Patient-specific Biomechanical Investigation of Percutaneous Pulmonary Valves: Towards the Integration of Routinely...

Percutaneous pulmonary valves (PPVs) offer a minimally invasive option to treat pulmonary valve dysfunction in patients with congenital heart disease. Fluid structure interaction (FSI) simulations can provide a comprehensive assessment of heart valves biomechanics by capturing the coupled hemodynamics and leaflet mechanics. However, their application to PPVs remains limited. As the range of commercially available devices expands, robust characterization of PPV biomechanics may support the evaluation of short and long-term treatment performance. In this context, this study presents a patient-specific FSI framework for PPV simulation based on routinely acquired clinical data. Pulmonary artery and bifurcation geometries from four patients with implanted PPV were reconstructed from computed tomography. A PPV model was created and positioned within each patient-specific geometry. Boundary conditions were prescribed using patient-specific flow-rate waveforms and flow splits. Two-way, strongly coupled FSI simulations were performed to quantify transvalvular pressure drop, PPV-related flow patterns, and leaflets mechanics. Simulations reproduced peak transvalvular pressure drop in good agreement with available clinical measurements. Hemodynamics varied markedly across patients, with inter patient differences up to 393% in vorticity stretching and 337% in helicity intensity. Leaflet mechanics provided insights into the distribution of wall shear stress and first principal stress on PPV leaflets. Overall, the FSI approach captured PPV biomechanics across diverse patient-specific scenarios matching clinical pressure measurements and providing additional information on PPV biomechanical behavior. These results support the potential use of patient-specific FSI modelling to investigate PPV behavior under different patient-specific operating conditions.