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The Effects of Positioning of Transcatheter Aortic Valves on Fluid Dynamics of the Aortic Root

Groves, Elliott M.*†; Falahatpisheh, Ahmad*; Su, Jimmy L.*‡; Kheradvar, Arash*†‡

doi: 10.1097/MAT.0000000000000107
Biomedical Engineering

Transcatheter aortic valve implantation is a novel treatment for severe aortic valve stenosis. Due to the recent use of this technology and the procedural variability, there is very little data that quantify the hemodynamic consequences of variations in valve placement. Changes in aortic wall stresses and fluid retention in the sinuses of Valsalva can have a significant effect on the clinical response a patient has to the procedure. By comprehensively characterizing complex flow in the sinuses of Valsalva using digital particle image velocimetry and an advanced heart-flow simulator, various positions of a deployed transcatheter valve with respect to a bioprosthetic aortic valve (valve-in-valve) were tested in vitro. Displacements of the transcatheter valve were axial and directed below the simulated native valve annulus. It was determined that for both blood residence time and aortic Reynolds stresses, it is optimal to have the annulus of the transcatheter valve deployed as close to the aortic valve annulus as possible.

From the *Edwards Lifesciences Center for Advanced Cardiovascular Technology, University of California at Irvine, Irvine, California; Division of Cardiovascular Diseases, University of California at Irvine, Irvine, California; and Department of Biomedical Engineering, University of California at Irvine, Irvine, California.

Submitted for consideration January 28, 2014; accepted for publication in revised form May 17, 2014.

The first two authors contributed equally to this work.

The authors have no conflicts of interest to report.

This work was partially supported by a Coulter Translational Research Award (CTRA) from the Wallace H. Coulter Foundation and by the National Center for Research Resources, the National Center for Advancing Translational Sciences, and National Institutes of Health, through grant UL1 TR000153.

Correspondence: Arash Kheradvar, Edwards Lifesciences Center for Advanced Cardiovascular Technology, University of California at Irvine, 2410 Engineering Hall, Irvine, CA 92697. Email: arashkh@uci.edu.

Copyright © 2014 by the American Society for Artificial Internal Organs