Why the study?
Current paediatric valve replacement options cannot compensate for somatic growth, causing flow obstruction and necessitating repeat revision surgeries as the child outgrows the prosthesis.
A novel expandable paediatric heart valve concept was computationally modeled to potentially compensate for somatic growth and reduce the need for revision surgeries.
Concept modeling of expandable pediatric valves warrants clinical caution; leaves open translation pending preclinical validation.
Current paediatric valve replacement options cannot compensate for somatic growth, leading to an obstruction of flow as the child outgrows the prosthesis. This often necessitates an increase in revision surgeries, leading to legacy issues into adulthood. An expandable valve concept was modelled with an inverse relationship between annulus size and height, to retain the leaflet geometry without requiring additional intervention. Parametric design modelling was used to define certain valve parameter aspect ratios in relation to the base radius, R b , including commissural radius, R c , valve height, H and coaptation height, x. Fluid-structure simulations were subsequently carried out using the Immersed Boundary method to radially compress down the fully expanded aortic valve whilst subjecting it to diastolic and systolic loading cycles. Leaflet radial displacements were analysed to determine if valve performance is likely to be compromised following compression. Work is ongoing to optimise valvular parameter design for the paediatric patient cohort.
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Kerr et al. (2020) studied this question.
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