Numerical investigation of the effects of pre-dilatation on paravalvular leakage during transcatheter aortic valve implantation
Year: 2024
Type: article
Abstract: Due to promising results, the patient cohort for transcather aortic valve replacement (TAVR) has been extended in recent years to include patients with a bicuspid aortic valve (BAV). There are different types of BAV. One variant is the tricommisural bicuspid aortic valve (TBAV). BAV have an increased risk of post-TAVR complications such as paravalvular leakage. In the case of paravalvular leakage, blood flows past the prosthesis back into the ventricle during diastole. Clinically, patients with BAV are often pre-dilated. For this reason, we want to investigate how pre-dilatation of BAV can affect the leakage rate. A simplified model is used for pre-dilatation, where the calcification nodule is cut along the free edge of the leaflets before the deployment. In order to evaluate the effects of this method, a deployment simulation was carried out for both geometries using an explicit calculation. A flow simulation was then performed to determine the paravalvular leakage. The pre-dilatation allows the leaflets to move independently of each other. Without pre-dilatation, the TAVR cannot fully expanded. The leakage rate is higher for the BAV than for the pre-dilated geometry (53.1mLs−1 vs. 19.4mLs−1). In this model, we have shown the effect of pre-dilatation on implantation results.
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4405554660