Assessment of Paravalvular Leak Severity and Thrombogenic Potential in Transcatheter Bicuspid Aortic Valve Replacements Using Patient-Specific Computational Modeling.
Assessment of Paravalvular Leak Severity and Thrombogenic Potential in Transcatheter Bicuspid Aortic Valve Replacements Using Patient-Specific Computational Modeling.
复制标题
使用患者特定计算模型评估经导管二尖瓣主动脉瓣置换术中的瓣周漏严重程度和血栓形成可能性。
DOI：
10.1007/s12265-021-10191-z
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发表时间：
2022-08
影响因子：
3.4
通讯作者：
Bluestein, Danny
中科院分区：
文献类型：
--
作者：
Anam, Salwa B.;Kovarovic, Brandon J.;Ghosh, Ram P.;Bianchi, Matteo;Hamdan, Ashraf;Haj-Ali, Rami;Bluestein, Danny
关键词：
BAV是最常见的先天性瓣膜异常，它会产生不对称的血流模式和对小叶的压力增加，从而加速瓣膜钙化和结构变性。最近，TAVR被应用于BAV患者，显示出良好的疗效，但由于BAV解剖的复杂性，TAVR后的并发症往往会加剧。利用特定患者的计算模型，我们解决了其中的一些并发症。使用植入的老一代TAVR装置评估3例BAV患者TAVR后PVL的程度和位置，分析血流致血栓形成的风险，并将其与最新一代TAVR装置的性能进行比较。在植入最新一代装置后，观察到PVL和血栓形成电位显著降低。目前的工作证明了在术前计划中使用模拟来评估tavr后并发症的潜力，并比较不同设备的性能以获得更好的临床结果。评估经导管双尖瓣置换术后瓣旁渗漏和血流诱发血栓并发症的患者特异性计算框架，并比较设备性能
BAV, the most common congenital valvular abnormality, generate asymmetric flow patterns and increased stresses on the leaflets that expedite valvular calcification and structural degeneration. Recently adapted for use in BAV patients, TAVR demonstrates promising performance, but post-TAVR complications tend to get exacerbated due to BAV anatomical complexities. Utilizing patient-specific computational modeling we address some of these complications. The degree and location of post-TAVR PVL was assessed and the risk of flow-induced thrombogenicity was analyzed in 3 BAV patients − using older generation TAVR devices that were implanted in these patients, and compared them to the performance of the newest generation TAVR devices using in-silico patient models. Significant decrease in PVL and thrombogenic potential was observed after implantation of the newest generation device. The current work demonstrates the potential of using simulations in pre-procedural planning to assess post-TAVR complicaitons, and compare the performance of different devices to achieve better clinical outcomes. Patient-specific computational framework to assess post-transcatheter bicuspid aortic valve replacement paravalvular leakage and flow-induced thrombogenic complications and compare device performances
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