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research article

Fluid-structure interaction analysis of transcatheter aortic valve implantation

Fumagalli, Ivan
•
Polidori, Rebecca
•
Renzi, Francesca
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April 5, 2023
International Journal For Numerical Methods In Biomedical Engineering

Transcatheter aortic valve implantation (TAVI) is a minimally invasive intervention for the treatment of severe aortic valve stenosis. The main cause of failure is the structural deterioration of the implanted prosthetic leaflets, possibly inducing a valvular re-stenosis 5-10 years after the implantation. Based solely on pre-implantation data, the aim of this work is to identify fluid-dynamics and structural indices that may predict the possible valvular deterioration, in order to assist the clinicians in the decision-making phase and in the intervention design. Patient-specific, pre-implantation geometries of the aortic root, the ascending aorta, and the native valvular calcifications were reconstructed from computed tomography images. The stent of the prosthesis was modeled as a hollow cylinder and virtually implanted in the reconstructed domain. The fluid-structure interaction between the blood flow, the stent, and the residual native tissue surrounding the prosthesis was simulated by a computational solver with suitable boundary conditions. Hemodynamical and structural indicators were analyzed for five different patients that underwent TAVI - three with prosthetic valve degeneration and two without degeneration - and the comparison of the results showed a correlation between the leaflets' structural degeneration and the wall shear stress distribution on the proximal aortic wall. This investigation represents a first step towards computational predictive analysis of TAVI degeneration, based on pre-implantation data and without requiring additional peri-operative or follow-up information. Indeed, being able to identify patients more likely to experience degeneration after TAVI may help to schedule a patient-specific timing of follow-up.

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Type
research article
DOI
10.1002/cnm.3704
Web of Science ID

WOS:000964559200001

Author(s)
Fumagalli, Ivan
Polidori, Rebecca
Renzi, Francesca
Fusini, Laura
Quarteroni, Alfio  
Pontone, Gianluca
Vergara, Christian
Date Issued

2023-04-05

Publisher

WILEY

Published in
International Journal For Numerical Methods In Biomedical Engineering
Article Number

e3704

Subjects

Engineering, Biomedical

•

Mathematical & Computational Biology

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Mathematics, Interdisciplinary Applications

•

Engineering

•

Mathematical & Computational Biology

•

Mathematics

•

computed tomography

•

fluid-structure interaction

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image-based simulations

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in-silico predictive investigation

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patient-specific analysis

•

transcatheter aortic valve implantation

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finite-element-method

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wall shear-stress

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cardiovascular-system

•

algorithms

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
CMCS  
Available on Infoscience
May 8, 2023
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/197464
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