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Heitkemper _ Dissertation _Final.pdf (3.62 MB)

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The Development of Computational Methods and Device Design Considerations Towards Improving Transcatheter Heart Valve Engineering

Heitkemper, Megan
http://orcid.org/0000-0001-7826-3685
http://rave.ohiolink.edu/etdc/view?acc_num=osu1595406932637358

Abstract Details

2020, Doctor of Philosophy, Ohio State University, Biomedical Engineering.
In the era of transcatheter aortic valve replacement (TAVR) and especially now with FDA approval for TAVR in low risk patient populations, the need for improved devices, device options, and patient specific pre-planning is especially important. This research uses both experimental and computational methods to study the mechanics and hemodynamics of transcatheter valve replacement with the overarching goal of improving the current technologies towards improved patient outcomes. In order to reduce the risk of fatal coronary obstruction during transcatheter valve replacement in an at-risk patient population, a patient specific 3D computational model to predict risk of coronary obstruction was developed using finite element analysis. The predictive index, DLC/d, was shown to have increased sensitivity and specificity of risk prediction as compared to the clinically used metrics. With the understanding that patient specific computational models are highly time consuming and impractical in a clinical setting, a 2D geometric model to predict risk of coronary obstruction was subsequently developed. Results suggest that while the 3D computational model is the most accurate at predicting risk of coronary obstruction, the 2D geometric model is still superior to the clinically used metrics. For transcatheter valve replacement expansion into lower risk and younger patient populations, durable transcatheter prostheses free from long term structural valve degeneration are needed. A potential solution was developed, in the form of a polymeric transcatheter aortic valve, called HA-TAV. Due to its unique material properties, geometry, and design, the HA-TAV showed reduced levels of blood damage related Reynolds shear stress and durability limiting pinwheeling of leaflets, while maintaining a comparable effective orifice area and regurgitant fraction to the leading commercially available transcatheter aortic valve. Another potential solution to the need for increased durability of transcatheter valves is a tissue-engineered heart valve, which is particularly exciting when considering their potential use in pediatric patients suffering from congenital valvular diseases. In this study, an in vitro methodology is developed that is capable of rapid and cost-effective analysis of the hemodynamic functionality of tissue-engineered prototypes. The method presented will move the field of heart valve tissue engineering further, allowing rapid development and design of prototypes. Combined, these studies provide concrete techniques, technologies, and methods to improve transcatheter heart valve engineering and thus transcatheter heart valve replacement. Optimization of the presented models, devices, and methodologies could result in improved transcatheter valve replacement options and eventually improved patient outcomes.
Christopher Breuer (Advisor)
Samir Ghadiali (Committee Member)
Scott Lilly (Committee Member)
177 p.
Biomedical Engineering
Transcatheter Aortic Valve Replacement, calcification, coronary obstruction, FEA, patient-specific, hemodynamic, polymeric, TAVR, turbulence, balloon-exbandable-valve, blood damage, fetal valve

Recommended Citations

Citations

  • Heitkemper, M. (2020). The Development of Computational Methods and Device Design Considerations Towards Improving Transcatheter Heart Valve Engineering [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1595406932637358

    APA Style (7th edition)

  • Heitkemper, Megan. The Development of Computational Methods and Device Design Considerations Towards Improving Transcatheter Heart Valve Engineering . 2020. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1595406932637358.

    MLA Style (8th edition)

  • Heitkemper, Megan. "The Development of Computational Methods and Device Design Considerations Towards Improving Transcatheter Heart Valve Engineering ." Doctoral dissertation, Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1595406932637358

    Chicago Manual of Style (17th edition)

osu1595406932637358
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