Document Type
Article
Publication Date
6-2022
Department
Department of Biomedical Engineering
Abstract
Objective: To evaluate the flow dynamics of self-expanding and balloon-expandable transcatheter aortic valves pertaining to turbulence and pressure recovery. Transcatheter aortic valves are characterized by different designs that have different valve performance and outcomes. Methods: Assessment of transcatheter aortic valves was performed using self-expanding devices (26-mm Evolut [Medtronic], 23-mm Allegra [New Valve Technologies], and small Acurate neo [Boston Scientific]) and a balloon-expandable device (23-mm Sapien 3 [Edwards Lifesciences]). Particle image velocimetry assessed the flow downstream. A Millar catheter was used for pressure recovery calculation. Velocity, Reynolds shear stresses, viscous shear stress, and pressure gradients were calculated. Results: The maximal velocity at peak systole obtained with the Evolut R, Sapien 3, Acurate neo, and Allegra was 2.12 ± 0.19 m/sec, 2.41 ± 0.06 m/sec, 2.99 ± 0.10 m/sec, and 2.45 ± 0.08 m/sec, respectively (P < .001). Leaflet oscillations with the flow were clear with the Evolut R and Acurate neo. The Allegra shows the minimal range of Reynolds shear stress magnitudes (up to 320 Pa), and Sapien 3 the maximal (up to 650 Pa). The Evolut had the smallest viscous shear stress magnitude range (up to 3.5 Pa), and the Sapien 3 the largest (up to 6.2 Pa). The largest pressure drop at the vena contracta occurred with the Acurate neo transcatheter aortic valve with a pressure gradient of 13.96 ± 1.35 mm Hg. In the recovery zone, the smallest pressure gradient was obtained with the Allegra (3.32 ± 0.94 mm Hg). Conclusions: Flow dynamics downstream of different transcatheter aortic valves vary significantly depending on the valve type, despite not having a general trend depending on whether or not valves are self-expanding or balloon-expandable. Deployment design did not have an influence on flow dynamics.
Publication Title
JTCVS Open
Recommended Citation
Hatoum, H.,
Samaee, M.,
Sathananthan, J.,
Sellers, S.,
Kuetting, M.,
Lilly, S.,
Ihdayhid, A.,
Blanke, P.,
Leipsic, J.,
Thourani, V.,
&
Dasi, L.
(2022).
Comparison of performance of self-expanding and balloon-expandable transcatheter aortic valves.
JTCVS Open.
http://doi.org/10.1016/j.xjon.2022.04.015
Retrieved from: https://digitalcommons.mtu.edu/michigantech-p/16029
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
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Publisher's Statement
© 2022 The Author(s). Published by Elsevier Inc. on behalf of The American Association for Thoracic Surgery. Publisher’s version of record: https://doi.org/10.1016/j.xjon.2022.04.015