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Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...

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The Effect of von Willebrand Disease on Platelet Adhesion Dynamics: Correlating a Multiscale Platelet Model to In Vitro Results.

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Development of a Polymeric TAVR Device Tailored to Bicuspid Aortic Valve Patients Using In Silico Design Optimization and Evaluation.

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Thrombogenic Risk Assessment of Transcatheter Prosthetic Heart Valves Using a Fluid-Structure Interaction Approach.

Computer methods and programs in biomedicine·2024

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Thrombogenic Risk Assessment of Transcatheter Prosthetic Heart Valves Using a Fluid-Structure Interaction Approach.

Kyle Baylous1, Brandon Kovarovic1, Salwa Anam1

  • 1Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA 11794.

Arxiv
|July 1, 2024
PubMed
Summary
This summary is machine-generated.

A new fluid-structure interaction (FSI) method assesses thrombotic risk in transcatheter aortic valve replacement (TAVR) devices. This computational approach optimizes valve design and evaluates patient-specific risks, improving long-term outcomes.

Keywords:
TAVRcardiovascular implantsfluid-structure interactionthrombogenic riskthrombus

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Area of Science:

  • Cardiovascular Engineering
  • Biomedical Fluid Dynamics
  • Computational Mechanics

Background:

  • Transcatheter Aortic Valve Replacement (TAVR) procedures have increased, but long-term thrombotic events remain a significant complication.
  • Accurate thrombogenic risk analysis for TAVR devices is crucial for improving patient outcomes.
  • Traditional in vitro thrombogenicity studies are challenging; revised ISO standards now incorporate computational testing.

Purpose of the Study:

  • To present and validate a fluid-structure interaction (FSI) approach for assessing the thrombogenic risk of prosthetic heart valves.
  • To utilize this FSI methodology for engineering optimization of TAVR devices and for clinical assessment of patient-specific risks.

Main Methods:

  • Implemented an FSI framework using Ansys LS-DYNA for incompressible computational fluid dynamics.
  • Validated the numerical model by comparing in silico flow rates and orifice areas with benchtop testing and literature data.
  • Analyzed thrombogenic risk by computing stress accumulation (SA) on virtual platelets within the simulated flow fields using Ansys EnSight.

Main Results:

  • The in silico model accurately predicted effective orifice areas and flow rates for commercial TAVR valves.
  • The FSI approach revealed varying stress accumulation magnitudes on platelets for different TAVR leaflet designs.
  • Patient-specific simulations demonstrated diverse thrombogenic risks in bicuspid aortic valve anatomies, even with mild paravalvular leaks.

Conclusions:

  • The developed FSI methodology enables the optimization of prosthetic valve thromboresistance from the design phase through clinical application.
  • Identified key TAVR leaflet design parameters to mitigate thrombogenic risk and demonstrated the utility of patient-specific modeling.
  • This advanced in silico analysis is valuable for thrombogenic risk assessment of TAVR devices and other blood-contacting implants.