-Photoprintable, Bio-, and Hemocompatible Nonisocyanate Polyurethane Elastomers for Biomedical Implants

An optical coherence tomography and endothelial shear stress study of a novel bioresorbable bypass graft

A fast in silico model for preoperative risk assessment of paravalvular leakage

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