Bioengineering Case Study to Evaluate Complications of Adverse Anatomy of Aortic Root in Transcatheter Aortic Valve Replacement: Combining Biomechanical Modelling with CT Imaging

Abstract

Gated computed tomography (CT) might not adequately predict occurrence of post-implantation transcatheter aortic valve replacement (TAVR) complications in hostile aortic root as it would require a more complex integration of morphological, functional and hemodynamical parameters. We used a computational framework based on finite element analysis (FEA) to simulate patient-specific implantation. Application of biomechanical modelling using FEA to gated-CT was able to demonstrate the relation of the device with voluminous calcification, its consequent misalignment and a significant stent deformation. Use of FEA and other advanced computed predictive modelling techniques as an adjunct to CT scan could improve our understanding of TAVR, potentially predict complications and fate of the devices after implantation and inform patient-specific treatment.

Keywords

• transcatheter aortic valve replacement (TAVR)
• finite element analysis (FEA)
• biomechanical modelling
• calcification
• complications