A Novel Personalized Pre-operational Transcatheter Aortic Valve Implantation (TAVI) Supporting Tool

Abstract

Objective: Cardiac implants may have a strong influence on the hemodynamics of the circulatory system. In this study, we present a novel personalized pre-operational transcatheter aortic valve implantation support tool. The main objective is to investigate the impact of TAVI devices on blood flow patterns that develop in the patient-specific model of ascending aorta under physiological flow conditions in vitro. Methods: The presented preoperational TAVI support tool is based on additive manufacturing, optical imaging and fluid dynamics. Optical measurements are performed in an anatomically accurate silicone aortic model. Two different cases were investigated, namely pre-operational stenotic blood flow and post-operational blood flow conditions. A ventricular assist device is used to mimic the function of the heart. It is driven by a pneumatical pump. We aimed to quantify the amount of backflow, shear stresses and kinetic energy in proximity of the valves. Results: We investigate the blood flow characteristics for both pre- and post-operational cases. It is found that the spatially averaged peak mean kinetic energy (MKE) of the pre-operational case is around seven times higher compared to the post-operational case (358J/m3 vs 49J/m3). In the diastolic phase, even for the lower velocity magnitudes, MKE is higher for the pre-operational case. Analysing the turbulent kinetic energies (TKE) shows that TKE of the pathological case is about one order of magnitude higher than the post-operational case during the peak systole (178 J/m3 vs 20 J/m3). Conclusions: We conclude that the pathological case introduces more disorganized flow features as a result of high shear stress. Furthermore the regions in the vicinity of the stenosed valve are found more risky for the destruction of the red blood cells and platelet deformation. It is presented that the developed novel personalized TAVI support tool is beneficial for pre-operational planning. Potential blood flow complications can be estimated using the support tool. KEYWORD: e-P-28 The authors do not declare any conflict of interest.