Related Experiment Video
Updated: Mar 27, 2026
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Simulation of Transcatheter Aortic Valve Replacement in patient-specific aortic roots: Effect of crimping and
Insights
A new polymeric valve shows better crimping mechanics than the SAPIEN valve for transcatheter aortic valve replacement (TAVR). Simulations reveal how aortic calcifications impact TAVR deployment and may cause paravalvular leakage.
Area of Science:
- Biomedical Engineering
- Cardiovascular Research
- Materials Science
Background:
- Calcific aortic valve disease (CAVD) narrows the aortic valve opening due to calcification.
- Transcatheter aortic valve replacement (TAVR) is a crucial treatment for patients unsuitable for surgical valve replacement.
- Sub-optimal TAVR procedures can lead to adverse effects like aortic root injury and paravalvular leakage (PVL), often due to native calcifications and valve crimping damage.
Purpose of the Study:
- To compare the crimping mechanics of the Edwards SAPIEN valve and an alternative polymeric valve (Polynova).
- To evaluate the impact of different TAVR deployment positions on patient outcomes using patient-specific numerical models.
- To understand the role of aortic calcifications in TAVR anchoring and PVL.
Main Methods:
- Comparative assessment of crimping mechanics for SAPIEN and Polynova valves.
- Patient-specific numerical modeling to simulate TAVR deployment.
- Analysis of TAVR stent-native aortic root interactions at various deployment positions.
Main Results:
- The Polynova valve demonstrated superior resistance to the crimping process compared to the SAPIEN valve.
- Deployment simulations highlighted the influence of calcification deposits on TAVR valve anchoring.
- Calcifications can lead to suboptimal valve anchoring and gaps, resulting in PVL.
Conclusions:
- The polymeric Polynova valve exhibits improved crimping durability for TAVR.
- Aortic calcifications significantly affect TAVR anchoring, potentially causing PVL.
- Optimizing TAVR deployment location is critical for mitigating risks associated with calcific aortic valve disease.
Abstract:
Calcific aortic valve disease (CAVD) is a cardiovascular condition that causes the progressive narrowing of the aortic valve (AV) opening, due to the growth of bone-like deposits all over the aortic root (AR). Transcatheter aortic valve replacement (TAVR), a minimally invasive procedure, has recently become the only lifesaving solution for patients that cannot tolerate the standard surgical valve replacement. However, adverse effects, such as AR injury or paravalvular leakage (PVL), may occur as a consequence of a sub-optimal procedure, due to the presence of calcifications in situ. Additionally, the crimping required for delivering the valve via stenting may damage the valve. The aim of the present study is to comparatively assess the crimping mechanics of the commercialized Edwards SAPIEN valve and an alternative polymeric valve (Polynova, Inc) and to evaluate the effect of different TAVR deployment positions using patient-specific numerical models. The optimal deployment location for achieving better patient outcomes was calculated and based on the interactions between the TAVR stent and the native AR. Results demonstrated that the Polynova valve withstands the crimping process better than the SAPIEN valve. Furthermore, deployment simulations showed the role that calcifications deposits may play in the TAVR sub-optimal valve anchoring to the AV wall, leading to the presence of gaps that result in PVL.
