Development and Simulation of a Computational Model for Transcatheter Balloon Valvuloplasty in Aortic Valve Stenosis

Sammanfattning

Aortic valve stenosis is a common congenital heart defect among children. In affected patients, the normal tricuspid valve structure is malformed into a bicuspid valve structure due to a fusion at one commissure. A common treatment is transcatheter balloon valvuloplasty, where a balloon is inserted through the aortic valve and inflated to mechanically tear the fused region, restoring a tricuspid structure. However, this procedure can sometimes cause damage to the aortic valve, leading to serious complications. Computational simulations can help provide valuable insights into procedure suitability, parameter optimization, and patient selection. This study presents a computational model of balloon valvuloplasty and investigates the effects of balloon inflation angle through a parameter study. The model, based on the finite element method, was developed in the software Abaqus/Explicit. It included a balloon and a symmetric valve, with two leaflets fused by a cohesive region modeled using cohesive zone modeling. Seven inflation angles were investigated. The results validated the model’s ability to capture the expected valve response and showed that inflation angle plays a significant role in stress distribution across the valve, its deformation, contact pressure from the balloon, and extent of the tear. The use of cohesive zone modeling captured the tear behavior well, and the properties of the fused region were found to significantly affect the stress levels and distribution of the valve. The developed model provides a good basis for future research, which could include the investigation of more asymmetrical valve morphologies and characterization of cohesive properties to match clinical cases.