title: Patient-specific image-based computer simulation for theprediction of valve morphology and calcium displacement after TAVI with the Medtronic CoreValve and the Edwards SAPIEN valve.
abstract: OBJECTIVE
  Our aim was to validate patient-specific software integrating baseline anatomy and biomechanical properties of both the aortic root and valve for the prediction of valve morphology and aortic leaflet calcium displacement after TAVI.
  
  
  RESULTS
  Finite element computer modelling was performed in 39 patients treated with a Medtronic CoreValve System (MCS; n=33) or an Edwards SAPIEN XT (ESV; n=6). Quantitative axial frame morphology at inflow (MCS, ESV) and nadir, coaptation and commissures (MCS) was compared between multislice computed tomography (MSCT) post TAVI and a computer model as well as displacement of the aortic leaflet calcifications, quantified by the distance between the coronary ostium and the closest calcium nodule. Bland-Altman analysis revealed a strong correlation between the observed (MSCT) and predicted frame dimensions, although small differences were detected for, e.g., Dmin at the inflow (mean±SD MSCT vs.
  
  
  METHODS
  21.6±2.4 mm vs. 22.0±2.4 mm; difference±SD: -0.4±1.3 mm, p<0.05) and Dmax (25.6±2.7 mm vs. 26.2±2.7 mm; difference±SD: -0.6±1.0 mm, p<0.01). The observed and predicted calcium displacements were highly correlated for the left and right coronary ostia (R2=0.67 and R2=0.71, respectively p<0.001).
  
  
  CONCLUSIONS
  Dedicated software allows accurate prediction of frame morphology and calcium displacement after valve implantation, which may help to improve outcome.
authors.affiliation: Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Carl
authors.initials: C
authors.lastname: Schultz
authors.forename: Ramon
authors.initials: R
authors.lastname: Rodriguez-Olivares
authors.forename: Johan
authors.initials: J
authors.lastname: Bosmans
authors.forename: Thierry
authors.initials: T
authors.lastname: Lefèvre
authors.forename: Gianluca
authors.initials: G
authors.lastname: De Santis
authors.forename: Nico
authors.initials: N
authors.lastname: Bruining
authors.forename: Valérie
authors.initials: V
authors.lastname: Collas
authors.forename: Tim
authors.initials: T
authors.lastname: Dezutter
authors.forename: Bart
authors.initials: B
authors.lastname: Bosmans
authors.forename: Zouhair
authors.initials: Z
authors.lastname: Rahhab
authors.forename: Nahid
authors.initials: N
authors.lastname: El Faquir
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Patrick
authors.initials: P
authors.lastname: Segers
authors.forename: Benedict
authors.initials: B
authors.lastname: Verhegghe
authors.forename: Bernard
authors.initials: B
authors.lastname: Chevalier
authors.forename: Nicolas
authors.initials: N
authors.lastname: van Mieghem
authors.forename: Matthieu
authors.initials: M
authors.lastname: De Beule
authors.forename: Peter
authors.initials: P
authors.lastname: Mortier
authors.forename: Peter
authors.initials: P
authors.lastname: de Jaegere
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001021:Aortic Valve / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000503:physiopathology / Q000628:therapy*; D001696:Biomechanical Phenomena; D002114:Calcinosis / Q000503:physiopathology / Q000628:therapy*; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation*; D003198:Computer Simulation; D005260:Female; D020342:Finite Element Analysis; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008955:Models, Cardiovascular; D061330:Multidetector Computed Tomography; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D012984:Software; D016896:Treatment Outcome