Date of Completion

4-10-2014

Embargo Period

4-4-2015

Keywords

heart valve, transcatheter, aortic, replacement, percutaneous, minimally-invasive

Major Advisor

Wei Sun

Associate Advisor

Tianfeng Lu

Associate Advisor

George Lykotrafitis

Associate Advisor

Donald Peterson

Associate Advisor

David Pierce

Field of Study

Mechanical Engineering

Degree

Doctor of Philosophy

Open Access

Campus Access

Abstract

Aortic stenosis is one of the leading causes of death in the US and in the world. The most common treatment for aortic stenosis is surgical replacement of the diseased valve with a mechanical or bioprosthetic valve. In the past, little could be done for patients with severe aortic stenosis that were too frail for surgery due to advanced age or other complicating medical conditions. Recently, transcatheter aortic valve replacement (TAV, TAVR) has emerged as a viable alternative for this patient group. In TAVR, the valve is delivered through a catheter, with no surgery required. The valve is held in place within the patient’s aortic annulus by the reaction force between the TAV stent and the native tissue. While this groundbreaking procedure has helped tens of thousands of patients, the unique disease treatment mechanism relies heavily on the biomechanical interaction between the device and the patient. Widespread use of TAVR has been held back by the presence of complications observed during clinical use including stroke, myocardial infarction, and death. The purpose of this research study was to model the patient-specific interactions between the TAV and the patient’s tissue using computational tools. Patient-specific geometries were reconstructed from pre-operative CT scans, deployed TAV geometry was predicted using finite element analysis, and pre- and post-deployment hemodynamics were explored using computational fluid dynamics. The results of the simulations were compared to known clinical outcomes. The models developed in this study have laid the foundation for patient-specific pre-operative planning, which could one day improve patient care.

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