Patient-Specific Immersed Finite Element-Difference Model of Transcatheter Aortic Valve Replacement.

Autor: Brown JA; Department of Mathematics, University of North Carolina, Chapel Hill, NC, USA. jordanbrown@unc.edu., Lee JH; Department of Mathematics, University of North Carolina, Chapel Hill, NC, USA., Smith MA; Department of Mathematics, University of North Carolina, Chapel Hill, NC, USA.; University of North Carolina School of Medicine, Chapel Hill, NC, USA., Wells DR; Department of Mathematics, University of North Carolina, Chapel Hill, NC, USA., Barrett A; Department of Mathematics, University of North Carolina, Chapel Hill, NC, USA., Puelz C; Division of Cardiology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA., Vavalle JP; Division of Cardiology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA., Griffith BE; Departments of Mathematics, Applied Physical Sciences, and Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA. boyceg@email.unc.edu.; Carolina Center for Interdisciplinary Applied Mathematics, University of North Carolina, Chapel Hill, NC, USA. boyceg@email.unc.edu.; Computational Medicine Program, University of North Carolina School of Medicine, Chapel Hill, NC, USA. boyceg@email.unc.edu.; McAllister Heart Institute, University of North Carolina School of Medicine, Chapel Hill, NC, USA. boyceg@email.unc.edu.
Jazyk: angličtina
Zdroj: Annals of biomedical engineering [Ann Biomed Eng] 2023 Jan; Vol. 51 (1), pp. 103-116. Date of Electronic Publication: 2022 Oct 20.
DOI: 10.1007/s10439-022-03047-3
Abstrakt: Transcatheter aortic valve replacement (TAVR) first received FDA approval for high-risk surgical patients in 2011 and has been approved for low-risk surgical patients since 2019. It is now the most common type of aortic valve replacement, and its use continues to accelerate. Computer modeling and simulation (CM&S) is a tool to aid in TAVR device design, regulatory approval, and indication in patient-specific care. This study introduces a computational fluid-structure interaction (FSI) model of TAVR with Medtronic's CoreValve Evolut R device using the immersed finite element-difference (IFED) method. We perform dynamic simulations of crimping and deployment of the Evolut R, as well as device behavior across the cardiac cycle in a patient-specific aortic root anatomy reconstructed from computed tomography (CT) image data. These IFED simulations, which incorporate biomechanics models fit to experimental tensile test data, automatically capture the contact within the device and between the self-expanding stent and native anatomy. Further, we apply realistic driving and loading conditions based on clinical measurements of human ventricular and aortic pressures and flow rates to demonstrate that our Evolut R model supports a physiological diastolic pressure load and provides informative clinical performance predictions.
(© 2022. The Author(s).)
Databáze: MEDLINE
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