The impact of different aortic valve calcification patterns on the outcome of transcatheter aortic valve implantation: A numerical simulation study / 医用生物力学

ABSTRACT

Objective To investigate the effect of different calcification patterns on the outcome of transcatheter aortic valve implantation (TAVI) by the finite element method. Methods Three calcified human aortic root models (coaptation line calcification model, attachment line calcification model and circular calcification model) were developed according to the location of calcified plaques on the aortic valve leaflets. The processes of self-expanding transcatheter aortic valve implanted into the 3 calcified models were simulated by ABAQUS software. The effects of different calcification patterns on the aortic root stresses, valve frame distortions and paravalvular gaps were analyzed. Results Circular calcification model had the largest maximum principal stress on calcified plaques (18.42 MPa), which might result in a higher risk of stroke after implantation; the circular calcification model also had the greatest distortion of the valve frame, which might lead to worse prosthetic durability; the paravalvular gaps area of the attachment line calcification model was 37.2 mm2, which was more than twice that of the other 2 models, causing more serious paravalvular regurgitation. Conclusions Different aortic valve calcification patterns are related to aortic root stresses, valve frame distortions and paravalvular gaps after TAVI, which will have an impact on postoperative complications and prothesis durability. The research findings provide references for the prediction of clinical outcome after TAVI.