Computational Modeling for Surgical Reconstruction of Aortic Valve by Using Autologous Pericardium

The objective of this study was to evaluate the clinical effectiveness of surgical reconstruction of aortic valve using autologous pericardium, and the hemodynamic impact of matching the circumferential direction of the trimmed leaflet to inherent fiber orientation of the pericardium during surgery....

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Main Authors: Yong Feng, Yuqi Cao, Wenshuo Wang, Huifeng Zhang, Lai Wei, Bing Jia, Shengzhang Wang
Format: Article
Language:English
Published: IEEE 2020-01-01
Series:IEEE Access
Subjects:
Online Access:https://ieeexplore.ieee.org/document/9099527/
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spelling doaj-a916d7962a7c46c983ff80fe8c19b2ac2021-03-30T02:15:48ZengIEEEIEEE Access2169-35362020-01-018973439735210.1109/ACCESS.2020.29976059099527Computational Modeling for Surgical Reconstruction of Aortic Valve by Using Autologous PericardiumYong Feng0https://orcid.org/0000-0003-2349-7868Yuqi Cao1Wenshuo Wang2Huifeng Zhang3Lai Wei4Bing Jia5Shengzhang Wang6Department of Aeronautics and Astronautics, Fudan University, Shanghai, ChinaDepartment of Cardiothoracic Surgery, Children’s Hospital of Fudan University, Shanghai, ChinaShanghai Engineering Research Center of Heart Valve, Shanghai, ChinaDepartment of Cardiothoracic Surgery, Children’s Hospital of Fudan University, Shanghai, ChinaShanghai Engineering Research Center of Heart Valve, Shanghai, ChinaDepartment of Cardiothoracic Surgery, Children’s Hospital of Fudan University, Shanghai, ChinaDepartment of Aeronautics and Astronautics, Fudan University, Shanghai, ChinaThe objective of this study was to evaluate the clinical effectiveness of surgical reconstruction of aortic valve using autologous pericardium, and the hemodynamic impact of matching the circumferential direction of the trimmed leaflet to inherent fiber orientation of the pericardium during surgery. A patient specific aortic valve model was built based on CTA data. The reconstructive surgery was carried out on the model following normal operating procedures. FSI simulation was performed to analyze the hemodynamic characteristics among the diseased model, normal model and three operative models with different misaligned angles between the circumferential direction of the substitute and inherent fiber orientation. The differences of EOA, velocity distribution, stress and strain on leaflets, and the valve deformation between the five models were compared and analyzed. The results showed that reconstructive surgery helps enlarge EOA, reduce abnormity of leaflet motion and blood ejection compared to diseased model. There was no significant difference between operative models with different misaligned angles in terms of leaflet motion and flow pattern, but as the misaligned angle increased, greater strain and deformation were observed on leaflets during the diastolic period. The present study demonstrated the instant clinical effectiveness of the reconstructive surgery of aortic valve by the improvement of EOA and flow pattern, and suggested that during the operation it may be unnecessary to match the circumferential direction of the substitute to inherent fiber orientation of the pericardium since the hemodynamic characteristics were insensitive to the fiber alignment, but the strain and deformation increment on the substitutes during diastolic period still raised concern about their durability.https://ieeexplore.ieee.org/document/9099527/Aortic stenosisaortic valve reconstructionmedical imagingfluid-structure interaction
collection DOAJ
language English
format Article
sources DOAJ
author Yong Feng
Yuqi Cao
Wenshuo Wang
Huifeng Zhang
Lai Wei
Bing Jia
Shengzhang Wang
spellingShingle Yong Feng
Yuqi Cao
Wenshuo Wang
Huifeng Zhang
Lai Wei
Bing Jia
Shengzhang Wang
Computational Modeling for Surgical Reconstruction of Aortic Valve by Using Autologous Pericardium
IEEE Access
Aortic stenosis
aortic valve reconstruction
medical imaging
fluid-structure interaction
author_facet Yong Feng
Yuqi Cao
Wenshuo Wang
Huifeng Zhang
Lai Wei
Bing Jia
Shengzhang Wang
author_sort Yong Feng
title Computational Modeling for Surgical Reconstruction of Aortic Valve by Using Autologous Pericardium
title_short Computational Modeling for Surgical Reconstruction of Aortic Valve by Using Autologous Pericardium
title_full Computational Modeling for Surgical Reconstruction of Aortic Valve by Using Autologous Pericardium
title_fullStr Computational Modeling for Surgical Reconstruction of Aortic Valve by Using Autologous Pericardium
title_full_unstemmed Computational Modeling for Surgical Reconstruction of Aortic Valve by Using Autologous Pericardium
title_sort computational modeling for surgical reconstruction of aortic valve by using autologous pericardium
publisher IEEE
series IEEE Access
issn 2169-3536
publishDate 2020-01-01
description The objective of this study was to evaluate the clinical effectiveness of surgical reconstruction of aortic valve using autologous pericardium, and the hemodynamic impact of matching the circumferential direction of the trimmed leaflet to inherent fiber orientation of the pericardium during surgery. A patient specific aortic valve model was built based on CTA data. The reconstructive surgery was carried out on the model following normal operating procedures. FSI simulation was performed to analyze the hemodynamic characteristics among the diseased model, normal model and three operative models with different misaligned angles between the circumferential direction of the substitute and inherent fiber orientation. The differences of EOA, velocity distribution, stress and strain on leaflets, and the valve deformation between the five models were compared and analyzed. The results showed that reconstructive surgery helps enlarge EOA, reduce abnormity of leaflet motion and blood ejection compared to diseased model. There was no significant difference between operative models with different misaligned angles in terms of leaflet motion and flow pattern, but as the misaligned angle increased, greater strain and deformation were observed on leaflets during the diastolic period. The present study demonstrated the instant clinical effectiveness of the reconstructive surgery of aortic valve by the improvement of EOA and flow pattern, and suggested that during the operation it may be unnecessary to match the circumferential direction of the substitute to inherent fiber orientation of the pericardium since the hemodynamic characteristics were insensitive to the fiber alignment, but the strain and deformation increment on the substitutes during diastolic period still raised concern about their durability.
topic Aortic stenosis
aortic valve reconstruction
medical imaging
fluid-structure interaction
url https://ieeexplore.ieee.org/document/9099527/
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