Patient-Specific Computer Simulation to Optimize Transcatheter Heart Valve Sizing and Positioning in Bicuspid Aortic Valve

2021 ◽  
Author(s):  
Cameron Dowling ◽  
Robert Gooley ◽  
Liam McCormick ◽  
Stephen J. Brecker ◽  
Sami Firoozi ◽  
...  
Keyword(s):  
Computer Simulation ◽  
Aortic Valve ◽  
Heart Valve ◽  
Bicuspid Aortic Valve ◽  
Patient Specific ◽  
Transcatheter Heart Valve

scholarly journals Patient-specific Computer Simulation: An Emerging Technology for Guiding the Transcatheter Treatment of Patients with Bicuspid Aortic Valve

2021 ◽  
Vol 16 ◽  
Author(s):  
Cameron Dowling ◽  
Robert Gooley ◽  
Liam McCormick ◽  
Sami Firoozi ◽  
Stephen J Brecker
Keyword(s):  
Computer Simulation ◽  
Aortic Valve ◽  
Clinical Outcomes ◽  
Bicuspid Aortic Valve ◽  
Patient Specific ◽  
Transcatheter Aortic Valve ◽  
Anatomical Basis ◽  
Transcatheter Heart Valve ◽  
Risk Patients ◽  
Valve Implantation

Transcatheter aortic valve implantation (TAVI) is increasingly being used to treat younger, lower-risk patients, many of whom have bicuspid aortic valve (BAV). As TAVI begins to enter these younger patient cohorts, it is critical that clinical outcomes from TAVI in BAV are matched to those achieved by surgery. Therefore, the identification of patients who, on an anatomical basis, may not be suitable for TAVI, would be desirable. Furthermore, clinical outcomes of TAVI in BAV might be improved through improved transcatheter heart valve sizing and positioning. One potential solution to these challenges is patient-specific computer simulation. This review presents the methodology and clinical evidence surrounding patient-specific computer simulation of TAVI in BAV.

scholarly journals Sealing Behavior in Transcatheter Bicuspid and Tricuspid Aortic Valves Replacement Through Patient-Specific Computational Modeling

2021 ◽  
Vol 8 ◽  
Author(s):  
Xianbao Liu ◽  
Jiaqi Fan ◽  
Peter Mortier ◽  
Yuxin He ◽  
Qifeng Zhu ◽  
...  
Keyword(s):  
Computer Simulation ◽  
Aortic Valve ◽  
Computational Modeling ◽  
Maximum Diameter ◽  
Patient Specific ◽  
Aortic Valves ◽  
Minimum Diameter ◽  
Transcatheter Aortic Valve ◽  
Patient Interaction ◽  
Transcatheter Heart Valve

Background: Patient-specific computer simulation of transcatheter aortic valve replacement (TAVR) can provide unique insights in device-patient interaction.Aims: This study was to compare transcatheter aortic valve sealing behavior in patients with bicuspid aortic valves (BAV) and tricuspid aortic valves (TAV) through patient-specific computational modeling.Methods: Patient-specific computer simulation was retrospectively performed with FEops HEARTguide for TAVR patients. Simulation output was compared with postprocedural computed tomography and echocardiography to validate the accuracy. Skirt malapposition was defined by a distance larger than 1 mm based on the predicted device-patient interaction by quantifying the distance between the transcatheter heart valve (THV) skirt and the surrounding anatomical regions.Results: In total, 43 patients were included in the study. Predicted and observed THV frame deformation showed good correlation (R2 ≥ 0.90) for all analyzed measurements (maximum diameter, minimum diameter, area, and perimeter). The amount of predicted THV skirt malapposition was strongly linked with the echocardiographic grading of paravalvular leakage (PVL). More THV skirt malapposition was observed for BAV cases when compared to TAV cases (22.7 vs. 15.5%, p < 0.05). A detailed analysis of skirt malapposition showed a higher degree of malapposition in the interleaflet triangles section for BAV cases as compared to TAV patients (11.1 vs. 5.8%, p < 0.05).Conclusions: Patient-specific computer simulation of TAVR can accurately predict the behavior of the Venus A-valve. BAV patients are associated with more malapposition of the THV skirt as compared to TAV patients, and this is mainly driven by more malapposition in the interleaflet triangle region.

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