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Impact of aortic valve leaflets calcium volume and distribution on Post-TAVR conduction abnormalities.

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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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Updated: Jul 7, 2026

Impact of Intracardiac Neurons on Cardiac Electrophysiology and Arrhythmogenesis in an Ex Vivo Langendorff System
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Assessing post-TAVR cardiac conduction abnormalities risk using an electromechanically coupled beating heart.

Symon Reza1, Brandon Kovarovic1, Danny Bluestein2

  • 1Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11794-8084, USA.

Biomechanics and Modeling in Mechanobiology
|October 3, 2024
PubMed
Summary

Transcatheter aortic valve replacement (TAVR) can cause cardiac conduction abnormalities (CCA) due to device pressure on heart fibers. Deeper implantation and right bundle branch block increase CCA risk, while aortic deployment and left bundle branch block may reduce it.

Keywords:
CCAConduction abnormalityFEALiving heart modelPPITAVR

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Area of Science:

  • Cardiovascular medicine
  • Biomedical engineering
  • Computational modeling

Background:

  • Transcatheter aortic valve replacement (TAVR) is increasingly preferred over surgical aortic valve replacement (SAVR).
  • Cardiac conduction abnormalities (CCA) are a significant complication following TAVR.
  • Pressure from the TAVR device on cardiac conduction fibers near the atrioventricular node can cause CCA.

Purpose of the Study:

  • To develop an in silico framework for assessing CCA risk after TAVR.
  • To investigate the impact of implantation depth and pre-existing cardiac asynchrony on CCA.
  • To analyze biomechanical parameters influencing post-TAVR CCA.

Main Methods:

  • Simulated self-expandable TAVR device deployment in an electromechanically coupled beating heart model.
  • Modeled five patient scenarios with varying implantation depths and pre-existing conditions (RBBB, LBBB).
  • Analyzed cumulative contact pressure on conduction fibers.

Main Results:

  • Aortic TAVR deployment resulted in lower contact pressure (0.018 MPa) compared to ventricular deployment (0.52 MPa).
  • Pre-existing right bundle branch block (RBBB) showed higher contact pressure (0.34 MPa) than left bundle branch block (LBBB) (0.25 MPa).
  • Deeper implantation and RBBB increased stress and contact pressure on conduction fibers.

Conclusions:

  • Deeper TAVR implantation and RBBB elevate the risk of post-TAVR CCA.
  • Aortic deployment and LBBB may reduce the risk of CCA.
  • In silico modeling provides a valuable tool for predicting and mitigating TAVR-related conduction complications.