Predicting the Outcomes of Transcatheter Aortic Valve Prosthesis Implantation Based on the Finite Element Analysis and Microcomputer Tomography Data

The aim of the investigation is to assess the possibility of predicting the outcome of transcatheter aortic valve prosthesis implantation in real clinical practice on the basis of patient-specific modeling.

Material and Methods. Modeling of transcatheter bioprosthesis implantation was carried out based on clinical data of a patient aged 72 years. Multispiral computed tomography (CT) was performed before and after the operative intervention. Reconstruction of aorta and valvular apparatus geometry was done on the basis of obtained slices using computer-aided design (CAD). With the help of microcomputer tomography and a series of projection images and mathematical algorithms a 3D-model of the frame was reconstructed, on which a 3D-mesh from 17,000 cubic (C3D8)-elements was built. Simulation of the system component interaction was conducted using a finite element method involving a number of successive steps: preliminary balloon dilatation — frame compression in the catheter — releasing the frame from the catheter. To evaluate the accuracy of modeling results compared to the CT data of the patient with the implanted bioprosthesis a proprietary algorithm was developed using MATLAB R2014a software (The MathWorks, USA). Arrays of points corresponding to the center of the supporting frame beams, obtained in 11 orthogonal sections, were used as input data.

Results. Peculiarities of patient-specific approach to modeling the implantation of transcatheter CoreValve bioprothesis by means of the developed bioinformation algorithm has been analyzed. We managed to achieve a high convergence of simulation and CT data for the frame inflow area (the difference of the simulation results for the first three layers did not exceed 4%). Comparison of the results in terms of the annulus area has also demonstrated a high convergence: the identity amounted to more than 90% for the inflow and middle zones of the supporting frame.

Conclusion. The highest level of detail, including calcium conglomerates modeling, as well as a comprehensive description of nonlinear elements of the system under study accurately reproduces the process of implantation of the transcatheter aortic valve prosthesis.

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