Research Papers

Comparative Fluid–Structure Interaction Analysis of Polymeric Transcatheter and Surgical Aortic Valves' Hemodynamics and Structural Mechanics

[+] Author and Article Information
Ram P. Ghosh

Department of Biomedical Engineering,
Stony Brook University,
Stony Brook, NY 11794-8151
e-mail: ramghosh7@gmail.com

Gil Marom

School of Mechanical Engineering,
Faculty of Engineering,
Tel Aviv University,
Tel Aviv 6997801, Israel;
Biomedical Engineering Department,
Stony Brook University,
Stony Brook, NY 11794
e-mail: maromgil@tau.ac.il

Oren M. Rotman

Department of Biomedical Engineering,
Stony Brook University,
Stony Brook, NY 11794-8151
e-mail: orenrotman1@gmail.com

Marvin J. Slepian

Department of Biomedical Engineering,
Sarver Heart Center,
University of Arizona,
Tucson, AZ 85724;
Department of Medicine,
Sarver Heart Center,
University of Arizona,
Tucson, AZ 85724
e-mail: chairman.syns@gmail.com

Saurabh Prabhakar

ANSYS Fluent India Pvt Ltd.,
Plot No. 34/1, Rajiv Gandhi IT Park,
Hinjewadi 411057, Pune, India
e-mail: saurabh.prabhakar@ansys.com

Marc Horner

ANSYS, Inc.,
1007 Church Street, Suite 250,
Evanston, IL 60201
e-mail: marc.horner@ansys.com

Danny Bluestein

Department of Biomedical Engineering,
Stony Brook University,
Stony Brook, NY 11794-8151
e-mail: danny.bluestein@stonybrook.edu

1Corresponding author.

Manuscript received November 6, 2017; final manuscript received May 30, 2018; published online September 25, 2018. Assoc. Editor: Sarah Kieweg.

J Biomech Eng 140(12), 121002 (Sep 25, 2018) (10 pages) Paper No: BIO-17-1507; doi: 10.1115/1.4040600 History: Received November 06, 2017; Revised May 30, 2018

Transcatheter aortic valve replacement (TAVR) has emerged as an effective alternative to conventional surgical aortic valve replacement (SAVR) in high-risk elderly patients with calcified aortic valve disease. All currently food and drug administration approved TAVR devices use tissue valves that were adapted to but not specifically designed for TAVR use. Emerging clinical evidence indicates that these valves may get damaged during crimping and deployment—leading to valvular calcification, thrombotic complications, and limited durability. This impedes the expected expansion of TAVR to lower-risk and younger patients. Viable polymeric valves have the potential to overcome such limitations. We have developed a polymeric SAVR valve, which was optimized to reduce leaflet stresses and offer a thromboresistance profile similar to that of a tissue valve. This study compares the polymeric SAVR valve's hemodynamic performance and mechanical stresses to a new version of the valve—specifically designed for TAVR. Fluid–structure interaction (FSI) models were utilized and the valves' hemodynamics, flexural stresses, strains, orifice area, and wall shear stresses (WSS) were compared. The TAVR valve had 42% larger opening area and 27% higher flow rate versus the SAVR valve, while WSS distribution and mechanical stress magnitudes were of the same order, demonstrating the enhanced performance of the TAVR valve prototype. The TAVR valve FSI simulation and Vivitro pulse duplicator experiments were compared in terms of the leaflets' kinematics and the effective orifice area. The numerical methodology presented can be further used as a predictive tool for valve design optimization for enhanced hemodynamics and durability.

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Grahic Jump Location
Fig. 1

(a) The polynova TAVR and (b) SAVR valve geometries; (c) the pressure boundary condition used during the TAVR and SAVR simulations, starting from the diastole and systole, respectively—according to their nominal position; fluid domain geometry of (d) TAVR and (e) SAVR valve simulations

Grahic Jump Location
Fig. 2

The TAVR and SAVR valve von Mises stress and flow velocity streamlines at six instances during the cardiac cycle. The velocity streamlines are plotted on a two-dimensional cross section through the center of the valves. (a), (b), (g), and (h) correspond to the acceleration phase. (c) and (i) correspond to peak systole. (d)–(f) and (j)–(l) corresponds to the deceleration phase.

Grahic Jump Location
Fig. 3

The TAVR and SAVR valve equivalent strains and flow velocity vectors at six instances throughout the cardiac cycle. The velocity vectors are plotted on a two-dimensional cross section through the center of the valves. Similar to Fig. 2, (a), (b), (g), and (h) correspond to the acceleration phase. (c) and (i) correspond to peak systole. (d)–(f) and (j)–(l) corresponds to the deceleration phase.

Grahic Jump Location
Fig. 4

(a) Flow rate as function of time during systole (systole portion in Fig. 1(c). The dashed lines represent the average flow rates—463.0 ml for TAVR and 333.5 ml for SAVR; (b) GOA as a function of time with cross section of their maximum opening during systole.

Grahic Jump Location
Fig. 5

Qualitative and quantitative comparison of TAVR valve GOA and leaflet kinematics obtained from experimental (top row) and numerical (bottom row) results

Grahic Jump Location
Fig. 6

The location specific von Mises stress and equivalent strain on both TAVR and SAVR valves during systole and diastole. TAVR valve is colored in green and SAVR in red.

Grahic Jump Location
Fig. 7

Flow WSS distributions on the ventricular side of TAVR (top) and SAVR (bottom) at three instances during systole

Grahic Jump Location
Fig. 8

The systolic WSS of the TAVR and SAVR valves as function of time



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