Document Detail


Simulation of Self Expanding Transcatheter Aortic Valve in a Realistic Aortic Root: Implications of Deployment Geometry on Leaflet Deformation.
MedLine Citation:
PMID:  24912765     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Self expanding Transcatheter Aortic Valve Replacements (TAVR) can conform to the geometry of the aortic annulus and the calcified leaflet complex, which may result in leaflet distortion and altered leaflet kinematics, but such changes have not yet been characterized. In this study we developed a computational model to investigate the deployment of a self expanding TAVR in a realistic aortic root model derived from multi-slice computed tomography (MSCT) images. We simulated TAVR crimping/deployment in realistic and idealized aortic root models, followed by diastolic loading of the TAVR leaflets in its final deployed configuration. The TAVR deployed in a realistic aortic root had increased peak loading in the commissural region of the leaflets compared to TAVRs under idealized circular deployment conditions (2.97 vs. 1.52 MPa). Furthermore, orientation of the TAVR in the asymmetric aortic annulus such that the commissures of the TAVR are aligned with the native valve commissures minimized the effect of TAVR stent distortion on peak stresses in the TAVR leaflets (2.97 vs. 2.35 MPa). We propose that preoperative planning of the orientation of the TAVR in the aortic root annulus might minimize the impact of potential stent distortion on leaflet function and may in turn increase long term leaflet durability.
Authors:
Paul S Gunning; Ted J Vaughan; Laoise M McNamara
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-10
Journal Detail:
Title:  Annals of biomedical engineering     Volume:  -     ISSN:  1573-9686     ISO Abbreviation:  Ann Biomed Eng     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0361512     Medline TA:  Ann Biomed Eng     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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