Sinus Hemodynamics Variation with Tilted Transcatheter Aortic Valve Deployments

Annals of Biomedical Engineering
Hoda HatoumLakshmi Prasad Dasi

Abstract

Leaflet thrombosis is a complication associated with transcatheter aortic valve (TAV) replacement (TAVR) correlated with sinus flow stasis. Sinus hemodynamics are important because they dictate shear stress and washout necessary to avoid stasis on TAV leaflets. Sinus flow is controlled by TAV axial deployment position but little is known regarding TAV axis misalignment effect. This study aims to elucidate TAV angular misalignment with respect to aortic root axis effect on sinus flow stasis potentially leading to leaflet thrombosis. Sinus hemodynamics were assessed in vitro using particle-image velocimetry in three different angular misalignments with respect to aorta axis: untilted, tilted away from the sinus and tilted towards sinus. A 26 mm Edwards SAPIEN3 was implanted in a 3D printed model of an anatomically realistic aortic root. TAV hemodynamics, sinus vortex tracking, leaflet shear stress probability density functions, and sinus blood time to washout were calculated. While pressure gradients differed insignificantly, blood velocity and vorticity decreased significantly in both tilted cases sinuses. Shear stress probability near the leaflet decreases with tilt indicating stasis. TAV tilted away from the sinus is the most ...Continue Reading

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Mar 5, 2018·The Annals of Thoracic Surgery·Hoda HatoumLakshmi Prasad Dasi
Jul 3, 2018·The Journal of Thoracic and Cardiovascular Surgery·Hoda HatoumLakshmi P Dasi
Jul 8, 2018·The Journal of Thoracic and Cardiovascular Surgery·Hoda HatoumLakshmi Prasad Dasi
Jul 10, 2018·Journal of the Mechanical Behavior of Biomedical Materials·Hoda HatoumLakshmi Prasad Dasi
Jul 22, 2018·Annals of Biomedical Engineering·Hoda HatoumLakshmi Prasad Dasi

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Citations

Oct 16, 2018·Expert Review of Medical Devices·Oren M RotmanDanny Bluestein
Sep 14, 2018·Annals of Biomedical Engineering·Hoda Hatoum, Lakshmi P Dasi
Jul 10, 2019·Annals of Surgery·Edwin Christopher Ellison
Feb 19, 2020·Current Cardiology Reports·Dmitry LevinBeth Ripley
Feb 14, 2020·Annals of Biomedical Engineering·Hoda HatoumLakshmi Prasad Dasi
May 18, 2020·Annals of Biomedical Engineering·Shelly Singh-GryzbonAjit P Yoganathan
Feb 3, 2019·Annals of Biomedical Engineering·Hoda Hatoum, Lakshmi Prasad Dasi
Nov 22, 2020·Annals of Biomedical Engineering·Bethany Rowson
Nov 27, 2019·The Journal of Thoracic and Cardiovascular Surgery·Hoda HatoumLakshmi Prasad Dasi
Dec 2, 2019·Journal of the Mechanical Behavior of Biomedical Materials·Hoda HatoumLakshmi Prasad Dasi
Jun 15, 2020·JACC. Cardiovascular Interventions·Etienne L CoutureBernard Chevalier
Dec 4, 2021·Cardiovascular Engineering and Technology·Hoda HatoumLakshmi Prasad Dasi
Mar 25, 2019·The Journal of Thoracic and Cardiovascular Surgery·Hoda HatoumLakshmi Prasad Dasi
Feb 1, 2022·Current Cardiology Reports·Breandan B YeatsVinod H Thourani

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