Reversed Auxiliary Flow to Reduce Embolism Risk During TAVI: A Computational Simulation and Experimental Study

Area of Science:

• Cardiovascular research
• Biomedical engineering
• Medical device innovation

Background:

• Transcatheter aortic valve implantation (TAVI) procedures carry a risk of cerebral embolization from dislodged debris.
• Existing embolic filters require further optimization to minimize cerebrovascular events.

Purpose of the Study:

• To investigate a novel embolic protection strategy during TAVI.
• To elucidate mechanisms of cerebral embolism in endovascular treatments.

Main Methods:

• Developed an experimental framework with in silico simulation for particle embolization studies.
• Investigated the effect of auxiliary flow from the right subclavian artery (RSA) on particle distribution.
• Utilized computational fluid dynamics (CFD) to determine optimal retrograde flow rates.

Main Results:

• A constant retrograde flow of 0.5 L/min from the RSA protected the brachiocephalic trunk from particle embolisms under a 4 L/min ascending aorta inflow.
• Flow distribution significantly impacts particle distribution in aortic branches, independent of release location or rate.
• Both computational and experimental data confirmed the efficacy of the proposed technique.

Conclusions:

• The integration of in vitro and in silico methods enables the design of novel embolic protection solutions.
• The proposed embo-deviation technique using auxiliary RSA flow offers a promising strategy for cerebral embolic protection during TAVI.
• This approach can help reduce cerebrovascular events associated with endovascular procedures.