目的:经导管主动脉瓣植入术(TAVI)已显著改变了主动脉瓣(AV)疾病的治疗,与传统的外科瓣膜置换术相比,提出了一种微创选择。TAVI的计算模拟变得越来越流行,并通过采用患者特定的模型提供了详细的调查。另一方面,采用准确的材料建模程序和应用基本建模步骤对于确定可靠的数值结果至关重要。因此,这篇综述旨在概述TAVI的基本建模方法,专注于材料建模和几何提取,并总结了最近计算研究的重要发现,以指导该领域的未来研究。
方法:本文解释了设置和运行TAVI模拟的基本步骤和要点。小叶的材料特性,阀门,支架,并提供了TAVI模拟中使用的组织,以及所采用的几何提取方法的全面解释。有限元分析之间的差异,计算流体力学,通过阐明最近的计算研究,指出了流体-结构相互作用的方法,并描述了TAVI建模的重要方面。
结果:总结了TAVI模拟的最新发现结果,以证明其强大的潜力。观察到,主动脉组织和植入瓣膜组件的材料特性应进行逼真的建模,以确定准确的结果。对于患者特定的AV几何形状,在小叶上掺入钙化沉积物对于确保计算结果的准确性至关重要。数值TAVI模拟的结果表明了选择最佳瓣膜和在适当解剖位置内精确部署的重要性。这些因素共同有助于植入瓣膜的有效功能。
结论:最近的文献研究揭示了患者特异性建模的重要性,选择准确的材料模型,和生物人工瓣膜直径。此外,这些研究强调了精确定位生物人工瓣膜的必要性,以实现TAVI的最佳性能,其特征是有效孔口面积增加和瓣周漏最小。
OBJECTIVE: Transcatheter aortic valve implantation (TAVI) has significantly transformed the management of aortic valve (AV) diseases, presenting a minimally invasive option compared to traditional surgical valve replacement. Computational simulations of TAVI become more popular and offer a detailed investigation by employing patient-specific models. On the other hand, employing accurate material modeling procedures and applying basic modeling steps are crucial to determining reliable numerical results. Therefore, this review aims to outline the basic modeling approaches for TAVI, focusing on material modeling and geometry extraction, as well as summarizing the important findings from recent computational studies to guide future research in the field.
METHODS: This paper explains the basic steps and important points in setting up and running TAVI simulations. The material properties of the leaflets, valves, stents, and tissues utilized in TAVI simulations are provided, along with a comprehensive explanation of the geometric extraction methods employed. The differences between the finite element analysis, computational fluid dynamics, and fluid-structure interaction approaches are pointed out and the important aspects of TAVI modeling are described by elucidating the recent computational studies.
RESULTS: The results of the recent findings on TAVI simulations are summarized to demonstrate its powerful potential. It is observed that the material properties of aortic tissues and components of implanted valves should be modeled realistically to determine accurate results. For patient-specific AV geometries, incorporating calcific deposits on the leaflets is essential for ensuring the accuracy of computational findings. The results of numerical TAVI simulations indicate the significance of the selection of optimal valves and precise deployment within the appropriate anatomical position. These factors collectively contribute to the effective functionality of the implanted valve.
CONCLUSIONS: Recent studies in the literature have revealed the critical importance of patient-specific modeling, the selection of accurate material models, and bio-prosthetic valve diameters. Additionally, these studies emphasize the necessity of precise positioning of bio-prosthetic valves to achieve optimal performance in TAVI, characterized by an increased effective orifice area and minimal paravalvular leakage.