OPTAVI · Adjoint-based OPTimization of deflection-based cerebral embolic protection devices for reducing stroke risk in Transcatheter Aortic Valve Implantation

Adjoint-based OPTimization of deflection-based cerebral embolic protection devices for reducing stroke risk in Transcatheter Aortic Valve Implantation

- The problem/issue addressed: The project OPTAVI aimed at developing optimization strategies based on gradient-based techniques widely used in fluid mechanics, for enabling improvement of transcatheter prosthetic heart valve implantation (TAVI) procedures. The project relied on developing sophisticated image-based blood flow simulation tools, which were to be designed to leverage the power of advanced hybrid-node (GPU-accelerated) supercomputers. The latter serves as a workhorse tool for evidence generation on fluid dynamics aspects of TAVI operation, and also as a base tool for optimization procedure. - Why is it important for society TAVI operations have grown to be the procedure of choice for a wide variety of aortic valve disease patients, mainly those at older age groups. This procedures are favourable because they eliminate the need for open heart surgery, which may impose high risks on a significant number of patients, especially those with other co-existing cardiac diseases. TAVI allows the impaired heart valve to be replaced via a catheter through an artery, which minimizes the hospitalization as well. It however, comes with certain risks, such as a high incidence of peri- and postoperative stroke. The "shoving" motion of the packaged heart valve through the arteries (which are likely to be plaqued in AV patients), and parachute-like opening of the valve inside the diseased valve site (which is often calcified) are prone to release a significant amount of plaque debris into blood flow. These released objects may then travel to the brain, interrup the cerbral blood flow circulation, and eventually cause stroke. In addition, TAVI is associated with stroke risk factors post-operation, that is, after the deployment of the valve. The latter is mainly due to the design of the prosthetic valve which can lead to narrow jets of blood flow that are likely to generate blood clots due to strong shear forces. Improving the design of TAVI and its implantation procedure can reduce the risk of stroke in TAVI, which reduces healthcare costs (higher durabiliy and lower need for re-operation) and improves the quality of life for the recipients of these valves (it reduces the morbidity factors associated with an impaired cerebral blood flow, e.g. dementia or small strokes or mortality factors such as fatal strokes). These improvements yield significant socioeconomical values. - What are the overal objectives: The objective of the project was to investigate the pacticality of an adjoint-based optimization procedure for a TAVI design. It relied on developing computational fluid dynamics tools for blood flow analysis and adjoint-based methods on top of the simulation environment, with the goal of minimizing the thrombogenicity of a aortic valve design.

Текст от CORDIS, на английски · Данни: CORDIS, © Европейски съюз