Corevalve vs Sapien 3 Transcatheter Aortic Valve Replacement: A Finite Element Analysis Study

Aim: To investigate factors implied in the development of postoperative complications in both self-expandable and balloon-expandable transcatheter heart valves by means of Finite Element Analysis (FEA). Materials and Methods: FEA was integrated to CT scan to investigate 2 cases of postoperative device failure for valve thrombosis after successful implantation of a CoreValve and a Sapien3 valve. Data were then compared with two patients undergone uncomplicated TAVR with the same type of valves. Results: Computational biomodelling showed calcifications persisting after device expansion not visible at CT scan. These calcifications determined geometrical distortion and elliptical deformation of the valve predisposing to hemodynamic disturbances and potential thrombosis. Increased regional stress was also identified in correspondence to the areas of distortion with associated paravalvular leak. Conclusion: The use of FEA as an adjunct to preoperative imaging might assist patient selection and procedure planning as well as help in the detection and prevention of TAVR complication