Research Papers

Numerical Parametric Study of Paravalvular Leak Following a Transcatheter Aortic Valve Deployment Into a Patient-Specific Aortic Root

[+] Author and Article Information
Wenbin Mao, Qian Wang

Tissue Mechanics Laboratory,
The Wallace H. Coulter Department
of Biomedical Engineering,
Georgia Institute of Technology
and Emory University,
Atlanta, GA 30313-2412

Susheel Kodali

Division of Cardiology,
Columbia University Medical Center,
New York 10032

Wei Sun

Tissue Mechanics Laboratory,
The Wallace H. Coulter Department
of Biomedical Engineering,
Georgia Institute of Technology
and Emory University,
206 Technology Enterprise Park,
Georgia Institute of Technology,
387 Technology Circle,
Atlanta, GA 30313-2412
e-mail: wei.sun@bme.gatech.edu

1Corresponding author.

Manuscript received November 20, 2017; final manuscript received May 28, 2018; published online June 21, 2018. Assoc. Editor: Alison Marsden.

J Biomech Eng 140(10), 101007 (Jun 21, 2018) (11 pages) Paper No: BIO-17-1533; doi: 10.1115/1.4040457 History: Received November 20, 2017; Revised May 28, 2018

Paravalvular leak (PVL) is a relatively frequent complication after transcatheter aortic valve replacement (TAVR) with increased mortality. Currently, there is no effective method to pre-operatively predict and prevent PVL. In this study, we developed a computational model to predict the severity of PVL after TAVR. Nonlinear finite element (FE) method was used to simulate a self-expandable CoreValve deployment into a patient-specific aortic root, specified with human material properties of aortic tissues. Subsequently, computational fluid dynamics (CFD) simulations were performed using the post-TAVR geometries from the FE simulation, and a parametric investigation of the impact of the transcatheter aortic valve (TAV) skirt shape, TAV orientation, and deployment height on PVL was conducted. The predicted PVL was in good agreement with the echocardiography data. Due to the scallop shape of CoreValve skirt, the difference of PVL due to TAV orientation can be as large as 40%. Although the stent thickness is small compared to the aortic annulus size, we found that inappropriate modeling of it can lead to an underestimation of PVL up to 10 ml/beat. Moreover, the deployment height could significantly alter the extent and the distribution of regurgitant jets, which results in a change of leaking volume up to 70%. Further investigation in a large cohort of patients is warranted to verify the accuracy of our model. This study demonstrated that a rigorously developed patient-specific computational model can provide useful insights into underlying mechanisms causing PVL and potentially assist in pre-operative planning for TAVR to minimize PVL.

