The rapid expansion of structural heart interventions over the past decade has created unprecedented challenges in procedural planning and complication prediction. While traditional imaging provides essential anatomical information, translating two-dimensional images into a comprehensive three-dimensional understanding of complex cardiac structures remains challenging. This review encompasses finite element analysis (FEA), computational fluid dynamics (CFD), and fluid–structure interaction (FSI) technologies across major structural heart procedures, including transcatheter aortic valve implantation (TAVI), transcatheter mitral valve interventions, and left atrial appendage occlusion (LAAO). We evaluated the technical foundations, clinical validation studies, and practical applications of various simulation platforms. Advanced computer simulation has demonstrated feasibility and clinical utility across multiple structural heart procedures. Computer simulation for structural heart interventions has evolved from a proof of concept to clinical implementation, with growing evidence of procedural planning benefits in TAVI and LAAO. While feasibility has been established across multiple intervention types, this field requires larger validation studies to demonstrate accuracy and clinical outcome improvements. Future directions include integration of machine learning, real-time simulation capabilities, and expanding applications to complex anatomies and redo procedures. This technology represents an emerging paradigm that may facilitate precision medicine in structural heart interventions, with potential for significant improvements in procedural success and patient safety.
Agarwal et al. (Mon,) studied this question.