TY - JOUR
T1 - Fragmentation of Different Calcification Growth Patterns in Bicuspid Valves During Balloon Valvuloplasty Procedure
AU - Morany, Adi
AU - Lavon, Karin
AU - Halevi, Rotem
AU - Haj-Ali, Nora
AU - Bluestein, Danny
AU - Raanani, Ehud
AU - Hamdan, Ashraf
AU - Haj-Ali, Rami
N1 - Publisher Copyright:
© 2022, The Author(s) under exclusive licence to Biomedical Engineering Society.
PY - 2023/5
Y1 - 2023/5
N2 - This study focuses on the calcification development and routes of type-1 bicuspid aortic valves based on CT scans and the effect of the unique geometrical shapes of calcium deposits on their fragmentation under balloon valvuloplasty procedures. Towards this goal, the novel Reverse Calcification Technique (RCT), which can predict the calcification progression leading to the current state based on CT scans, is utilized for n = 26 bicuspid aortic valves patients. Two main calcification patterns of type-1 bicuspid aortic valves were identified; asymmetric and symmetric with either partial or full arcs and circles. Subsequently, a calcification fragmentation biomechanical model was introduced to study the balloon valvuloplasty procedure prior to transcatheter aortic valve replacement implantation that allows better device expansion. To achieve this goal, six representative stenotic bicuspid aortic valves of different calcification patterns were investigated. It was found that the distinct geometrical shape of the calcium deposits had a significant effect on the cracks' initiations. Full or partial circle deposits had stronger resistance to fragmentation and mainly remained intact, yet, arc-shaped pattern deposits resulted in multiple cracks in bottleneck regions. The proposed biomechanical computational models could help assess calcification fragmentation patterns toward improving treatment approaches in stenotic bicuspid aortic valve patients, particularly for the off-label use of transcatheter aortic valve replacement.
AB - This study focuses on the calcification development and routes of type-1 bicuspid aortic valves based on CT scans and the effect of the unique geometrical shapes of calcium deposits on their fragmentation under balloon valvuloplasty procedures. Towards this goal, the novel Reverse Calcification Technique (RCT), which can predict the calcification progression leading to the current state based on CT scans, is utilized for n = 26 bicuspid aortic valves patients. Two main calcification patterns of type-1 bicuspid aortic valves were identified; asymmetric and symmetric with either partial or full arcs and circles. Subsequently, a calcification fragmentation biomechanical model was introduced to study the balloon valvuloplasty procedure prior to transcatheter aortic valve replacement implantation that allows better device expansion. To achieve this goal, six representative stenotic bicuspid aortic valves of different calcification patterns were investigated. It was found that the distinct geometrical shape of the calcium deposits had a significant effect on the cracks' initiations. Full or partial circle deposits had stronger resistance to fragmentation and mainly remained intact, yet, arc-shaped pattern deposits resulted in multiple cracks in bottleneck regions. The proposed biomechanical computational models could help assess calcification fragmentation patterns toward improving treatment approaches in stenotic bicuspid aortic valve patients, particularly for the off-label use of transcatheter aortic valve replacement.
KW - Balloon valvuloplasty procedure
KW - Bicuspid aortic valve (BAV)
KW - Calcific aortic valve disease (CAVD)
KW - Calcification fragmentation
KW - Reverse Calcification Technique (RCT)
UR - http://www.scopus.com/inward/record.url?scp=85143171023&partnerID=8YFLogxK
U2 - 10.1007/s10439-022-03115-8
DO - 10.1007/s10439-022-03115-8
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C2 - 36451023
AN - SCOPUS:85143171023
SN - 0090-6964
VL - 51
SP - 1014
EP - 1027
JO - Annals of Biomedical Engineering
JF - Annals of Biomedical Engineering
IS - 5
ER -