Computer simulation help predict the frame deformation following a Venus-A transcatheter aortic valve implantation in patients with pure aortic regurgitation: a retrospective study.

IF 2.1 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular diagnosis and therapy Pub Date : 2024-08-31 Epub Date: 2024-08-21 DOI:10.21037/cdt-24-60

Feicheng Yu, Songzan Chen, Lili Tian, Xulin Hong, Bei Wang, Lili Wu, Yan Ma, Guosheng Fu

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引用次数: 0

Abstract

Background: Patient-specific computer simulation of transcatheter aortic valve implantation (TAVI) predicts the interaction between an implanted device and the surrounding anatomy. In this study, we validated the predictive value of computer simulation for the frame deformation following a Venus-A TAVI implant in patients with pure aortic regurgitation (AR). Furthermore, we used the validated computational model to evaluate the anchoring mechanism within the same cohort.

Methods: This was a retrospective study. FEops HEARTguide technology was used to simulate the virtual implantation of a Venus-A valve model in a patient-specific geometry. The predicted frame deformation was quantitatively compared to the postoperative device deformation at multiple levels. The outward forces acting on the frame were extracted for each patient and the total outward force acting around the aortic annular (AA) and sinotubular junction (STJ) planes were recorded.

Results: Thirty patients were enrolled in the study with 10 in the migration group and 20 in the non-migration group. The dimensions of the simulated and observed frames had good correlations at Dmax (R²=0.88), Dmin (R²=0.91), perimeter (R²=0.92), and area (R²=0.92). The predicted outward force acting on the frame at the AA level was comparable between the migration and no-migration groups. The predicted outward force acting on the frame at the STJ level was always significantly higher in the migration group than the no migration group at different bandwidths: 3 mm (P=0.002), 5 mm (P=0.005), 10 mm (P=0.002).

Conclusions: Patient-specific computer simulation of TAVI accurately predicted frame deformation in Chinese patients with pure AR. The forces at the STJ facilitated stabilization of the device within the aortic root, which might be used as a discriminator to identify patients at risk of device migration prior to intervention.

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计算机模拟有助于预测纯主动脉瓣反流患者接受 Venus-A 经导管主动脉瓣植入术后的瓣框变形：一项回顾性研究。

背景：针对患者的经导管主动脉瓣植入术（TAVI）计算机模拟可预测植入装置与周围解剖结构之间的相互作用。在这项研究中，我们验证了计算机模拟对单纯主动脉瓣反流（AR）患者进行 Venus-A TAVI 植入术后瓣框变形的预测价值。此外，我们还使用经过验证的计算模型评估了同一队列中的锚定机制：这是一项回顾性研究。方法：这是一项回顾性研究，采用 FEops HEARTguide 技术模拟患者特定几何形状的 Venus-A 瓣膜模型的虚拟植入。预测的框架变形与术后装置变形在多个层面上进行了定量比较。提取了每位患者作用在瓣框上的外力，并记录了主动脉瓣环（AA）和窦管交界处（STJ）平面周围的总外力：30 名患者参加了研究，其中 10 人属于移位组，20 人属于非移位组。模拟框架和观察框架的尺寸在Dmax（R2=0.88）、Dmin（R2=0.91）、周长（R2=0.92）和面积（R2=0.92）方面具有良好的相关性。迁移组和非迁移组在 AA 水平上作用在框架上的预测向外力相当。在不同带宽下，移轴组在 STJ 水平上作用于框架的预测外力始终显著高于未移轴组：3毫米（P=0.002）、5毫米（P=0.005）、10毫米（P=0.002）：结论：针对特定患者的 TAVI 计算机模拟准确预测了中国纯 AR 患者的支架变形。STJ处的作用力有助于装置在主动脉根部的稳定，可作为介入治疗前识别有装置移位风险的患者的鉴别指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular diagnosis and therapy Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

4.20%

发文量

期刊介绍： The journal ''Cardiovascular Diagnosis and Therapy'' (Print ISSN: 2223-3652; Online ISSN: 2223-3660) accepts basic and clinical science submissions related to Cardiovascular Medicine and Surgery. The mission of the journal is the rapid exchange of scientific information between clinicians and scientists worldwide. To reach this goal, the journal will focus on novel media, using a web-based, digital format in addition to traditional print-version. This includes on-line submission, review, publication, and distribution. The digital format will also allow submission of extensive supporting visual material, both images and video. The website www.thecdt.org will serve as the central hub and also allow posting of comments and on-line discussion. The web-site of the journal will be linked to a number of international web-sites (e.g. www.dxy.cn), which will significantly expand the distribution of its contents.