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The Accelerated Transcatheter Heart Valve Testing Environment: Loading, Motion, and Fluid Dynamics.
Sailahari V Ponnaluri1, Michael S Sacks2, Keefe B Manning3
1Department of Biomedical Engineering, The Pennsylvania State University, 122 Chemical and Biomedical Engineering Building, University Park, PA 16802.
Journal of Biomechanical Engineering
|November 23, 2022
Summary
Transcatheter aortic valve replacement (TAVR) durability testing in accelerated wear testers does not accurately reflect in vivo conditions. Optimizing AWT operating parameters is crucial for reliable TAVR fatigue and failure prediction.
Area of Science:
- Biomedical Engineering
- Cardiovascular Devices
- Materials Science
Background:
- Transcatheter aortic valve replacements (TAVRs) are common minimally invasive treatments for aortic valve disease.
- Thinner TAVR leaflets face higher stresses, raising concerns about durability compared to surgical valves.
- Current understanding of TAVR durability is limited, with preclinical testing facing challenges.
Purpose of the Study:
- To investigate the effects of frequency and diastolic period on the dynamic environment within an accelerated wear tester (AWT).
- To quantify TAVR valve motion and fluid dynamics under varying AWT operating conditions.
- To assess the physiological relevance of AWT testing for predicting TAVR durability.
Main Methods:
- Utilized high-speed enface imaging to quantify valve motion.
- Employed particle image velocimetry to measure fluid dynamics.
- Tested a Durapulse™ AWT at frequencies of 10, 15, and 20 Hz.
Main Results:
- No tested AWT operating condition produced physiologically relevant transvalvular loading pressures.
- While general fluid mechanics showed similarities to in vivo conditions, AWT geometry induced secondary flow structures.
- Variability in loading and non-physiologic conditions were observed across different operating parameters.
Conclusions:
- Current accelerated wear testing protocols may not accurately predict TAVR fatigue failure mechanisms.
- Careful regulation of AWT operating conditions is necessary to ensure physiologically relevant fatigue testing.
- Further research is needed to optimize AWTs for accurate preclinical evaluation of TAVR durability.
