adfa, p. 1, 2011.
© Springer-Verlag Berlin Heidelberg 2011
Reconstruction of Stent Induced Loading Forces on the
Aortic Valve Complex
Raoul Hopf
1,*
, Michael Gessat
3
, Volkmar Falk
2
, Edoardo Mazza
1
1
Institute of Mechanical Systems, Department of Mechanical Engineering, Swiss Federal Insti-
tute of Technology (ETH), Switzerland
{rhopf, emazza}@ethz.ch
2
Division of Cardiovascular Surgery, University Hospital Zurich, Switzerland
volkmar.falk@usz.ch
3
Computer Vision Laboratory, Department of Electrical Engineering, Swiss Federal Institute of
Technology (ETH), Switzerland
mgessat@ethz.ch
Abstract. In order to evaluate the performance of stents used in transcatheter
aortic valve implantation (T-AVI), finite element simulations are set up to re-
construct patient specific contact forces between implant and its surrounding
tissue. The reference geometry of the stent is obtained using micro-CT scanning
data. A procedure is defined to create a numerically efficient and robust model
of the stent made of beam elements. The model is validated with experiments
applying representative loading cases. Post-op CT image data provide patient
specific displacement maps used to define kinematic boundary conditions for
the finite element simulation. An approach to deal with the issue of spurious
strains induced by measurement uncertainties from CT images is proposed.
Maps of radial forces acting on the aortic tissue are obtained.
Keywords: tavi, aortic stent, corevalve, simulation, contact forces
1 Introduction
Knowledge about the contact forces between a medical implant and its surrounding
tissue can provide essential information on the overall performance of the implant. In
particular, in the case of transcatheter aortic valve implantation (T-AVI). Insufficient
contact forces between stent and tissue might cause paravalvular leaks [1]. On the
contrary, excessive contact forces are suspected to impair the conductibility of the
atrioventricular (AV) node, the bundle of His, and/or the left bundle branch. All three
result in bradicaridal arrhythmia, which is a common complication after T-AVI, usu-
ally requiring pacemaker implantation [2]. The two main risk factors which could be
identified as significant in clinical studies are (i) the type of valve selected for implan-
tation and (ii) valve oversizing (resulting in high radial loads) [2,3]. These findings
indicate a connection between mechanical stress induced on the tissues and the neces-
sity for a pacemaker after T-AVI. Nevertheless, there exists no quantitative investiga-
tion of this relationship, which would allow predicting or help reducing the onset of
conduction abnormalities after T-AVI.
Demirci, Lee, Radeva, Unal (Eds.): MICCAI-STENT 2012. 104