The Impact of Size and Position of a Mechanical Expandable Transcatheter Aortic Valve: Novel Insights Through Computational Modelling and Simulation

Giorgia Rocatello, Nahid El Faquir, Ole de Backer, Martin J. Swaans, Azeem Latib, Luca Vicentini, Patrick Segers, Matthieu De Beule, Peter de Jaegere, Peter Mortier

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Transcatheter aortic valve implantation has become an established procedure to treat severe aortic stenosis. Correct device sizing/positioning is crucial for optimal outcome. Lotus valve sizing is based upon multiple aortic root dimensions. Hence, it often occurs that two valve sizes can be selected. In this study, patient-specific computer simulation is adopted to evaluate the influence of Lotus size/position on paravalvular aortic regurgitation (AR) and conduction abnormalities, in patients with equivocal aortic root dimensions. First, simulation was performed in 62 patients to validate the model in terms of predicted AR and conduction abnormalities using postoperative echocardiographic, angiographic and ECG-based data. Then, two Lotus sizes were simulated at two positions in patients with equivocal aortic root dimensions. Large valve size and deep position were associated with higher contact pressure, while only large size, not position, significantly reduced the predicted AR. Despite general trends, simulations revealed that optimal device size/position is patient-specific.

Original languageEnglish (US)
Pages (from-to)435-446
Number of pages12
JournalJournal of Cardiovascular Translational Research
Volume12
Issue number5
DOIs
StatePublished - Oct 1 2019
Externally publishedYes

Keywords

  • Aortic regurgitation
  • Computer simulations
  • Conduction abnormalities
  • Equivocal aortic root dimensions
  • TAVI

ASJC Scopus subject areas

  • Molecular Medicine
  • Genetics
  • Pharmaceutical Science
  • Cardiology and Cardiovascular Medicine
  • Genetics(clinical)

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