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Webb, J. G. , Chandavimol, M. , Thompson, C. R. , Ricci, D. R. , Carere, R. G. , Munt, B. I. , Buller, C. E. , Pasupati, S. , and Lichtenstein, S. , 2006, “ Percutaneous Aortic Valve Implantation Retrograde From the Femoral Artery,” Circulation, 113(6), pp. 842–850. [CrossRef]
Leon, M. B. , Smith, C. R. , Mack, M. , Miller, D. C. , Moses, J. W. , Svensson, L. G. , Tuzcu, E. M. , Webb, J. G. , Fontana, G. P. , Makkar, R. R. , Brown, D. L. , Block, P. C. , Guyton, R. A. , Pichard, A. D. , Bavaria, J. E. , Herrmann, H. C. , Douglas, P. S. , Petersen, J. L. , Akin, J. J. , Anderson, W. N. , Wang, D. , Pocock, S. , and Investigators, P. T. , 2010, “ Transcatheter Aortic-Valve Implantation for Aortic Stenosis in Patients Who Cannot Undergo Surgery,” N. Engl. J. Med., 363(17), pp. 1597–1607. [CrossRef]
Smith, C. R. , Leon, M. B. , Mack, M. J. , Miller, D. C. , Moses, J. W. , Svensson, L. G. , Tuzcu, E. M. , Webb, J. G. , Fontana, G. P. , Makkar, R. R. , Williams, M. , Dewey, T. , Kapadia, S. , Babaliaros, V. , Thourani, V. H. , Corso, P. , Pichard, A. D. , Bavaria, J. E. , Herrmann, H. C. , Akin, J. J. , Anderson, W. N. , Wang, D. , and Pocock, S. J. , 2011, “ Transcatheter Versus Surgical Aortic-Valve Replacement in High-Risk Patients,” N. Engl. J. Med., 364(23), pp. 2187–2198. [CrossRef]
Cribier, A. , 2017, “ The Development of Transcatheter Aortic Valve Replacement (TAVR),” Global Cardiol. Sci. Pract., 2016(4), p. e201632.
Thyregod, H. G. H. , Steinbrüchel, D. A. , Ihlemann, N. , Nissen, H. , Kjeldsen, B. J. , Petursson, P. , Chang, Y. , Franzen, O. W. , Engstrøm, T. , and Clemmensen, P. , 2015, “ Transcatheter Versus Surgical Aortic Valve Replacement in Patients With Severe Aortic Valve Stenosis: 1-Year Results From the All-Comers NOTION Randomized Clinical Trial,” J. Am. Coll. Cardiol., 65(20), pp. 2184–2194. [CrossRef]
Généreux, P. , Head, S. J. , Hahn, R. , Daneault, B. , Kodali, S. , Williams, M. R. , van Mieghem, N. M. , Alu, M. C. , Serruys, P. W. , Kappetein, A. P. , and Leon, M. B. , 2013, “ Paravalvular Leak After Transcatheter Aortic Valve Replacement: The New Achilles' Heel? A Comprehensive Review Literature,” J. Am. Coll. Cardiol., 61(11), pp. 1125–1136. [CrossRef]
Leon, M. B. , Smith, C. R. , Mack, M. J. , Makkar, R. R. , Svensson, L. G. , Kodali, S. K. , Thourani, V. H. , Tuzcu, E. M. , Miller, D. C. , Herrmann, H. C. , Doshi, D. , Cohen, D. J. , Pichard, A. D. , Kapadia, S. , Dewey, T. , Babaliaros, V. , Szeto, W. Y. , Williams, M. R. , Kereiakes, D. , Zajarias, A. , Greason, K. L. , Whisenant, B. K. , Hodson, R. W. , Moses, J. W. , Trento, A. , Brown, D. L. , Fearon, W. F. , Pibarot, P. , Hahn, R. T. , Jaber, W. A. , Anderson, W. N. , Alu, M. C. , Webb, J. G. , and Investigators, P. , 2016, “ Transcatheter or Surgical Aortic-Valve Replacement in Intermediate-Risk Patients,” N. Engl. J. Med., 374(17), pp. 1609–1620. [CrossRef]
Kodali, S. K. , Williams, M. R. , Smith, C. R. , Svensson, L. G. , Webb, J. G. , Makkar, R. R. , Fontana, G. P. , Dewey, T. M. , Thourani, V. H. , Pichard, A. D. , Fischbein, M. , Szeto, W. Y. , Lim, S. , Greason, K. L. , Teirstein, P. S. , Malaisrie, S. C. , Douglas, P. S. , Hahn, R. T. , Whisenant, B. , Zajarias, A. , Wang, D. , Akin, J. J. , Anderson, W. N. , and Leon, M. B. , 2012, “ Two-Year Outcomes After Transcatheter or Surgical Aortic-Valve Replacement,” N. Engl. J. Med., 366(18), pp. 1686–1695. [CrossRef]
Leon, M. B. , Gada, H. , and Fontana, G. P. , 2014, “ Challenges and Future Opportunities for Transcatheter Aortic Valve Therapy,” Prog. Cardiovasc. Dis., 56(6), pp. 635–645. [CrossRef]
Salaun, E. , Jacquier, A. , Theron, A. , Giorgi, R. , Lambert, M. , Jaussaud, N. , Hubert, S. , Collart, F. , Bonnet, J. , and Habib, G. , 2015, “ Value of CMR in Quantification of Paravalvular Aortic Regurgitation After TAVI,” Eur. Heart J. Cardiovasc. Imaging, 17(1), pp. 41–50.
