Evidence map›Paper›PMID 30460623›Full record

ArticleBiomechanics and modeling in mechanobiology2019

Patient-specific simulation of transcatheter aortic valve replacement: impact of deployment options on paravalvular leakage.

Matteo Bianchi, Gil Marom, Ram P Ghosh, Oren M Rotman, Puja Parikh, Luis Gruberg, Danny Bluestein

Erratum issuedAbstract read
In one paragraph

Article in Biomechanics and modeling in mechanobiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 57 papers.

0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed
7.8field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

57 citing papers in PubMed, 123 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 2 countries.

Matteo BianchiDepartment of Biomedical Engineering, Stony Brook University, T15-090 Health Sciences Center, Stony Brook, NY, 11794-8151, USA.
Gil MaromDepartment of Biomedical Engineering, Stony Brook University, T15-090 Health Sciences Center, Stony Brook, NY, 11794-8151, USA.
Ram P GhoshDepartment of Biomedical Engineering, Stony Brook University, T15-090 Health Sciences Center, Stony Brook, NY, 11794-8151, USA.
Oren M RotmanDepartment of Biomedical Engineering, Stony Brook University, T15-090 Health Sciences Center, Stony Brook, NY, 11794-8151, USA.
Puja ParikhDivision of Cardiovascular Diseases, Stony Brook University Hospital, Stony Brook, NY, USA.
Luis GrubergDivision of Cardiology, Southside Hospital, Northwell Health, Bay Shore, NY, USA.
Danny BluesteinDepartment of Biomedical Engineering, Stony Brook University, T15-090 Health Sciences Center, Stony Brook, NY, 11794-8151, USA. danny.bluestein@stonybrook.edu.
Stony Brook University · USNorthwell Health · USStony Brook University Hospital · USTel Aviv University · IL

Funding

Optimizing Cardiovascular Device Thromboresistance for Eliminating AnticoagulantsU01EB012487 · NIBIB · STATE UNIVERSITY NEW YORK STONY BROOK · PI BLUESTEIN, DANNY · 2010 to 2014
$6.9M
Biomechanical Approaches and Technologies for Enhancing TAVR OutcomesU01EB026414 · NIBIB · STATE UNIVERSITY NEW YORK STONY BROOK · PI BLUESTEIN, DANNY · 2018 to 2022
$3.8M
A Novel Polymeric Valve for Transcatheter Aortic Valve ReplacementR41HL134418 · NHLBI · POLYNOVA CARDIOVASCULAR, INC · PI BLUESTEIN, DANNY · 2017 to 2018
$225k
National Institute of Biomedical Imaging and Bioengineering 1U01EB012487National Institute of Biomedical Imaging and Bioengineering 1U01EB026414NHLBI NIH HHS R41 HL134418NIBIB NIH HHS U01 EB012487NIBIB NIH HHS U01 EB026414
6 · The paper itself

Abstract

Transcatheter aortic valve replacement (TAVR) has emerged as an effective alternative to conventional surgical valve replacement in high-risk patients afflicted by severe aortic stenosis. Despite newer-generation devices enhancements, post-procedural complications such as paravalvular leakage (PVL) and related thromboembolic events have been hindering TAVR expansion into lower-risk patients. Computational methods can be used to build and simulate patient-specific deployment of transcatheter aortic valves (TAVs) and help predict the occurrence and degree of PVL. In this study finite element analysis and computational fluid dynamics were used to investigate the influence of procedural parameters on post-deployment hemodynamics on three retrospective clinical cases affected by PVL. Specifically, TAV implantation depth and balloon inflation volume effects on stent anchorage, degree of paravalvular regurgitation and thrombogenic potential were analyzed for cases in which Edwards SAPIEN and Medtronic CoreValve were employed. CFD results were in good agreement with corresponding echocardiography data measured in patients in terms of the PVL jets locations and overall PVL degree. Furthermore, parametric analyses demonstrated that positioning and balloon over-expansion may have a direct impact on the post-deployment TAVR performance, achieving as high as 47% in PVL volume reduction. While the model predicted very well clinical data, further validation on a larger cohort of patients is needed to verify the level of the model's predictions in various patient-specific conditions. This study demonstrated that rigorous and realistic patient-specific numerical models could potentially serve as a valuable tool to assist physicians in pre-operative TAVR planning and TAV selection to ultimately reduce the risk of clinical complications.

Indexed as

Computer SimulationTranscatheter Aortic Valve ReplacementAortic ValveBlood Flow VelocityHemodynamicsHumansRegional Blood FlowStentsStress, MechanicalThrombosisCFDComputational fluid dynamicsFEAFinite element analysisTAVITAVR

Identifiers

PMID30460623
PMCPMC6476328
OpenAlexW2900865211

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.