Simulation-based Surgical Planning
Transcatheter Aortic Valve Replacement (TAVR) planning
Computer models unleash unprecedented predictive abilities and can guide cardiac surgery in the future to minimize uncertainty in patient outcomes, but must facilitate accurate yet quick simulations!
I combined a biomechanics simulation of a balloon-expandable TAVR deployment in a pre-operative personalized aorta model with ViCar3D CFD solver and a versatile + efficient prosthetic valve dynamics model from my PhD research to predict post-operative valve shape and associated hemodynamics.
Such simulations can rapidly provide a priori knowledge of valvular performance in different deployment configurations. This information enables clinicians to determine best deployment parameters and minimize future risks of structural as well as hemodynamic complications.
Credits:
TAV Deployment Simulation: Fateme Esmailie, Huang Chen & Lakshmi Dasi
Co-authors: Jung Hee Seo & Rajat Mittal
Mitral Valve modeling:
Unlike the aortic valve which has three distinct cusps, the mitral valve (MV) may be viewed as one continuous tissue with two functional valves. As such, a simplified MV may be modeled as a conical shell instead of two distinct leaflets attached at the annulus. Due to this difference in structure, MV closure and coaptation is better described by a buckling of the shell, as opposed to hinging at the annulus.
The animation alongside shows an asymmetric conical shell, tethered at two points along its free (inferior) edge, subject to pulsatile pressure. Two MV conditions are modeled: healthy (left) and post-clip (right), where a prolapsing MV is restricted at the mid-plane along its free edge (clip not shown). Even with such a minimal model, the complex coaptation features of the MV may be reproduced, both in the healthy and clipped states.
Additionally, the running markers at the bottom, show the geometric orifice areas (GOA) in the healthy (blue) and clipped (red) cases.