Sakrana, A. , Nasr, M. , Ashamallah, G. , Abuelatta, R. , Naeim, H. , and Tahlawi, M. , 2016, “ Paravalvular Leak After Transcatheter Aortic Valve Implantation: Is It Anatomically Predictable or Procedurally Determined? MDCT Study,” Clin. Radiol., 71(11), pp. 1095–1103. [CrossRef]
Kappetein, A. P. , Head, S. J. , Généreux, P. , Piazza, N. , Van Mieghem, N. M. , Blackstone, E. H. , Brott, T. G. , Cohen, D. J. , Cutlip, D. E. , and van Es, G.-A. , 2012, “ Updated Standardized Endpoint Definitions for Transcatheter Aortic Valve Implantation: The Valve Academic Research Consortium-2 Consensus Document,” J. Am. Coll. Cardiol., 60(15), pp. 1438–1454. [CrossRef]
Geleijnse, M. L. , Di Martino, L. F. , Vletter, W. B. , Ren, B. , Galema, T. W. , Van Mieghem, N. M. , de Jaegere, P. P. , and Soliman, O. I. , 2016, “ Limitations and Difficulties of Echocardiographic Short-Axis Assessment of Paravalvular Leakage After Corevalve Transcatheter Aortic Valve Implantation,” Cardiovasc. Ultrasound, 14(1), p. 37. [CrossRef]
Pibarot, P. , Hahn, R. T. , Weissman, N. J. , and Monaghan, M. J. , 2015, “ Assessment of Paravalvular Regurgitation Following TAVR: A Proposal of Unifying Grading Scheme,” JACC: Cardiovasc. Imaging, 8(3), pp. 340–360. [CrossRef]
Auricchio, F. , Conti, M. , Morganti, S. , and Reali, A. , 2013, “ Simulation of Transcatheter Aortic Valve Implantation: A Patient-Specific Finite Element Approach,” Comput. Methods Biomech. Biomed. Eng., 17(12), pp. 1347–1357. [CrossRef]
Capelli, C. , Bosi, G. M. , Cerri, E. , Nordmeyer, J. , Odenwald, T. , Bonhoeffer, P. , Migliavacca, F. , Taylor, A. M. , and Schievano, S. , 2012, “ Patient-Specific Simulations of Transcatheter Aortic Valve Stent Implantation,” Med. Biol. Eng. Comput., 50(2), pp. 183–192. [CrossRef]
Gunning, P. S. , Vaughan, T. J. , and McNamara, L. M. , 2014, “ Simulation of Self Expanding Transcatheter Aortic Valve in a Realistic Aortic Root: Implications of Deployment Geometry on Leaflet Deformation,” Ann. Biomed. Eng., 42(9), pp. 1989–2001. [CrossRef]
Russ, C. , Hopf, R. , Hirsch, S. , Sundermann, S. , Falk, V. , Szekely, G. , and Gessat, M. , 2013, “ Simulation of Transcatheter Aortic Valve Implantation Under Consideration of Leaflet Calcification,” 35th Annual International Conference of the Engineering in Medicine and Biology Society (EMBC), Osaka, Japan, July 3–7, pp. 711–714.
Wang, Q. , Sirois, E. , and Sun, W. , 2012, “ Patient-Specific Modeling of Biomechanical Interaction in Transcatheter Aortic Valve Deployment,” J. Biomech., 45(11), pp. 1965–1971. [CrossRef]
de Jaegere, P. , De Santis, G. , Rodriguez-Olivares, R. , Bosmans, J. , Bruining, N. , Dezutter, T. , Rahhab, Z. , El Faquir, N. , Collas, V. , and Bosmans, B. , 2016, “ Patient-Specific Computer Modeling to Predict Aortic Regurgitation After Transcatheter Aortic Valve Replacement,” JACC: Cardiovasc. Interventions, 9(5), pp. 508–512. [CrossRef]
El Faquir, N. , Ren, B. , Van Mieghem, N. , Bosmans, J. , and de Jaegere, P. , 2017, “ Patient-Specific Computer Modelling–Its Role in the Planning of Transcatheter Aortic Valve Implantation,” Netherlands Heart J., 25(2), pp. 100–105. [CrossRef]
Saeedi, A. , 2015, “ Energetic and Hemodynamic Characteristics of Paravalvular Leak Following Transcatheter Aortic Valve Replacement,” Masters thesis, Concordia University, Montreal, QC, Canada. https://spectrum.library.concordia.ca/980160/1/Saeedi-%20MASc-F2015.pdf
Bosmans, B. , Famaey, N. , Verhoelst, E. , Bosmans, J. , and Vander Sloten, J. , 2016, “ A Validated Methodology for Patient Specific Computational Modeling of Self-Expandable Transcatheter Aortic Valve Implantation,” J. Biomech., 49(13), pp. 2824–2830. [CrossRef]
Gessat, M. , Altwegg, L. , Frauenfelder, T. , Plass, A. , and Falk, V. , 2011, “ Cubic Hermite Bezier Spline Based Reconstruction of Implanted Aortic Valve Stents From CT Images,” Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Boston, MA, Aug. 30–Sept. 3, pp. 2667–2670.
