Force distribution within the frame of self-expanding transcatheter aortic valve: Insights from in-vivo finite element analysis

Tian Yuan Xiong, Elisa Stoppani, Matthieu De Beule, Fei Chen, Yi Jian Li, Yan Biao Liao, Yuan Feng, Peter de Jaegere*, Mao Chen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

We sought to assess the amount and distribution of force on the valve frame after transcatheter aortic valve replacement (TAVR) via patient-specific computer simulation. Patients successfully treated with the self-expanding Venus A-Valve and multislice computed tomography (MSCT) pre- and post-TAVR were retrospectively included. Patient-specific finite element models of the aortic root and prosthesis were constructed. The force (in Newton) on the valve frame was derived at every 3 mm from the inflow and at every 22.5° on each level. Twenty patients of whom 10 had bicuspid aortic valve (BAV) were analyzed. The total force on the frame was 74.9 N in median (interquartile range 24.0). The maximal force was observed at level 5 that corresponds with the nadir of the bioprosthetic leaflets and was 9.9 (7.1) N in all patients, 10.3 (6.6) N in BAV and 9.7 (9.2) N for patients with tricuspid aortic valve (TAV). The level of maximal force located higher from the native annulus in BAV and TAV patients (8.8 [4.8] vs. 1.8 [7.4] mm). The area of the valve frame at the level of maximal force decreased from 437.4 (239.7) mm2 at the annulus to 377.6 (114.3) mm2 in BAV, but increased from 397.5 (114.3) mm2 at the annulus to 406.7 (108.9) mm2 in TAV. The maximum force on the bioprosthetic valve frame is located at the plane of the nadir of the bioprosthetic leaflets. It remains to be elucidated whether this may be associated with bioprosthetic frame and leaflet integrity and/or function.

Original languageEnglish
Article number110804
JournalJournal of Biomechanics
Volume128
Early online date11 Oct 2021
DOIs
Publication statusPublished - 9 Nov 2021

Bibliographical note

Funding Information:
This work was supported by National Natural Science Foundation of China (82102129), the European Union’s Horizon 2020 research and innovation program (945698), the fellowship of China Postdoctoral Science Foundation (2020M683327) and Open Fund Research from State Key Laboratory of Hydraulics and Mountain River Engineering (SKHL1920).

Publisher Copyright:
© 2021 Elsevier Ltd

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