Thrombosis in post-transcatheter aortic valve replacement (TAVR) patients has been correlated with flow stasis in the neo-sinus. This study investigated the effect of the post-TAVR geometry on flow stasis. Computed tomography angiography of 155 patients who underwent TAVR using a SAPIEN 3 were used to identify patients with and without thrombosis, and quantify thrombus volumes. Six patients with 23-mm SAPIEN 3 valves were then selected from the cohort and used to create patient-specific post-TAVR computational fluid dynamic models. Regions of flow stasis (%Volstasis, velocities below 0.05 m/s) were identified. The results showed that all post-TAVR anatomical measurements were significantly different in patients with and without thrombus, but only sinus diameter had a linear correlation with thrombus volume (r = 0.471, p = 0.008). A linear correlation was observed between %Volstasis and thrombus volume (r = 0.821, p = 0.007). The combination of anatomy and valve deployment created a unique geometry in each patient, which when combined with patient-specific cardiac output, resulted in distinct flow patterns. While parametric studies have shown individual anatomical or deployment metrics may relate to flow stasis, the combined effects of these metrics potentially contributes to the biomechanical environment promoting thrombosis, therefore hemodynamic studies of TAVR should account for these patient-specific factors.

中文翻译：

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患者特定特征对经导管心脏瓣膜新窦血流的影响：一项计算机研究。

经导管主动脉瓣置换术 (TAVR) 患者的血栓形成与新窦中的血流停滞相关。本研究调查了 TAVR 后几何结构对血流停滞的影响。使用 SAPIEN 3 对 155 名接受 TAVR 的患者进行计算机断层扫描血管造影，以识别有无血栓形成的患者，并量化血栓体积。然后从队列中选择了 6 名具有 23-mm SAPIEN 3 瓣膜的患者，并用于创建特定于患者的 TAVR 后计算流体动力学模型。确定了流动停滞区域（%Volstasis，速度低于 0.05 m/s）。结果显示，有血栓和无血栓患者的所有 TAVR 后解剖测量值均有显着差异，但只有窦直径与血栓体积呈线性相关 (r = 0.471，p = 0.008)。在 %Volstasis 和血栓体积之间观察到线性相关性（r = 0.821，p = 0.007）。解剖结构和瓣膜部署的结合为每个患者创造了独特的几何形状，当与患者特定的心输出量相结合时，会产生不同的流动模式。虽然参数研究表明个体解剖学或部署指标可能与血流停滞有关，但这些指标的综合影响可能有助于促进血栓形成的生物力学环境，因此 TAVR 的血流动力学研究应考虑这些患者特异性因素。