Holzapfel, G. A. , Gasser, T. C. , and Ogden, R. W. , 2000, “ A New Constitutive Framework for Arterial Wall Mechanics and a Comparative Study of Material Models,” J. Elasticity Phys. Sci. Solids, 61(1–3), pp. 1–48.
Gasser, T. C. , Ogden, R. W. , and Holzapfel, G. A. , 2006, “ Hyperelastic Modelling of Arterial Layers With Distributed Collagen Fibre Orientations,” J. R. Soc. Interface, 3(6), pp. 15–35. [CrossRef]
Liu, H. , and Sun, W. , 2017, “ Numerical Approximation of Elasticity Tensor Associated With Green-Naghdi Rate,” ASME J. Biomech. Eng., 139(8), p. 081007. [CrossRef]
Liu, H. , and Sun, W. , 2016, “ Computational Efficiency of Numerical Approximations of Tangent Moduli for Finite Element Implementation of a Fiber-Reinforced Hyperelastic Material Model,” Comput. Methods Biomech. Biomed. Eng., 19(11), pp. 1171–1180. [CrossRef]
Sun, W. , Chaikof, E. L. , and Levenston, M. E. , 2008, “ Numerical Approximation of Tangent Moduli for Finite Element Implementations of Nonlinear Hyperelastic Material Models,” ASME J. Biomech. Eng., 130(6), p. 061003. [CrossRef]
Ogden, R. , 1972, “ Large Deformation Isotropic Elasticity-on the Correlation of Theory and Experiment for Incompressible Rubberlike Solids,” Proc. R. Soc. London A: Math., Phys. Eng. Sci., R. Soc., 326(1567), pp. 565–584. [CrossRef]
Holzapfel, G. A. , Sommer, G. , and Regitnig, P. , 2004, “ Anisotropic Mechanical Properties of Tissue Components in Human Atherosclerotic Plaques,” ASME J. Biomech. Eng., 126(5), pp. 657–665. [CrossRef]
Wang, Q. , Kodali, S. , Primiano, C. , and Sun, W. , 2015, “ Simulations of Transcatheter Aortic Valve Implantation: Implications for Aortic Root Rupture,” Biomech. Modeling Mechanobiol., 14(1), pp. 29–38. [CrossRef]
Martin, C. , Pham, T. , and Sun, W. , 2011, “ Significant Differences in the Material Properties Between Aged Human and Porcine Aortic Tissues,” Eur. J. Cardio-Thorac. Surg., 40(1), pp. 28–34. [CrossRef]
Tzamtzis, S. , Viquerat, J. , Yap, J. , Mullen, M. , and Burriesci, G. , 2013, “ Numerical Analysis of the Radial Force Produced by the Medtronic-CoreValve and Edwards-SAPIEN after Transcatheter Aortic Valve Implantation (TAVI),” Med. Eng. Phys., 35(1), pp. 125–130. [CrossRef]
Mummert, J. , Sirois, E. , and Sun, W. , 2013, “ Quantification of Biomechanical Interaction of Transcatheter Aortic Valve Stent Deployed in Porcine and Ovine Hearts,” Ann. Biomed. Eng., 41(3), pp. 577–586. [CrossRef]
Schultz, C. J. , Weustink, A. , Piazza, N. , Otten, A. , Mollet, N. , Krestin, G. , van Geuns, R. J. , de Feyter, P. , Serruys, P. W. , and de Jaegere, P. , 2009, “ Geometry and Degree of Apposition of the CoreValve ReValving System With Multislice Computed Tomography After Implantation in Patients With Aortic Stenosis,” J. Am. Coll. Cardiol., 54(10), pp. 911–918. [CrossRef]
CD-Adapco, 2015, “ STAR-CCM+ User Guide, Version 10.02,” CD-adapco, Melville, NY.
Wood, N. , 1999, “ Aspects of Fluid Dynamics Applied to the Larger Arteries,” J. Theor. Biol., 199(2), pp. 137–161. [CrossRef]
Calderan, J. , Mao, W. , Sirois, E. , and Sun, W. , 2016, “ Development of an In Vivo Model to Characterize the Effects of Transcatheter Aortic Valve on Coronary Artery Flow,” Artif. Organs, 40(6), pp. 612–619. [CrossRef]
Grube, E. , Laborde, J. C. , Gerckens, U. , Felderhoff, T. , Sauren, B. , Buellesfeld, L. , Mueller, R. , Menichelli, M. , Schmidt, T. , and Zickmann, B. , 2006, “ Percutaneous Implantation of the CoreValve Self-Expanding Valve Prosthesis in High-Risk Patients With Aortic Valve Disease,” Circulation, 114(15), pp. 1616–1624. [CrossRef]
Geven, M. C. , Bohté, V. N. , Aarnoudse, W. H. , van den Berg, P. M. , Rutten, M. C. , Pijls, N. H. , and van de Vosse, F. N. , 2004, “ A Physiologically Representative In Vitro Model of the Coronary Circulation,” Physiol. Meas., 25(4), p. 891. [CrossRef]
