An in vitro model of aortic stenosis for the assessment of transcatheter aortic valve implantation

Authors: Maleki, Hoda; Shahriari, Shahrokh; Labrosse, Michel; Pibarot, PhilippeKadem, Lyes
Abstract: A significant number of elderly patients with severe symptomatic aortic stenosis are denied surgical aortic valve replacement (SAVR) because of high operative risk. Transcatheter aortic valve implantation (TAVI) has emerged as a valid alternative to SAVR in these patients. One of the main characteristics of TAVI, when compared to SAVR, is that the diseased native aortic valve remains in place. For hemodynamic testing of new percutaneous valves and clinical training, one should rely on animal models. However, the development of an appropriate animal model of severe aortic stenosis is not straightforward. This work aims at developing and testing an elastic model of the ascending aorta including a severe aortic stenosis. The physical model was built based on a previous silicone model and tested experimentally in this study. Experimental results showed that the error between the computer-aided design (CAD) file and the physical elastic model was <5%, the compliance of the ascending aorta was 1.15 ml/mm Hg, the effective orifice area (EOA) of the stenotic valve was 0.86 cm2, the peak jet velocity was 4.9 m/s and mean transvalvular pressure gradient was 50 mm Hg, consistent with as severe. An EDWARDS-SAPIEN 26 mm valve was then implanted in the model leading to a significant increase in EOA (2.22 cm2) and a significant decrease in both peak jet velocity (1.29 m/s) and mean transvalvular pressure gradient (3.1 mm Hg). This model can be useful for preliminary in vitro testing of percutaneous valves before more extensive animal and in vivo tests.
Document Type: Article de recherche
Issue Date: 1 May 2014
Open Access Date: 26 September 2016
Document version: VoR
Permalink: http://hdl.handle.net/20.500.11794/8228
This document was published in: Journal of biomechanical engineering, Vol. 136 (5), (2014)
http://dx.doi.org/10.1115/1.4026576
American Society of Mechanical Engineers
Alternative version: 10.1115/1.4026576ar
24474441
Collection:Articles publiés dans des revues avec comité de lecture

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