Force distribution within the frame of self-expanding transcatheter aortic valve: Insights from in-vivo finite element analysis. (9th November 2021)

• Record Type: Journal Article
• Authors: Xiong, Tian-Yuan; Stoppani, Elisa; De Beule, Matthieu; Chen, Fei; Li, Yi-Jian; Liao, Yan-Biao; Feng, Yuan; de Jaegere, Peter; Chen, Mao
• Is Part Of: Journal of biomechanics. Volume 128(2021)
• Publication Date: 2021-11-09
• Subjects: Transcatheter aortic valve replacement -- Finite element analysis -- Computer simulation -- Force; Animal mechanics -- Periodicals; Biomechanics -- Periodicals; Biomechanics -- Periodicals; Mécanique animale -- Périodiques; Biomécanique -- Périodiques; Electronic journals; 571.4305
• DOI: 10.1016/j.jbiomech.2021.110804
• Languages: English
• ISSNs: 0021-9290

Abstract

Abstract: We sought to assess the amount and distribution of force on the valve frame after transcatheter aortic valve replacement (TAVR) via patient-specific computer simulation. Patients successfully treated with the self-expanding Venus A-Valve and multislice computed tomography (MSCT) pre- and post-TAVR were retrospectively included. Patient-specific finite element models of the aortic root and prosthesis were constructed. The force (in Newton) on the valve frame was derived at every 3 mm from the inflow and at every 22.5° on each level. Twenty patients of whom 10 had bicuspid aortic valve (BAV) were analyzed. The total force on the frame was 74.9 N in median (interquartile range 24.0). The maximal force was observed at level 5 that corresponds with the nadir of the bioprosthetic leaflets and was 9.9 (7.1) N in all patients, 10.3 (6.6) N in BAV and 9.7 (9.2) N for patients with tricuspid aortic valve (TAV). The level of maximal force located higher from the native annulus in BAV and TAV patients (8.8 [4.8] vs. 1.8 [7.4] mm). The area of the valve frame at the level of maximal force decreased from 437.4 (239.7) mm 2 at the annulus to 377.6 (114.3) mm 2 in BAV, but increased from 397.5 (114.3) mm 2 at the annulus to 406.7 (108.9) mm 2 in TAV. The maximum force on the bioprosthetic valve frame is located at the plane of the nadir of the bioprosthetic leaflets. It remains to be elucidated whether this may be associated with bioprosthetic frame and leaflet integrity and/or function.