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Simulation of transcatheter aortic valve implantation under consideration of leaflet calcification


Russ, Christoph; Hopf, Raoul; Hirsch, Sven; Sündermann, Simon; Falk, Volkmar; Szekely, Gabor; Gessat, Michael (2013). Simulation of transcatheter aortic valve implantation under consideration of leaflet calcification. IEEE Engineering in Medicine and Biology Society. Conference Proceedings, 2013:711-714.

Abstract

Transcatheter aortic valve implantation (TAVI) is a minimally invasive off-pump procedure to replace diseased aortic heart valves. Known complications include paravalvular leaks, atrioventricular blocks, coronary obstruction and annular rupture. Careful procedure planning including appropriate stent selection and sizing are crucial. Few patient-specific geometric parameters, like annular diameters, annular perimeter and measurement of the distance to the coronary ostia, are currently used within this process. Biomechanical simulation allows the consideration of extracted anatomy and material parameters for the intervention, which may improve planning and execution phases. We present a simulation workflow using a fully segmented aortic root anatomy, which was extracted from pre-operative CT-scan data and apply individual material models and parameters to predict the procedure outcome. Our results indicate the high relevance of calcification location and size for intervention planning, which are not sufficiently considered at this time. Our analysis can further provide guidance for accurate, patient-specific device positioning and future adaptations to stent design.

Abstract

Transcatheter aortic valve implantation (TAVI) is a minimally invasive off-pump procedure to replace diseased aortic heart valves. Known complications include paravalvular leaks, atrioventricular blocks, coronary obstruction and annular rupture. Careful procedure planning including appropriate stent selection and sizing are crucial. Few patient-specific geometric parameters, like annular diameters, annular perimeter and measurement of the distance to the coronary ostia, are currently used within this process. Biomechanical simulation allows the consideration of extracted anatomy and material parameters for the intervention, which may improve planning and execution phases. We present a simulation workflow using a fully segmented aortic root anatomy, which was extracted from pre-operative CT-scan data and apply individual material models and parameters to predict the procedure outcome. Our results indicate the high relevance of calcification location and size for intervention planning, which are not sufficiently considered at this time. Our analysis can further provide guidance for accurate, patient-specific device positioning and future adaptations to stent design.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiovascular Surgery
Dewey Decimal Classification:610 Medicine & health
Language:German
Date:2013
Deposited On:04 Feb 2014 07:54
Last Modified:05 Apr 2016 17:30
Publisher:Institute of Electrical and Electronics Engineers
ISSN:1557-170X
Publisher DOI:https://doi.org/10.1109/EMBC.2013.6609599
PubMed ID:24109786

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