September 29, 2025Open Access

In Silico Modeling of Transcatheter Heart Valve Oversizing and Ellipticity, Part II: Effects on Leaflet Mechanics, Hemodynamics, and Stent Deflection Contributing to Thrombogenic Risk and Structural Degeneration

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Maximal THV oversizing decreased valve expansion at the valve level, increasing leaflet coaptation while reducing peak stresses.
Simulated THV elliptical deployment led to variable stent deflections, affecting leaflet stress distributions and potentially increasing thrombogenic risk.
In silico modeling demonstrated altered hemodynamics, including early flow separation, that may promote structural degeneration.
Flexible THV designs could counteract the negative effects of elliptical deployment, supporting the need for enhanced assessment strategies.

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Modeling reveals how THV oversizing alters hemodynamics and thrombogenic risk, suggesting a need for better deployment strategies.

Boxwell et al. (2025) studied this question.

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