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Títol:
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On the modeling of patient-specific transcatheter aortic valve replacement: a fluid–structure interaction approach
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Autor/a:
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Luraghi, Giulia; Migliavacca, Francesco; García González, Alberto; Chiastra, Claudio; Rossi, Alexia; Cao, Davide; Stefanini, Giulio; Rodríguez Matas, José Félix
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Altres autors:
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Universitat Politècnica de Catalunya. Departament d'Enginyeria Civil i Ambiental; Universitat Politècnica de Catalunya. LACÀN - Mètodes Numèrics en Ciències Aplicades i Enginyeria |
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Abstract:
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This is a post-peer-review, pre-copyedit version of an article published in Cardiovascular engineering and technology. The final authenticated version is available online at: http://dx.doi.org/10.1007/s13239-019-00427-0 |
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Abstract:
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Purpose Transcatheter aortic valve replacement (TAVR) is a minimally invasive treatment for high-risk patients with aortic diseases. Despite its increasing use, many influential factors are still to be understood and require continuous investigation. The best numerical approach capable of reproducing both the valves mechanics and the hemodynamics is the fluid–structure interaction (FSI) modeling. The aim of this work is the development of a patient-specific FSI methodology able to model the implantation phase as well as the valve working conditions during cardiac cycles. Methods The patient-specific domain, which included the aortic root, native valve and calcifications, was reconstructed from CT images, while the CAD model of the device, metallic frame and pericardium, was drawn from literature data. Ventricular and aortic pressure waveforms, derived from the patient’s data, were used as boundary conditions. The proposed method was applied to two real clinical cases, which presented different outcomes in terms of paravalvular leakage (PVL), the main complication after TAVR. Results The results confirmed the clinical prognosis of mild and moderate PVL with coherent values of regurgitant volume and effective regurgitant orifice area. Moreover, the final release configuration of the device and the velocity field were compared with postoperative CT scans and Doppler traces showing a good qualitative and quantitative matching. Conclusion In conclusion, the development of realistic and accurate FSI patient-specific models can be used as a support for clinical decisions before the implantation. |
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Abstract:
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Peer Reviewed |
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Matèries:
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-Àrees temàtiques de la UPC::Matemàtiques i estadística::Anàlisi numèrica
-Àrees temàtiques de la UPC::Matemàtiques i estadística::Investigació operativa::Programació matemàtica
-Numerical analysis
-Numerical analysis--Simulation methods
-Transcatheter aortic valve replacement (TAVR)
-Transcatheter aortic valve implantation (TAVI)
-Fluid–structure interaction simulation (FSI)
-Aortic valve
-Patient-specific numerical model
-Finite-element analysis (FE)
-Anàlisi numèrica
-Anàlisi numèrica
-Classificació AMS::65 Numerical analysis::65K Mathematical programming, optimization and variational techniques
-Classificació AMS::65 Numerical analysis::65C Probabilistic methods, simulation and stochastic differential equations |
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Drets:
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Tipus de document:
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Article - Versió presentada
Article |
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Publicat per:
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Springer
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