Fluid–Structure Interaction Model of a Percutaneous Aortic Valve: Comparison with an In Vitro Test and Feasibility Study in a Patient-Specific Case
- 979 Downloads
Transcatheter aortic valve replacement (TAVR) represents an established recent technology in a high risk patient base. To better understand TAVR performance, a fluid–structure interaction (FSI) model of a self-expandable transcatheter aortic valve was proposed. After an in vitro durability experiment was done to test the valve, the FSI model was built to reproduce the experimental test. Lastly, the FSI model was used to simulate the virtual implant and performance in a patient-specific case. Results showed that the leaflet opening area during the cycle was similar to that of the in vitro test and the difference of the maximum leaflet opening between the two methodologies was of 0.42%. Furthermore, the FSI simulation quantified the pressure and velocity fields. The computed strain amplitudes in the stent frame showed that this distribution in the patient-specific case is highly affected by the aortic root anatomy, suggesting that the in vitro tests that follow standards might not be representative of the real behavior of the percutaneous valve. The patient-specific case also compared in vivo literature data on fast opening and closing characteristics of the aortic valve during systolic ejection. FSI simulations represent useful tools in determining design errors or optimization potentials before the fabrication of aortic valve prototypes and the performance of tests.
KeywordsFluid–structure interaction Valve mechanics Mathematical models Stent Transcatheter aortic valve
Wei Wu is supported by the Politecnico di Milano International Fellowships Program (PIF). Claudio Chiastra is partially supported by the ERC starting Grant (310457, BioCCora). Desiree Pott is supported by the Deutsche Forschungsgemeinschaft (DFG) Grant STE1680/5-1.
Conflict of interests
There is no conflict of interests.
- 3.Bianchi M., R. Ghosh, D. Das, G. Marom, T. Claiborne, M. Slepian, and D. Bluenstein. Transcatheter aortic valve replacement model: crimping and deploying in patient-pathology specific roots. In: Summer Biomechanics, Bioengineering and Biotransport Conference. Utah: Snowbird Resort, 2015.Google Scholar
- 4.Bonhoeffer, P., Y. Boudjemline, Z. Saliba, J. Merckx, Y. Aggoun, D. Bonnet, P. Acar, J. Le Bidois, D. Sidi, and J. Kachaner. Percutaneous replacement of pulmonary valve in a right-ventricle to pulmonary-artery prosthetic conduit with valve dysfunction. Lancet 356:1403–1405, 2000.CrossRefPubMedGoogle Scholar
- 5.Bosi, G. M., C. Capelli, S. Khambadkone, A. M. Taylor, and S. Schievano. Patient-specific finite element models to support clinical decisions: a lesson learnt from a case study of percutaneous pulmonary valve implantation. Catheter. Cardiovasc. Interv. 2015. doi: 10.1002/ccd.25944.PubMedGoogle Scholar
- 10.Cosentino, D., M. A. Quail, G. Pennati, C. Capelli, P. Bonhoeffer, V. Diaz-Zuccarini, A. M. Taylor, and S. Schievano. Geometrical and stress analysis of factors associated with stent fracture after melody percutaneous pulmonary valve implantation. Circ. Cardiovasc. Interv. 7:510–517, 2014.CrossRefPubMedGoogle Scholar
- 11.Cribier, A., H. Eltchaninoff, A. Bash, N. Borenstein, C. Tron, F. Bauer, G. Derumeaux, F. Anselme, F. Laborde, and M. B. Leon. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis—first human case description. Circulation 106:3006–3008, 2002.CrossRefPubMedGoogle Scholar
- 16.Grube, E., J. C. Laborde, U. Gerckens, T. Felderhoff, B. Sauren, L. Buellesfeld, R. Mueller, M. Menichelli, T. Schmidt, B. Zickmann, S. Iversen, and G. W. Stone. Percutaneous implantation of the CoreValve self-expanding valve prosthesis in high-risk patients with aortic valve disease—the Siegburg first-in-man study. Circulation 114:1616–1624, 2006.CrossRefPubMedGoogle Scholar
- 19.Laflamme, J., R. Puri, M. Urena, L. Laflamme, H. DeLarochelliere, O. A.-J. Altisent, M. del Trigo, F. Campelo-Parada, R. DeLarochelliere, J.-M. Paradis, E. Dumont, D. Doyle, S. Mohammadi, M. Cote, P. Pibarot, V. Laroche, and J. Rodes-Cabau. Incidence and risk factors of hemolysis after transcatheter aortic valve implantation with a balloon-expandable valve. Am. J. Cardiol. 115:1574–1579, 2015.CrossRefPubMedGoogle Scholar
- 30.Schievano, S., A. M. Taylor, C. Capelli, P. Lurz, J. Nordmeyer, F. Migliavacca, and P. Bonhoeffer. Patient specific finite element analysis results in more accurate prediction of stent fractures: application to percutaneous pulmonary valve implantation. J. Biomech. 43:687–693, 2010.CrossRefPubMedGoogle Scholar