Simulation of transcatheter aortic valve implantation through patient-specific finite element analysis: Two clinical cases

S. Morganti, M. Conti, M. Aiello, A. Valentini, A. Mazzola, A. Reali, F. Auricchio

Research output: Contribution to journalArticle

Abstract

Transcatheter aortic valve implantation (TAVI) is a minimally invasive procedure introduced to treat aortic valve stenosis in elder patients. Its clinical outcomes are strictly related to patient selection, operator skills, and dedicated pre-procedural planning based on accurate medical imaging analysis. The goal of this work is to define a finite element framework to realistically reproduce TAVI and evaluate the impact of aortic root anatomy on procedure outcomes starting from two real patient datasets. Patient-specific aortic root models including native leaflets, calcific plaques extracted from medical images, and an accurate stent geometry based on micro-tomography reconstruction are key aspects included in the present study. Through the proposed simulation strategy we observe that, in both patients, stent apposition significantly induces anatomical configuration changes, while it leads to different stress distributions on the aortic wall. Moreover, for one patient, a possible risk of paravalvular leakage has been found while an asymmetric coaptation occurs in both investigated cases. Post-operative clinical data, that have been analyzed to prove reliability of the performed simulations, show a good agreement with analysis results. The proposed work thus represents a further step towards the use of realistic computer-based simulations of TAVI procedures, aiming at improving the efficacy of the operation technique and supporting device optimization.

Original languageEnglish
Pages (from-to)2547-2555
Number of pages9
JournalJournal of Biomechanics
Volume47
Issue number11
DOIs
Publication statusPublished - Aug 22 2014

Keywords

  • Aortic valve
  • Patient-specific modeling
  • Structural finite element
  • TAVI

ASJC Scopus subject areas

  • Biophysics
  • Biomedical Engineering
  • Orthopedics and Sports Medicine
  • Rehabilitation

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