Prediction of patient-specific post-operative outcomes of TAVI procedure: The impact of the positioning strategy on valve performance

Morganti, Simone; Brambilla, Nedy; Petronio, Anna Sonia; Reali, Alessandro; Bedogni, Francesco; Auricchio, Ferdinando

doi:10.1016/j.jbiomech.2015.10.048

Cited by 78 publications

(156 citation statements)

References 28 publications

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“…On the other hand, during the recoil phase only the stent is coming in contact with the leaflets, thus providing direct information about the prosthesis anchorage. The recoil phase, ignored by most of the previous models of TAVR stent deployment (14, 15, 17, 20, 33), also represents an important phenomenon that is related to valve migration, as observed in the current proximal positioning. In this model the loss of contact area at the beginning of the recoil was more pronounced than in the other two configurations.…”

Section: Discussionmentioning

confidence: 99%

Effect of Balloon‐Expandable Transcatheter Aortic Valve Replacement Positioning: A Patient‐Specific Numerical Model

Bianchi¹,

Marom²,

Ghosh³

et al. 2016

Artificial Organs

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Transcatheter aortic valve replacement (TAVR) has emerged as a life-saving and effective alternative to surgical valve replacement in high-risk, elderly patients with severe calcific aortic stenosis. Despite its early promise, certain limitations and adverse events, such as suboptimal placement and valve migration, have been reported. In the present study, we aim to evaluate the effect of various TAVR deployment locations on the procedural outcome by assessing the risk for valve migration. The deployment of a balloon-expandable Edwards SAPIEN valve was simulated via finite element analysis in a patient-specific calcified aortic root, which was reconstructed from CT scans of a retrospective case of valve migration. The deployment location was parametrized in three configurations and the anchorage was quantitatively assessed based on the contact between the stent and the native valve during the deployment and recoil phases. The proximal deployment led to lower contact area between the native leaflets and the stent which poses higher risk for valve migration. The distal and midway positions resulted in comparable outcomes, with the former providing a slightly better anchorage. The approach presented might be used as a predictive tool for procedural planning in order to prevent prosthesis migration and achieve better clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Effect of Balloon‐Expandable Transcatheter Aortic Valve Replacement Positioning: A Patient‐Specific Numerical Model

Bianchi¹,

Marom²,

Ghosh³

et al. 2016

Artificial Organs

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“…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.…”

Section: Methodsmentioning

confidence: 84%

“…This may be the reason that the orientation of the bend of the ascending aortic has the lowest interaction between the stent and aortic, inducing the maximum gaps. Previous studies had indicated ascending aortic angle would influence the paravalvular regurgitation [Morganti et al (2014); Morganti et al (2016)]. Stent 1 had the maximum total gaps.…”

Section: Paravalvular Gapsmentioning

confidence: 94%

“…The material of the calcification plaque was set as linear-elastic, isotropic material. Young modulus, Poisson ratio and density were set at 12.6 MPa, 0.3 and 2,000 kg/m 3 , respectively [Morganti et al (2016)]. C3D10M tetrahedral element was adopted for calcification plaque.…”

Section: Aortic Root Modelmentioning

confidence: 99%

“…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)].…”

Section: Introductionmentioning

confidence: 99%

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

Chang

Liu

Zhong³

et al. 2019

Int. J. Comput. Methods

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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.

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Effect of aorto‐ventricular angulation on procedural success in transcatheter aortic valve replacements with the Lotus Valve system

Rashid

McCormick

Talman

et al. 2017

Cathet Cardio Intervent

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Prediction of patient-specific post-operative outcomes of TAVI procedure: The impact of the positioning strategy on valve performance

Cited by 78 publications

References 28 publications

Effect of Balloon‐Expandable Transcatheter Aortic Valve Replacement Positioning: A Patient‐Specific Numerical Model

Effect of Balloon‐Expandable Transcatheter Aortic Valve Replacement Positioning: A Patient‐Specific Numerical Model

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

Effect of aorto‐ventricular angulation on procedural success in transcatheter aortic valve replacements with the Lotus Valve system

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