Simulation of Transcatheter Aortic Valve Replacement in patient-specific aortic roots: Effect of crimping and positioning on device performance

Matteo Bianchi, Ram P. Ghosh, Gil Marom, Marvin J. Slepian, Danny Bluestein

Research output: Chapter in Book/Report/Conference proceedingConference contribution

9 Scopus citations

Abstract

Calcific aortic valve disease (CAVD) is a cardiovascular condition that causes the progressive narrowing of the aortic valve (AV) opening, due to the growth of bone-like deposits all over the aortic root (AR). Transcatheter aortic valve replacement (TAVR), a minimally invasive procedure, has recently become the only lifesaving solution for patients that cannot tolerate the standard surgical valve replacement. However, adverse effects, such as AR injury or paravalvular leakage (PVL), may occur as a consequence of a sub-optimal procedure, due to the presence of calcifications in situ. Additionally, the crimping required for delivering the valve via stenting may damage the valve. The aim of the present study is to comparatively assess the crimping mechanics of the commercialized Edwards SAPIEN valve and an alternative polymeric valve (Polynova, Inc) and to evaluate the effect of different TAVR deployment positions using patient-specific numerical models. The optimal deployment location for achieving better patient outcomes was calculated and based on the interactions between the TAVR stent and the native AR. Results demonstrated that the Polynova valve withstands the crimping process better than the SAPIEN valve. Furthermore, deployment simulations showed the role that calcifications deposits may play in the TAVR sub-optimal valve anchoring to the AV wall, leading to the presence of gaps that result in PVL.

Original languageEnglish (US)
Title of host publication2015 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2015
PublisherInstitute of Electrical and Electronics Engineers Inc.
Pages282-285
Number of pages4
ISBN (Electronic)9781424492718
DOIs
StatePublished - Nov 4 2015
Event37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2015 - Milan, Italy
Duration: Aug 25 2015Aug 29 2015

Publication series

NameProceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS
Volume2015-November
ISSN (Print)1557-170X

Other

Other37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2015
CountryItaly
CityMilan
Period8/25/158/29/15

ASJC Scopus subject areas

  • Signal Processing
  • Biomedical Engineering
  • Computer Vision and Pattern Recognition
  • Health Informatics

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    Bianchi, M., Ghosh, R. P., Marom, G., Slepian, M. J., & Bluestein, D. (2015). Simulation of Transcatheter Aortic Valve Replacement in patient-specific aortic roots: Effect of crimping and positioning on device performance. In 2015 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBC 2015 (pp. 282-285). [7318355] (Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, EMBS; Vol. 2015-November). Institute of Electrical and Electronics Engineers Inc.. https://doi.org/10.1109/EMBC.2015.7318355