Tricuspid valve edge-to-edge repair simulations are highly sensitive to annular boundary conditions.
Document Type
Article
Publication Date
12-22-2024
Publication Title
Journal of the mechanical behavior of biomedical materials
Abstract
Transcatheter edge-to-edge repair (TEER) simulations may provide insight into this novel therapeutic technology and help optimize its use. However, because of the relatively short history and technical complexity of TEER simulations, important questions remain unanswered. For example, there is no consensus on how to handle the annular boundary conditions in these simulations. In this short communication, we tested the sensitivity of such simulations to the choice of annular boundary conditions using a high-fidelity finite element model of a human tricuspid valve. Therein, we embedded the annulus among elastic springs to simulate the compliance of the perivalvular myocardium. Next, we varied the spring stiffness parametrically and explored the impact on two key measures of valve function: coaptation area and leaflet stress. Additionally, we compared our results to simulations with a pinned annulus. We found that a compliant annular boundary condition led to a TEER-induced "annuloplasty effect," i.e., annular remodeling, as observed clinically. Moreover, softer springs led to a larger coaptation area and smaller leaflet stresses. On the other hand, pinned annular boundary conditions led to unrealistically high stresses and no "annuloplasty effect." Furthermore, we found that the impact of the boundary conditions depended on the clip position. Our findings in this case study emphasize the importance of the annular boundary condition in tricuspid TEER simulations. Thus, we recommend that care be taken when choosing annular boundary conditions and that results from simulations using pinned boundaries should be interpreted with caution.
Volume
163
First Page
106879
Recommended Citation
Haese CE, Dubey V, Mathur M, Pouch AM, Timek TA, Rausch MK. Tricuspid valve edge-to-edge repair simulations are highly sensitive to annular boundary conditions. J Mech Behav Biomed Mater. 2024 Dec 22;163:106879. doi: 10.1016/j.jmbbm.2024.106879. Epub ahead of print. PMID: 39742687.
DOI
10.1016/j.jmbbm.2024.106879
ISSN
1878-0180
PubMed ID
39742687