Abstract
During aortic valve repair procedures, surgeons improve the function of the valve by modifying its anatomy. Such improvements are aimed at achieving sufficient coaptation area and effective height, two parameters that were identified as indicators for the long-term function of repaired aortic valves [1]. Valve-sparing procedures, in which the aneurysmatic aortic root is replaced with a graft while retaining the native valve, give surgeons the freedom to choose both the sinotubular and aortoventricular sizes and the height of the commissures [2]. Other types of valve repairs that involve cusp interventions also directly influence the final anatomy of the cusps. The size of the cusp needs to be chosen for various valve types and prolapse corrections [3], and the desired inter-commissural angle of the bicuspid aortic valve (BAV) should be decided during reimplantation [4] and sinus plication [5] procedures. Numerical models can be used as a predictive tool to estimate the mechanical performance of valves with various geometrical configurations. In this chapter, we review our numerical studies of aortic valve repair techniques and the clinically relevant conclusions that they provide.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Bierbach BO, Aichera D, Issaa OA, Bomberga H, Gräber S, Glombitza P, Schäfers HJ. Aortic root and cusp configuration determine aortic valve function. Eur J Cardiothorac Surg. 2010;38(4):400–6. https://doi.org/10.1016/j.ejcts.2010.01.060.
David TE, Feindel CM, David CM, Manlhiot C. A quarter of a century of experience with aortic valve-sparing operations. J Thorac Cardiovasc Surg. 2014;148(3):872–9. https://doi.org/10.1016/j.jtcvs.2014.04.048.
Aicher D, Langer F, Adam O, Tscholl D, Lausberg H, Schafers HJ. Cusp repair in aortic valve reconstruction: does the technique affect stability? J Thorac Cardiovasc Surg. 2007;134(6):1533–8. https://doi.org/10.1016/j.jtcvs.2007.08.023.
Kari FA, Kvitting JP, Stephens EH, Liang DH, Merk DR, Fischbein MP, Mitchell RS, Miller DC. Tirone David procedure for bicuspid aortic valve disease: impact of root geometry and valve type on mid-term outcomes. Interact Cardiovasc Thorac Surg. 2014;19(3):375–81. https://doi.org/10.1093/icvts/ivu123.
Schneider U, Schmied W, Aicher D, Giebels C, Winter L, Schafers HJ. Sinus plication to improve valve configuration in bicuspid aortic valve repair-early results. Ann Thorac Surg. 2016; https://doi.org/10.1016/j.athoracsur.2016.06.064.
Haj-Ali R, Marom G, Ben Zekry S, Rosenfeld M, Raanani E. A general three-dimensional parametric geometry of the native aortic valve and root for biomechanical modeling. J Biomech. 2012;45(14):2392–7. https://doi.org/10.1016/j.jbiomech.2012.07.017.
Marom G, Halevi R, Haj-Ali R, Rosenfeld M, Schafers HJ, Raanani E. Numerical model of the aortic root and valve: optimization of graft size and sinotubular junction to annulus ratio. J Thorac Cardiovasc Surg. 2013;146(5):1227–31. https://doi.org/10.1016/j.jtcvs.2013.01.030.
Marom G, Haj-Ali R, Rosenfeld M, Schafers HJ, Raanani E. Aortic root numeric model: correlation between intraoperative effective height and diastolic coaptation. J Thorac Cardiovasc Surg. 2013;145(1):303–4. https://doi.org/10.1016/j.jtcvs.2012.08.043.
Lavon K, Halevi R, Marom G, Ben Zekry S, Hamdan A, Schafers HJ, Raanani E, Haj-Ali R. Fluid-structure interaction models of bicuspid aortic valves: the effects of nonfused cusp angles. J Biomech Eng. 2017; 140(3):031010. https://doi.org/10.1115/1.4038329.
Marom G, Haj-Ali R, Rosenfeld M, Schafers HJ, Raanani E. Aortic root numeric model: annulus diameter prediction of effective height and coaptation in post-aortic valve repair. J Thorac Cardiovasc Surg. 2013;145(2):406–411.e1. https://doi.org/10.1016/j.jtcvs.2012.01.080.
Marom G, Peleg M, Halevi R, Rosenfeld M, Raanani E, Hamdan A, Haj-Ali R. Fluid-structure interaction model of aortic valve with porcine-specific collagen fiber alignment in the cusps. J Biomech Eng. 2013;135(10):101001–6. https://doi.org/10.1115/1.4024824.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Marom, G., Lavon, K., Haj-Ali, R., Raanani, E. (2019). ONE-POINT ADVICE: Optimizing Aortic Valve Repair Techniques with Computational Models. In: Kunihara, T., Takanashi, S. (eds) Aortic Valve Preservation. Springer, Singapore. https://doi.org/10.1007/978-981-13-2068-2_5
Download citation
DOI: https://doi.org/10.1007/978-981-13-2068-2_5
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-13-2067-5
Online ISBN: 978-981-13-2068-2
eBook Packages: MedicineMedicine (R0)