Aortic stenosis is the most common valvular heart disease in the Western world and its prevalence is growing with an aging population. The current preferred method of treatment is complete valve replacement with a surgically implanted prosthetic valve. However, for high-risk patients with advanced age and co- morbidities, operative mortality escalates. Recently, minimally invasive transcatheter aortic valve (TAV) implantation has been investigated as an endovascular alternative to surgical valve replacement. Although significant experience has been gained, TAV implantation clinical trials have been associated with complications such as device migration, paravalvular leakage, coronary obstruction, and access site injury. Furthermore, the long-term durability and safety of TAV prostheses are largely unknown and must be evaluated and studied carefully. To gain a quantitative understanding of the biomechanics involved in TAV intervention, our objectives in this project are to develop probabilistic computational models to investigate aortic tissue-TAV structural interaction and hemodynamics under a variety of patient conditions, and to offer scientific rationale for TAV patient screening and TAV design improvement. To accomplish these goals, the following specific aims are proposed: 1) Investigation of elastic properties and microstructure of the human stenotic aortic root through a series of biomechanical tests performed on 50 human cadaver hearts; 2) Image analysis of clinical CT scans, which will yield 60 reconstructed patient-specific aortic valve geometries. Statistical shape models will be developed to facilitate the reconstruction process as well as the description of anatomic geometric variation among the patient population; and 3) Probabilistic computational analysis of aortic tissue-TAV structural interaction and hemodynamics. Deterministic finite element (FE) models and computational fluid dynamics (CFD) models will be developed using 12 actual TAV patient data measured prior to the TAV intervention, and validated by the post-TAV clinical CT scans, flow and pressure measurements. A statistical description of patient material properties and geometric variations will be mapped into the computational models and a probabilistic analysis will be conducted to evaluate aortic tissue-TAV structural interaction and hemodynamics. The fundamental study of the biomechanics involved in TAV intervention and the computational modeling of tissue-implant interaction proposed here could lead to the development of a new knowledgebase that has been previously unavailable to academia, clinicians, and the heart valve industry. The methodologies and computational framework developed in this study will serve as a basis for future studies, which will include more design and environmental variables such as different patient demographics, and could also be utilized to facilitate the development of other novel device designs or pre-operative patient screening techniques for different valve diseases, such as mitral valve regurgitation.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL104080-05
Application #
8731269
Study Section
Special Emphasis Panel (ZRG1)
Program Officer
Baldwin, Tim
Project Start
2011-08-20
Project End
2017-05-31
Budget Start
2015-06-01
Budget End
2017-05-31
Support Year
5
Fiscal Year
2015
Total Cost
Indirect Cost
Name
Georgia Institute of Technology
Department
Type
Organized Research Units
DUNS #
097394084
City
Atlanta
State
GA
Country
United States
Zip Code
30318
Kong, Fanwei; Pham, Thuy; Martin, Caitlin et al. (2018) Finite element analysis of annuloplasty and papillary muscle relocation on a patient-specific mitral regurgitation model. PLoS One 13:e0198331
Sirois, Eric; Mao, Wenbin; Li, Kewei et al. (2018) Simulated Transcatheter Aortic Valve Flow: Implications of Elliptical Deployment and Under-Expansion at the Aortic Annulus. Artif Organs 42:E141-E152
Pokutta-Paskaleva, Anastassia; Sulejmani, Fatiesa; DelRocini, Marissa et al. (2018) Comparative mechanical, morphological, and microstructural characterization of porcine mitral and tricuspid leaflets and chordae tendineae. Acta Biomater :
Liang, Liang; Liu, Minliang; Martin, Caitlin et al. (2018) A deep learning approach to estimate stress distribution: a fast and accurate surrogate of finite-element analysis. J R Soc Interface 15:
Wei, Zhenglun Alan; Sonntag, Simon Johannes; Toma, Milan et al. (2018) Computational Fluid Dynamics Assessment Associated with Transcatheter Heart Valve Prostheses: A Position Paper of the ISO Working Group. Cardiovasc Eng Technol 9:289-299
Liu, Minliang; Liang, Liang; Sun, Wei (2018) Estimation of in vivo mechanical properties of the aortic wall: A multi-resolution direct search approach. J Mech Behav Biomed Mater 77:649-659
Mao, Wenbin; Wang, Qian; Kodali, Susheel et al. (2018) Numerical Parametric Study of Paravalvular Leak Following a Transcatheter Aortic Valve Deployment Into a Patient-Specific Aortic Root. J Biomech Eng 140:
Madukauwa-David, Immanuel David; Pierce, Eric L; Sulejmani, Fatiesa et al. (2018) Suture dehiscence and collagen content in the human mitral and tricuspid annuli. Biomech Model Mechanobiol :
Murdock, Kyle; Martin, Caitlin; Sun, Wei (2018) Characterization of mechanical properties of pericardium tissue using planar biaxial tension and flexural deformation. J Mech Behav Biomed Mater 77:148-156
Kong, Fanwei; Pham, Thuy; Martin, Caitlin et al. (2018) Finite Element Analysis of Tricuspid Valve Deformation from Multi-slice Computed Tomography Images. Ann Biomed Eng 46:1112-1127

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