Sturla, F;
Ronzoni, M;
Vitali, M;
Dimasi, A;
Vismara, R;
Preston-Maher, G;
Burriesci, G;
... Redaelli, A; + view all
(2016)
Impact of different aortic valve calcification patterns on the outcome of transcatheter aortic valve implantation: A finite element study.
Journal of Biomechanics
, 49
(12)
pp. 2520-2530.
10.1016/j.jbiomech.2016.03.036.
Preview |
Text
Impact of different aortic valve calcification patterns on the outcome of transcatheter aortic valve implantation: A finite element study.pdf - Published Version Download (11MB) | Preview |
Abstract
Transcatheter aortic valve implantation (TAVI) can treat symptomatic patients with calcific aortic stenosis. However, the severity and distribution of the calcification of valve leaflets can impair the TAVI efficacy. Here we tackle this issue from a biomechanical standpoint, by finite element simulation of a widely adopted balloon-expandable TAVI in three models representing the aortic root with different scenarios of calcific aortic stenosis. We developed a modeling approach realistically accounting for aortic root pressurization and complex anatomy, detailed calcification patterns, and for the actual stent deployment through balloon-expansion. Numerical results highlighted the dependency on the specific calcification pattern of the "dog-boning" of the stent. Also, local stent distortions were associated with leaflet calcifications, and led to localized gaps between the TAVI stent and the aortic tissues, with potential implications in terms of paravalvular leakage. High stresses were found on calcium deposits, which may be a risk factor for stroke; their magnitude and the extent of the affected regions substantially increased for the case of an "arc-shaped" calcification, running from commissure to commissure. Moreover, high stresses due to the interaction between the aortic wall and the leaflet calcifications were computed in the annular region, suggesting an increased risk for annular damage. Our analyses suggest a relation between the alteration of the stresses in the native anatomical components and prosthetic implant with the presence and distribution of relevant calcifications. This alteration is dependent on the patient-specific features of the calcific aortic stenosis and may be a relevant indicator of suboptimal TAVI results.
| Type: | Article |
|---|---|
| Title: | Impact of different aortic valve calcification patterns on the outcome of transcatheter aortic valve implantation: A finite element study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jbiomech.2016.03.036 |
| Publisher version: | http://dx.doi.org/10.1016/j.jbiomech.2016.03.036 |
| Language: | English |
| Additional information: | Copyright © 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | Aortic stenosis, Biomechanics, Calcifications, Finite element models, TAVI |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Mechanical Engineering |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1480259 |
Archive Staff Only
 |
View Item |
