Abstract Transcatheter aortic valve replacement (TAVR) first received FDA approval for high-risk surgical patients in 2011 and has been approved for low-risk surgical patients since 2019. It is now the most common type of aortic valve replacement, and its use continues to accelerate. Computer modeling and simulation (CM&S) is a tool to aid in TAVR device design, regulatory approval, and indication in patient-specific care. This study introduces a computational fluid-structure interaction (FSI) model of TAVR with Medtronic’s CoreValve Evolut R device using the immersed finite element-difference (IFED) method. We perform dynamic simulations of crimping and deployment of the Evolut R, as well as device behavior across the cardiac cycle in a patient-specific aortic root anatomy reconstructed from computed tomography (CT) image data. These IFED simulations, which incorporate biomechanics models fit to experimental tensile test data, automatically capture the contact within the device and between the self-expanding stent and native anatomy. Further, we apply realistic driving and loading conditions based on clinical measurements of human ventricular and aortic pressures and flow rates to demonstrate that our Evolut R model supports a physiological diastolic pressure load and provides informative clinical performance predictions.
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Modeling the mitral valve
This work is concerned with modeling and simulation of the mitral valve, one of the four valves in the human heart. The valve is composed of leaflets, the free edges of which are supported by a system of chordae, which themselves are anchored to the papillary muscles inside the left ventricle. First, we examine valve anatomy and present the results of original dissections. These display the gross anatomy and information on fiber structure of the mitral valve. Next, we build a model valve following a design‐based methodology, meaning that we derive the model geometry and the forces that are needed to support a given load and construct the model accordingly. We incorporate information from the dissections to specify the fiber topology of this model. We assume the valve achieves mechanical equilibrium while supporting a static pressure load. The solution to the resulting differential equations determines the pressurized configuration of the valve model. To complete the model, we then specify a constitutive law based on a stress‐strain relation consistent with experimental data that achieves the necessary forces computed in previous steps. Finally, using the immersed boundary method, we simulate the model valve in fluid in a computer test chamber. The model opens easily and closes without leak when driven by physiological pressures over multiple beats. Further, its closure is robust to driving pressures that lack atrial systole or are much lower or higher than normal.
more » « less- NSF-PAR ID:
- 10453551
- Publisher / Repository:
- Wiley Blackwell (John Wiley & Sons)
- Date Published:
- Journal Name:
- International Journal for Numerical Methods in Biomedical Engineering
- Volume:
- 35
- Issue:
- 11
- ISSN:
- 2040-7939
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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