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CoreValve vs. Sapien 3 Transcatheter Aortic Valve Replacement: A Finite Element Analysis Study
Francesco Nappi1, Laura Mazzocchi2, Cristiano Spadaccio3
1Department of Cardiac Surgery, Centre Cardiologique du Nord, 93200 Saint Denis, France.
Bioengineering (Basel, Switzerland)
|April 30, 2021
Summary
Finite element analysis (FEA) revealed that persistent calcifications after transcatheter heart valve replacement (TAVR) cause valve distortion and complications. This FEA approach can improve patient selection and procedure planning for TAVR.
Area of Science:
- Biomedical Engineering
- Computational Mechanics
- Cardiovascular Research
Background:
- Transcatheter Aortic Valve Replacement (TAVR) is a common procedure for aortic stenosis.
- Postoperative complications, including valve thrombosis and paravalvular leak, can occur.
- Understanding the biomechanical factors contributing to TAVR complications is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the biomechanical factors contributing to postoperative complications in self-expandable and balloon-expandable transcatheter heart valves using Finite Element Analysis (FEA).
- To identify predictors of valve thrombosis and paravalvular leak following TAVR.
Main Methods:
- FEA was integrated with CT scans of patients who experienced TAVR complications (valve thrombosis) and those with uncomplicated TAVR.
- Two cases of CoreValve and Sapien 3 valve implantation with device failure were analyzed.
- FEA results were compared with imaging data from uncomplicated TAVR cases.
Main Results:
- Computational modeling identified persistent calcifications, not visible on CT scans, after valve expansion.
- These calcifications caused geometrical distortion and elliptical deformation of the valves, leading to hemodynamic disturbances and potential thrombosis.
- Increased regional stress and paravalvular leak were observed in areas of valve distortion.
Conclusions:
- FEA can reveal sub-visual calcifications and biomechanical issues contributing to TAVR complications.
- FEA, as an adjunct to preoperative imaging, can aid in patient selection and procedure planning.
- This approach may help in the detection and prevention of TAVR-related complications.
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