Development and validation of a numerical model for the investigation of transcatheter aortic valve implantations

用于研究经导管主动脉瓣植入的数值模型的开发和验证

• 批准号: 237767598
• 负责人: Professor Dr.-Ing. Ulrich Steinseifer
• 金额: --
• 依托单位: PRO-CVE, Verein zur Förderung der Kardiovaskulären Forshung e. V.
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2014
• 资助国家: 德国
• 起止时间: 2013-12-31 至 2020-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/237767598?language=en
• 关键词: Development; validation; numerical; model; investigation

Transcatheter aortic valve implantation is a minimal-invasive alternative for high-risk patients with severe aortic stenosis when open-heart surgery carries to much risk. Because of missing long-term experience and existing complications during and after the intervention, this rather new approach is not a replacement of the classic surgical procedure. Paravalvular aortic regurgitation due to malposition of the prosthesis is the most frequent complication. Current studies, however, are only based on empirical data of clinical outcomes.The aim of this project is the development and experimental in-vitro validation of a novel simulation model which makes the systematic study of potential complications possible. One of the main tasks is the modeling of the fluid-structure-interactions of the blood flow and the heart valve leaflets. An extensive numerical analysis of the mesh, the material properties, the boundary conditions, the coupling and the turbulence are indispensable with respect to accuracy and stability of the solution process. For this purpose, in vitro tests are performed to validate the numerical model and make adjustments as needed. By using the validated simulation model, the effects of malpositioning of the prosthesis can subsequently be evaluated. Patient specific geometries of the heart and surrounding vessels are created based on medical imaging data from patients suffering from severe aortic stenosis. The prosthesis is virtually implanted at different locations. The sensitivity of the implantation site on paravalvular leakage is evaluated in close cooperation with a clinical partner. The long-term aim of this research project is the development of a methodology that objectifies the decision making of the doctors in charge about possible strategies of the intervention (e.g. choice of implantation site and prosthesis size) in order to optimize the outcome of the treatment.

经导管主动脉瓣植入术是一种微创的替代方案，适用于严重主动脉瓣狭窄的高危患者，因为心内直视手术具有很大的风险。由于缺乏长期的经验和现有的并发症期间和之后的干预，这种相当新的方法是不是一个替代的经典外科手术。由于假体位置不当而引起的瓣周主动脉瓣返流是最常见的并发症。然而，目前的研究仅基于临床结果的经验数据，本项目的目的是开发和实验体外验证一种新的模拟模型，使潜在并发症的系统研究成为可能。主要任务之一是血流和心脏瓣膜小叶的流体-结构-相互作用的建模。对网格、材料性质、边界条件、耦合和湍流的广泛的数值分析对于求解过程的准确性和稳定性是必不可少的。为此，进行体外试验以验证数值模型并根据需要进行调整。通过使用经验证的模拟模型，随后可以评估假体错位的影响。基于来自患有严重主动脉瓣狭窄的患者的医学成像数据来创建心脏和周围血管的患者特定几何形状。假体实际上被植入不同的位置。与临床合作伙伴密切合作，评价植入部位对瓣周漏的敏感性。该研究项目的长期目标是开发一种方法，使负责医生对可能的干预策略（例如植入部位和假体尺寸的选择）的决策客观化，以优化治疗结果。

项目成果

Hemodynamics inside the neo- and native sinus after TAVR: effects of implant depth and cardiac output on flow field and coronary flow.

TAVR 后新窦和原生窦内的血流动力学：植入深度和心输出量对流场和冠状动脉流量的影响

• DOI: 10.1111/aor.13789
• 发表时间: 2021
• 期刊: Artificial organs
• 影响因子: 2.4
• 作者: Pott D;Sedaghat A;Schmitz C
• 通讯作者: Schmitz C

Fluid‐structure interaction of a pulsatile flow with an aortic valve model: A combined experimental and numerical study

• DOI: 10.1002/cnm.2945
• 发表时间: 2018-04
• 期刊: International Journal for Numerical Methods in Biomedical Engineering
• 影响因子: 2.1
• 作者: J. Sigüenza;D. Pott;S. Mendez;S. Sonntag;T. Kaufmann;U. Steinseifer;F. Nicoud

Fluid–Structure Simulation of a Transcatheter Aortic Valve Implantation: Potential Application to Patient-Specific Cases

经导管主动脉瓣植入的流固模拟：在特定患者病例中的潜在应用

• DOI: 10.1007/978-3-319-59764-5_11
• 发表时间: 2017
• 作者: Pott D;Chiastra C;Petrini L;Pennati G;Dubini G;Steinseifer U;Sonntag S;Kuetting M;Migliavacca F
• 通讯作者: Migliavacca F