Patient Specific Transcatheter Aortic Valve Replacement Therapy Pathway with Computational Fluid Structure Interaction Analysis

Abstract

Total cardiovascular disease (CVD) prevalence has risen dramatically from 271 million in 1990 to 523 million in 2019, and CVD fatalities rose gradually from 12.1 million in 1990 to 18.6 million in 2019. According to American Heart Association statistics, annual heart valve procedures in the United States were above 100,000 in 2013, with approximately 50,000 AV replacements. The ideal replacement valve should be durable, resistant to thrombosis, and have excellent hemodynamics features. Transcatheter aortic valve replacement (TAVR) has been introduced about two decades ago as an alternative for minimally invasive implantation of new generation bioprosthetic heart valves. Computational modeling can be used during therapy planning for the selection of appropriate replacement valves for TAVR. In this NPRP funded project, we are establishing a mechanical and FSI analysis path, for a detailed patient-specific hemodynamics analysis for TAVR, considering the most important parameters affecting TAV efficiency. This approach will enable the choice of the most suitable TAV type and deployment position for the treatment. TAV which is crimped and placed into the catheter by mechanical analysis is deployed in a patient-specific geometry in a virtual treatment then contact pressure and the stress are measured on the aortic root, stent, and aortic leaflets. TAV performance indicators are determined by FSI analysis using coupled ABAQUS and Flow-vision software. With this advanced analysis and simulation path, we expect to estimate accurately the clinical TAVR parameters such as contact pressure, contact area, principal stress, etc. before the operation during therapy planning. This approach will help clinicians in optimal valve selection for TAVR patients.