UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Impact of different aortic valve calcification patterns on the outcome of transcatheter aortic valve implantation: A finite element study

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. Green open access

[img]
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 > 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
Downloads since deposit
58Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item