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Early Detection of Risk of Neo-Sinus Blood Stasis Post-Transcatheter Aortic Valve Replacement Using Personalized Hemodynamic Analysis.
Khodaei, Seyedvahid; Abdelkhalek, Mohamed; Maftoon, Nima; Emadi, Ali; Keshavarz-Motamed, Zahra.
Afiliación
  • Khodaei S; Department of Mechanical Engineering, McMaster University, Hamilton, Ontario, Canada.
  • Abdelkhalek M; School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada.
  • Maftoon N; Department of Systems Design Engineering, University of Waterloo, Waterloo, Ontario, Canada.
  • Emadi A; Centre for Bioengineering and Biotechnology, University of Waterloo, Waterloo, Ontario, Canada.
  • Keshavarz-Motamed Z; Department of Mechanical Engineering, McMaster University, Hamilton, Ontario, Canada.
Struct Heart ; 7(5): 100180, 2023 Sep.
Article en En | MEDLINE | ID: mdl-37745677
Background: Despite the demonstrated benefits of transcatheter aortic valve replacement (TAVR), subclinical leaflet thrombosis and hypoattenuated leaflet thickening are commonly seen as initial indications of decreased valve durability and augmented risk of transient ischemic attack. Methods: We developed a multiscale patient-specific computational framework to quantify metrics of global circulatory function, metrics of global cardiac function, and local cardiac fluid dynamics of the aortic root and coronary arteries. Results: Based on our findings, TAVR might be associated with a high risk of blood stagnation in the neo-sinus region due to the lack of sufficient blood flow washout during the diastole phase (e.g., maximum blood stasis volume increased by 13, 8, and 2.7 fold in the left coronary cusp, right coronary cusp, and noncoronary cusp, respectively [N = 26]). Moreover, in some patients, TAVR might not be associated with left ventricle load relief (e.g., left ventricle load reduced only by 1.2 % [N = 26]) and diastolic coronary flow improvement (e.g., maximum coronary flow reduced by 4.94%, 15.05%, and 23.59% in the left anterior descending, left circumflex coronary artery, and right coronary artery, respectively, [N = 26]). Conclusions: The transvalvular pressure gradient amelioration after TAVR might not translate into adequate sinus blood washout, optimal coronary flow, and reduced cardiac stress. Noninvasive personalized computational modeling can facilitate the determination of the most effective revascularization strategy pre-TAVR and monitor leaflet thrombosis and coronary plaque progression post-TAVR.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Idioma: En Revista: Struct Heart Año: 2023 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Idioma: En Revista: Struct Heart Año: 2023 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos