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ORIGINAL RESEARCH article

Front. Physiol.
Sec. Computational Physiology and Medicine
Volume 15 - 2024 | doi: 10.3389/fphys.2024.1407215

Computational Study of Transcatheter Aortic Valve Replacement Based on Patient-Specific Models -Rapid Surgical Planning for Self-Expanding Valves

Provisionally accepted
Zhuangyuan Meng Zhuangyuan Meng 1*Haishan Zhang Haishan Zhang 2*Yunhan Cai Yunhan Cai 1*Yuan Gao Yuan Gao 2*Changbin Liang Changbin Liang 2*Jun Wang Jun Wang 3*Xin Chen Xin Chen 4*Liang Guo Liang Guo 2*Shengzhang Wang Shengzhang Wang 5*
  • 1 Department of Aeronautics and Astronautics, Fudan University, Shanghai, Shanghai Municipality, China
  • 2 Department of Geriatrics Cardiology, First Hospital of China Medical University, Shenyang, Liaoning Province, China
  • 3 Department of Anesthesiology, First Hospital of China Medical University, Shenyang, Liaoning Province, China
  • 4 Department of Ultrasound, The First Hospital of China Medical University, Shenyang, Liaoning Province, China
  • 5 Department of Aeronautics and Astronautics, Fudan University, Shanghai, China

The final, formatted version of the article will be published soon.

    Transcatheter aortic valve replacement (TAVR) is a minimally invasive interventional solution for treating aortic stenosis. The complex post-TAVR complications are associated with the type of valve implanted and the position of the implantation. The study aimed to establish a rapid numerical research method for TAVR to assess the performance differences of self-expanding valves released at various positions. It also aimed to calculate the risks of postoperative paravalvular leak and atrioventricular conduction block, comparing these risks to clinical outcomes to verify the method's effectiveness and accuracy. Based on medical images, six cases were established, including the aortic wall, native valve and calcification; one with a bicuspid aortic valve and five with tricuspid aortic valves. The parameters for the stent materials used by the patients were customized. High strain in the contact area between the stent and the valve annulus may lead to atrioventricular conduction block. Postoperatively, the self-expanding valve maintained a circular cross-section, reducing the risk of paravalvular leak and demonstrating favorable hemodynamic characteristics, consistent with clinical observations. The outcomes of the six simulations showed no significant difference in valve frame morphology or paravalvular leak risk compared to clinical results, thereby validating the numerical simulation process proposed for quickly selecting valve models and optimal release positions, aiding in TAVR preoperative planning based on patients'geometric characteristics.

    Keywords: Finite Element Analysis, Transcatheter aortic valve replacement, Structural simulation, Self-expanding valve, computational fluid dynamics

    Received: 26 Mar 2024; Accepted: 15 May 2024.

    Copyright: © 2024 Meng, Zhang, Cai, Gao, Liang, Wang, Chen, Guo and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Zhuangyuan Meng, Department of Aeronautics and Astronautics, Fudan University, Shanghai, 200433, Shanghai Municipality, China
    Haishan Zhang, Department of Geriatrics Cardiology, First Hospital of China Medical University, Shenyang, Liaoning Province, China
    Yunhan Cai, Department of Aeronautics and Astronautics, Fudan University, Shanghai, 200433, Shanghai Municipality, China
    Yuan Gao, Department of Geriatrics Cardiology, First Hospital of China Medical University, Shenyang, Liaoning Province, China
    Changbin Liang, Department of Geriatrics Cardiology, First Hospital of China Medical University, Shenyang, Liaoning Province, China
    Jun Wang, Department of Anesthesiology, First Hospital of China Medical University, Shenyang, 110000, Liaoning Province, China
    Xin Chen, Department of Ultrasound, The First Hospital of China Medical University, Shenyang, 110000, Liaoning Province, China
    Liang Guo, Department of Geriatrics Cardiology, First Hospital of China Medical University, Shenyang, Liaoning Province, China
    Shengzhang Wang, Department of Aeronautics and Astronautics, Fudan University, Shanghai, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.