Gaillard, E. , Garcia, D. , Kadem, L. , Pibarot, P. , and Durand, L.-G. , 2010, “ In Vitro Investigation of the Impact of Aortic Valve Stenosis Severity on Left Coronary Artery Flow,” ASME J. Biomech. Eng., 132(4), p. 044502. [CrossRef]
Lancellotti, P. , Tribouilloy, C. , Hagendorff, A. , Moura, L. , Popescu, B. A. , Agricola, E. , Monin, J.-L. , Pierard, L. A. , Badano, L. , and Zamorano, J. L. , 2010, “ European Association of Echocardiography Recommendations for the Assessment of Valvular Regurgitation—Part 1: Aortic and Pulmonary Regurgitation (Native Valve Disease),” Eur. J. Echocardiography, 11(3), pp. 223–244. [CrossRef]
Enriquez-Sarano, M. , Seward, J. B. , Bailey, K. R. , and Tajik, A. J. , 1994, “ Effective Regurgitant Orifice Area: A Noninvasive Doppler Development of an Old Hemodynamic Concept,” J. Am. Coll. Cardiol., 23(2), pp. 443–451. [CrossRef]
Ewe, S. H. , Ng, A. C. , Schuijf, J. D. , van der Kley, F. , Colli, A. , Palmen, M. , de Weger, A. , Marsan, N. A. , Holman, E. R. , and de Roos, A. , 2011, “ Location and Severity of Aortic Valve Calcium and Implications for Aortic Regurgitation After Transcatheter Aortic Valve Implantation,” Am. J. Cardiol., 108(10), pp. 1470–1477. [CrossRef]
Koos, R. , Mahnken, A. H. , Dohmen, G. , Brehmer, K. , Günther, R. W. , Autschbach, R. , Marx, N. , and Hoffmann, R. , 2011, “ Association of Aortic Valve Calcification Severity With the Degree of Aortic Regurgitation After Transcatheter Aortic Valve Implantation,” Int. J. Cardiol., 150(2), pp. 142–145. [CrossRef]
Mihara, H. , Shibayama, K. , Berdejo, J. , Harada, K. , Itabashi, Y. , Siegel, R. J. , Kashif, M. , Jilaihawi, H. , Makkar, R. R. , and Shiota, T. , 2015, “ Impact of Device Landing Zone Calcification on Paravalvular Regurgitation After Transcatheter Aortic Valve Replacement: A Real-Time Three-Dimensional Transesophageal Echocardiographic Study,” J. Am. Soc. Echocardiography, 28(4), pp. 404–414. [CrossRef]
Marwan, M. , Achenbach, S. , Ensminger, S. M. , Pflederer, T. , Ropers, D. , Ludwig, J. , Weyand, M. , Daniel, W. G. , and Arnold, M. , 2013, “ CT Predictors of Post-Procedural Aortic Regurgitation in Patients Referred for Transcatheter Aortic Valve Implantation: An Analysis of 105 Patients,” Int. J. Cardiovasc. Imaging, 29(5), pp. 1191–1198. [CrossRef]
Sun, W. , Li, K. , and Sirois, E. , 2010, “ Simulated Elliptical Bioprosthetic Valve Deformation: Implications for Asymmetric Transcatheter Valve Deployment,” J. Biomech., 43(16), pp. 3085–3090. [CrossRef]
Sinning, J.-M. , Werner, N. , Nickenig, G. , and Grube, E. , 2013, “ Medtronic CoreValve Evolut R with EnVeo R,” EuroIntervention, 9, pp. S95–S96. [CrossRef]
Binder, R. K. , Rodés-Cabau, J. , Wood, D. A. , Mok, M. , Leipsic, J. , De Larochellière, R. , Toggweiler, S. , Dumont, E. , Freeman, M. , and Willson, A. B. , 2013, “ Transcatheter Aortic Valve Replacement With the SAPIEN 3: A New Balloon-Expandable Transcatheter Heart Valve,” JACC: Cardiovasc. Interventions, 6(3), pp. 293–300. [CrossRef]
Schymik, G. , Schröfel, H. , Heimeshoff, M. , Luik, A. , Thoenes, M. , and Mandinov, L. , 2015, “ How to Adapt the Implantation Technique for the New SAPIEN 3 Transcatheter Heart Valve Design,” J. Interventional Cardiol., 28(1), pp. 82–89. [CrossRef]
Bird, R. B. , Stewart, W. E. , and Lightfoot, E. N. , 2007, Transport Phenomena, Wiley, Hoboken, NJ.
Murdock, K. , Martin, C. , and Sun, W. , 2018, “ Characterization of Mechanical Properties of Pericardium Tissue Using Planar Biaxial Tension and Flexural Deformation,” J. Mechanical Behavior Biomedical Materials, 77, pp. 148–156. [CrossRef]
Sotiropoulos, F. , Le, T. B. , and Gilmanov, A. , 2016, “ Fluid Mechanics of Heart Valves and Their Replacements,” Annu. Rev. Fluid Mech., 48, pp. 259–283. [CrossRef]
Yilmaz, F. , and Gundogdu, M. Y. , 2008, “ A Critical Review on Blood Flow in Large Arteries; Relevance to Blood Rheology, Viscosity Models, and Physiologic Conditions,” Korea-Australia Rheol. J., 20(4), pp. 197–211. http://citeseerx.ist.psu.edu/viewdoc/download?doi=


