Finite Element Modeling Using Patient-Specific Geometry to Predict Aortic Valve Insufficiency During Percutaneous Pulmonary Valve Implantation

Abstract

Percutaneous pulmonary valve implantation (PPVI) is a non-surgical treatment in which a stented valve is delivered via catheter to replace a stenosed or leaky pulmonary valve. Stent oversizing is used to anchor the valve within the right ventricular outflow tract (RVOT), but overexpansion may interfere with adjoining structures specifically the aortic root and coronary arteries. Potential devastating consequences include distortion of the aortic sinus, causing aortic valve insufficiency, and/or compression of the coronary arteries. Because the outcome of PPVI is determined by the patient’s anatomy, we propose a method that uses patient-specific finite-element (FE) models constructed from pre-procedural cross-sectional CT scan images to evaluate these potential risks prior to clinical intervention. In five cases from an ongoing retrospective study, our preliminary results demonstrate our model’s ability to accurately identify the risk of aortic valve insufficiency as a consequence of the PPVI procedure.