Author + information
- Koohyar Vahidkhaha,b,
- Mostafa Abbasia,b,
- Shahnaz Javania,b,
- Peyman Azadania,b,
- Anwar Tandara,b and
- Ali Azadania,b
Background: Leaflet thrombosis following transcatheter aortic valve replacement (TAVR) has been increasingly recognized. Recent studies have suggested that reduced cardiac output (CO) may be associated with increased risk of thrombosis. The present study aims to quantify the effects of cardiac output on blood stasis on TAV leaflets as a precursor mechanism to the thrombus formation.
Methods: A patient-specific geometry of the left ventricle, aorta, and coronary arteries was reconstructed from computed tomographic angiography images (Fig 1a). A computational model representing a TAV was developed in the patient-specific geometry. 3D flow fields were obtained at different COs (2, 3.5, and 5 L/min) via a fluid-solid interaction modeling approach. Subsequently, the blood residence time (BRT) was calculated on the leaflets.
Results: The average BRT exhibited larger values at lower COs, specifically during diastole. At the end of diastole, significantly larger areas of high BRT (>1.2 s) were observed at lower COs, particularly at leaflets boundaries (Fig 1b-c). Such areas were calculated to be 2, 6, and 10% of the total surface area of the three leaflets at CO=5.0, 3.5, and 2.0 L/min, respectively, which indicates a 5-fold increase from the highest to the lowest CO under consideration.
Conclusions: Considering blood stasis on TAV leaflets as a precursor mechanism to post-TAVR thrombosis, the result of this study indicates an association between reduced cardiac output and increased risk of valve thrombosis.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Valvular Heart Disease: Aortic Stenosis
Abstract Category: 36. Valvular Heart Disease: Clinical
Presentation Number: 1233-028
- 2017 American College of Cardiology Foundation