Grahic Jump Location
Fig. 1

(a) Pre-TAVR aortic root geometry from CT scans used for FE simulations of TAV deployment and (b) post-TAVR geometry obtained from FE simulation results. TAV skirt and leaflets were added to accommodate CFD simulations.

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Fig. 2

Computational fluid dynamics mesh and boundary conditions. Physiological pressure waveforms were used at the LVOT and ascending aorta as the pressure outlet and pressure inlet boundary conditions, respectively. Lumped parameter model was used at each coronary outlet.

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Fig. 3

TAV models with (a) two different orientations: r1 and r2, (b) three different deployment heights: h1, h2, and h3, (c) three skirt shapes: s1, s2, and s3, and (d) brick stent and shell stent

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Fig. 4

(a) The representative coronary artery flow rate and pressure waveforms from the simulation. (b) PVL flow rate curve calculated from the simulation of brick-s1-r1-h2 model. The dotted line represents the pressure drop between the ascending aorta and LVOT.

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Fig. 5

(a) Paravalvular leak flow rate curves from three TAV models with different skirt shapes as shown in Fig. 3(c) and (b) velocity vector profiles in a vertical cross section illustrate the leaking flow through the gaps between the aortic root and TAV stent

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Fig. 6

Regurgitant velocity vectors of a vertical cross section from (a) the brick stent (brick-s1-r2-h3) model and (b) shell stent (shell-s1-r2-h3) model

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Fig. 7

Volume rendering of velocity fields from the models of (a) aligned orientation r1 (brick-s1-r1-h3 model), and (b) misaligned orientation r2 (brick-s1-r2-h3 model)

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Fig. 8

Volume rendering of velocity fields from the models with different deployment heights (a) higher than the optimum, h1 (brick-s1-r2-h1 model), (b) around the optimum, h2 (brick-s1-r2-h2 model), (c) lower than the optimum, h3 (brick-s1-r2-h3 model), and (d) corresponding PVL flow rate curves from five TAV models in Figs. 68

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Fig. 9

(a) Pressure distribution on the skirt with a regurgitant flow velocity profile to show the distribution of regurgitant jets from the brick-s1-r1-h3 model. (b) A corresponding FE simulation to show the skirt bending under a pressure load of 10 mmHg.



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