6533b855fe1ef96bd12b0a09

RESEARCH PRODUCT

Pre-Operative Modeling of Transcatheter Mitral Valve Replacement in a Surgical Heart Valve Bioprosthesis

Salvatore PastaCaterina Gandolfo

subject

medicine.medical_specialtytranscatheter mitral valve replacementmedicine.medical_treatment0206 medical engineeringHemodynamics02 engineering and technology030204 cardiovascular system & hematologybioprosthetic heart valve03 medical and health sciences0302 clinical medicinefinite-element analysiInternal medicinemedicineVentricular outflow tractHeart valvebusiness.industryHeart anatomyMitral valve replacementGeneral Medicine020601 biomedical engineeringPre operativemedicine.anatomical_structureCardiologyImplantComplicationbusiness

description

Obstruction of the left ventricular outflow tract (LVOT) is a common complication of transcatheter mitral valve replacement (TMVR). This procedure can determine an elongation of an LVOT (namely, the neo-LVOT), ultimately portending hemodynamic impairment and patient death. This study aimed to understand the biomechanical implications of LVOT obstruction in a patient who underwent TMVR using a transcatheter heart valve (THV) to repair a failed bioprosthetic heart valve. We first reconstructed the heart anatomy and the bioprosthetic heart valve to virtually implant a computer-aided-design (CAD) model of THV and evaluate the neo-LVOT area. A numerical simulation of THV deployment was then developed to assess the anchorage of the THV to the bioprosthetic heart valve as well as the resulting Von Mises stress at the mitral annulus and the contract pressure among implanted bioprostheses. Quantification of neo-LVOT and THV deployment may facilitate more accurate predictions of the LVOT obstruction in TMVR and help clinicians in the optimal choice of the THV size.

yearjournalcountryeditionlanguage
2020-03-20
10.3390/prosthesis2010004http://hdl.handle.net/10447/403919