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Aortic root sizing for transcatheter aortic valve implantation using a shape model parameterisation

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Abstract

During a transcatheter aortic valve implantation, an axisymmetric implant is placed in an irregularly shaped aortic root. Implanting an incorrect size can cause complications such as leakage of blood alongside or through the implant. The aim of this study was to construct a method that determines the optimal size of the implant based on the three-dimensional shape of the aortic root. Based on the pre-interventional computed tomography scan of 89 patients, a statistical shape model of their aortic root was constructed. The weights associated with the principal components and the volume of calcification in the aortic valve were used as parameters in a classification algorithm. The classification algorithm was trained using the patients with no or mild leakage after their intervention. Subsequently, the algorithms were applied to the patients with moderate to severe leakage. Cross validation showed that a random forest classifier assigned the same size in 65 ± 7% of the training cases, while 57 ± 8% of the patients with moderate to severe leakage were assigned a different size. This initial study showed that this semi-automatic method has the potential to correctly assign an implant size. Further research is required to assess whether the different size implants would improve the outcome of those patients.

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Funding

This work was supported in part by a PhD grant (120198) from the agency for innovation through science and technology (IWT) of the Flemish government.

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Authors and Affiliations

  1. KULeuven, Faculty of Engineering Science, Departement of Mechanical Engineering, Biomechanics Section, Celestijnenlaan 300C, 3001, Leuven, Belgium

    Bart Bosmans, Patricia Lopes & Jos Vander Sloten

  2. Materialise N.V., Technologielaan 15, 3001, Leuven, Belgium

    Bart Bosmans, Patricia Lopes & Eva Verhoelst

  3. Faculty of Medicine and Health Sciences, Department of Translational Pathophysiological Research, Cardiovascular diseases, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium

    Bart Bosmans & Johan Bosmans

  4. iMinds-Vision Lab, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium

    Toon Huysmans, Patricia Lopes & Jan Sijbers

  5. Applied Ergonomics and Design, Department of Industrial Design, TU Delft, Landbergstraat 15, 2628, CE, Delft, The Netherlands

    Toon Huysmans

  6. UGent, IBiTech-bioMMeda, iMinds medical IT, Ghent University, Ghent, Belgium

    Tim Dezutter

  7. FEops N.V., Technologiepark 3, 9052, Ghent, Belgium

    Tim Dezutter

  8. Erasmus Medical Center, Thoraxcenter, Departement of Cardiology, ’s-Gravendijkwal 230, 3015, CE, Rotterdam, The Netherlands

    Peter de Jaegere

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  1. Bart Bosmans
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Corresponding authors

Correspondence to Bart Bosmans or Toon Huysmans.

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Conflict of interest

Prof. Dr. Johan Bosmans and Prof. Dr. Peter de Jaegere are part-time clinical proctor for Medtronic. Prof. Dr. ir. Jos Vander Sloten is a member of the Board of Directors of Materialise N.V. and a shareholder. The remaining authors have no conflicts of interest to declare.

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Bosmans, B., Huysmans, T., Lopes, P. et al. Aortic root sizing for transcatheter aortic valve implantation using a shape model parameterisation. Med Biol Eng Comput 57, 2081–2092 (2019). https://doi.org/10.1007/s11517-019-01996-x

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  • DOI: https://doi.org/10.1007/s11517-019-01996-x

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