The VTAVR framework accurately predicted optimal device landing zones with a median surface error of 0.633 mm compared to in-vivo post-TAVR CT stent frames.
Observational (n=40)
No
Does the VTAVR computational framework accurately predict optimal device landing zones and post-procedural device configuration compared to actual post-TAVR imaging in patients with aortic stenosis?
The VTAVR framework accurately predicts post-TAVR device configuration and landing zone parameters, offering a non-invasive, simulation-based tool for personalized pre-procedural planning to potentially reduce complications.
VTAVR, a novel simulation for Transcatheter Aortic Valve Replacement (TAVR), optimizes device placement using routine patient-specific CT angiography data. It integrates image processing, geometric reconstruction, and centerline estimation for accurate valve deployment. The framework employs a kinematic simulator to optimize valve performance by adjusting parameters like expansion area, anchoring depth, and implantation height, aiming to reduce complications such as paravalvular leaks (PVL) and left bundle branch block (LBBB). In this retrospective study (N = 40; pre and post TAVR), VTAVR demonstrated high fidelity with average Surface Error of pre CT simulated device versus in-vivo post CT stent frame (L2 Norm) Median: 0.633 mm; IQR= 0.216–1.37 mm. Median post-TAVR CT device diameters were 24.4 mm 22.0–25.9 mm at the outflow, 24.4 mm 22.5–26.0 mm at the midflow, and 24.9 mm 22.9–26.7 mm at the inflow, showing no significant differences compared to VTAVR simulations (p < 0.001). Median implantation height was 8.1 mm 6.9–10.4 mm vs 7.2 mm 6.7–8 mm, with VTAVR predicting similar heights (p < 0.05). Additionally, VTAVR accurately predicted the area cover index, with a median of 101.4% 91.9–105.3% closely matching post-TAVR CT (p < 0.01). The system provides assessments of peri-procedural risk factors by quantifying geometrical “safety” margins, aiming to minimize common complications such as improper implantation depth and over-expansion. VTAVR’s simulation of various deployment scenarios allows clinicians to foresee and address potential complications effectively, marking a significant advance in personalized cardiac interventions through virtual, non-invasive pre-procedural optimization.
Abdelkhalek et al. (Fri,) conducted a observational in Aortic stenosis (n=40). Virtual Transcatheter Aortic Valve Replacement (VTAVR) framework vs. In-vivo post-TAVR CT measurements was evaluated on Surface Error (L2 Norm) of simulated device versus in-vivo post-CT stent frame. The VTAVR framework accurately predicted optimal device landing zones with a median surface error of 0.633 mm compared to in-vivo post-TAVR CT stent frames.
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