Patient-Specific Computational Simulations of Transcatheter Aortic Valve Implantation (TAVI)

In the past decade, Transcatheter Aortic Valve Replacement (TAVI) has been shown to be a feasible, less invasive option to open heart surgery for aortic valve replacement; however, TAVI is indicated only in patients with severe, symptomatic, aortic stenosis and who are considered at high or prohibitive risk for conventional surgery [1]. To date, two different TAVI devices are available on the market — the balloon-expandable Edwards-Sapien^® Valve (Edwards Lifesciences, CA, USA) and the self-expandable CoreValve ReValving System^® (Medtronic, MN, USA) — with many other devices currently under development and clinical trials. The procedural success rate has been >90% in all studies [1], but vascular complications, electrical conduction abnormalities and paravalvular leak — 65–89% of cases, the majority being trivial to mild, with 0 to 26% moderate and 0 to 10% severe — still remain major safety concerns. In particular, a negative influence of moderate to severe paravalvular leak on survival rates has recently been demonstrated [2].