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Sensor-Enabled 3D Printed Tissue-Mimicking Phantoms: Application in Pre-Procedural Planning for Transcatheter Aortic Valve Replacement
Published in Ayman El-Baz, Jasjit S. Suri, Cardiovascular Imaging and Image Analysis, 2018
Kan Wang, Chuck Zhang, Ben Wang, Mani A Vannan, Zhen Qian
Patients with severe aortic stenosis may be asymptomatic for many years. However, once the symptoms appear and are only treated medically, the condition of the symptomatic AS patient declines quickly. Mortality rates from the onset of symptoms are approximately 25% at 1 year and 50% at 2 years. Aortic valve replacement where the diseased aortic valve is replaced with a mechanical or tissue valve during a surgical procedure, is a viable treatment option for symptomatic AS patients. Conventional aortic replacement surgery requires sternotomy, cardioplegic arrest, and cardiopulmonary bypass. For severe AS patients with inoperable conditions or who are designated as high risk for surgery, transcatheter aortic valve replacement (TAVR), also known as transcatheter aortic valve implantation (TAVI) or percutaneous aortic valve replacement (PAVR), has been established as the treatment of choice. In this procedure, an aortic valve is implanted using a transcatheter technique and the sternotomy and cardiopulmonary bypass procedures are avoided.
A distributionally robust optimization approach for coordinating clinical and surgical appointments
Published in IISE Transactions, 2021
Ankit Bansal, Bjorn Berg, Yu-Li Huang
TAVR is a minimally invasive heart procedure to replace a narrowed aortic valve that fails to open properly (aortic valve stenosis). TAVR may be an option for patients who are at intermediate or high risk of complications from surgical aortic valve replacement, an open-heart surgery. TAVR can relieve the signs and symptoms of aortic valve stenosis and may improve survival for patients who have severe symptoms. The decision to treat aortic valve stenosis with the TAVR procedure is based on an initial consultation with a team of heart and heart surgery specialists who work together to determine the best treatment option. We present a case study of the proposed model motivated by the TAVR procedure appointment process at the Mayo Clinic in Rochester, Minnesota which performs hundreds of TAVR procedures each year.
Image decomposition-based sparse extreme pixel-level feature detection model with application to medical images
Published in IISE Transactions on Healthcare Systems Engineering, 2021
Geet Lahoti, Jialei Chen, Xiaowei Yue, Hao Yan, Chitta Ranjan, Zhen Qian, Chuck Zhang, Ben Wang
In medicine, image segmentation or feature detection is of particular importance (Bradshaw et al., 2013; Gaw et al., 2018; Wang, 2015). Consider aortic stenosis (AS), which is one of the most common yet severe valvular heart diseases. Transcatheter aortic valve replacement (TAVR) is a less-invasive treatment option for AS patients who have a high risk of open-heart surgery. TAVR procedure involves implanting a bioprosthetic aortic valve. Major post-procedural complications of TAVR are the paravalvular leakage (PVL), i.e. the blood flow leakage around the implanted artificial valve (Qian et al., 2017; Wang et al., 2018), and the over-stretching in the aortic tissues introduced due to the implant. For patients undergoing TAVR, computed tomography (CT) image (see Figure 1) is usually taken before the surgery, as an important visualization of the contrast-enhanced blood pool (i.e. the moderate intensity region in the CT image), the calcification (i.e. the high-intensity region), and the soft tissues (i.e. the low-intensity region).
The impact of calcification patterns in transcatheter aortic valve performance: a fluid-structure interaction analysis
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Giulia Luraghi, Jose Felix Rodriguez Matas, Marta Beretta, Nicole Chiozzi, Laura Iannetti, Francesco Migliavacca
Transcatheter aortic valve implantation (TAVR) is a minimally invasive procedure that is being increasingly adopted in the treatment of AS (Smith et al. 2011). The procedure consists of the insertion of a stented valve in the aortic root using a catheter. The heart valve (polymeric or from biological tissue) is mounted within a stent made by an elasto-plastic metal or a Nitinol super-elastic alloy. The performance of percutaneous valves strongly depends on the calcification patterns. In fact, the presence of calcific deposits may lead to a malapposition of the stented valve in the aorta and/or prevent the complete valve deployment. In this scenario, some common complications as the presence of paravalvular leaks (PVLs), vascular damage, and conduction system impairment could occur (Khalique et al. 2014; Raggi 2014; Krishnaswamy and Tuzcu 2015).