TY - JOUR
T1 - The Impact of Size and Position of a Mechanical Expandable Transcatheter Aortic Valve
T2 - Novel Insights Through Computational Modelling and Simulation
AU - Rocatello, Giorgia
AU - El Faquir, Nahid
AU - de Backer, Ole
AU - Swaans, Martin J.
AU - Latib, Azeem
AU - Vicentini, Luca
AU - Segers, Patrick
AU - De Beule, Matthieu
AU - de Jaegere, Peter
AU - Mortier, Peter
N1 - Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - 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.
AB - 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.
KW - Aortic regurgitation
KW - Computer simulations
KW - Conduction abnormalities
KW - Equivocal aortic root dimensions
KW - TAVI
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U2 - 10.1007/s12265-019-09877-2
DO - 10.1007/s12265-019-09877-2
M3 - Article
C2 - 31444672
AN - SCOPUS:85071297376
SN - 1937-5387
VL - 12
SP - 435
EP - 446
JO - Journal of Cardiovascular Translational Research
JF - Journal of Cardiovascular Translational Research
IS - 5
ER -