Supra-annular Valve-in-Valve implantation reduces blood stasis on the transcatheter aortic valve leaflets

Journal of Biomechanics
Koohyar Vahidkhah, Ali N Azadani

Abstract

Leaflet thrombosis following transcatheter aortic valve replacement (TAVR) and Valve-in-Valve (ViV) procedures has been increasingly recognized. This study aimed to investigate the effect of positioning of the transcatheter aortic valve (TAV) in ViV setting on the flow dynamics aspect of post-ViV thrombosis by quantifying the blood stasis in the intra-annular and supra-annular settings. To that end, two idealized computational models, representing ViV intra-annular and supra-annular positioning of a TAV were developed in a patient-specific geometry. Three-dimensional flow fields were then obtained via fluid-solid interaction modeling to study the difference in blood residence time (BRT) on the TAV leaflets in the two settings. At the end of diastole, a strip of high BRT (⩾1.2s) region was observed on the TAV leaflets in the ViV intra-annular positioning at the fixed boundary where the leaflets are attached to the frame. Such a high BRT region was absent on the TAV leaflets in the supra-annular positioning. The maximum value of BRT on the surface of non-, right, and left coronary leaflets of the TAV in the supra-annular positioning were 53%, 11%, and 27% smaller compared to the intra-annular positioning, respectively. It was con...Continue Reading

Citations

May 24, 2018·Journal of Interventional Cardiology·Somsupha KanjanauthaiChad A Kliger
Feb 27, 2018·Interactive Cardiovascular and Thoracic Surgery·Silje Ekroll JahrenDominik Obrist
Dec 21, 2018·Circulation. Cardiovascular Interventions·Mohamed Abdel-WahabDanny Dvir
Nov 22, 2018·Biomechanics and Modeling in Mechanobiology·Matteo BianchiDanny Bluestein
Dec 25, 2019·Interactive Cardiovascular and Thoracic Surgery·Farhan KhodaeeAli N Azadani
Jan 24, 2018·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Ulrich SchäferLenard Conradi
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Aug 29, 2018·Annals of Biomedical Engineering·Hoda HatoumLakshmi Prasad Dasi
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Jan 25, 2021·The Journal of Thoracic and Cardiovascular Surgery·Hellmuth R Muller MoranKevin J Lachapelle
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Jan 31, 2021·Journal of Biomechanics·Mohammadreza Soltany SadrabadiAmirhossein Arzani
Feb 19, 2021·Journal of Biomechanics·Romina Plitman MayoGil Marom
Dec 4, 2021·Cardiovascular Engineering and Technology·Hoda HatoumLakshmi Prasad Dasi

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