Study of the behavior of different guidewire shapes in a patient-specific numerical model for transcatheter aortic valve implantation

Abstract

Transcatheter Aortic Valve Implantation is a mini-invasive procedure to replace aortic valves. The approach consists in delivering a fully collapsible bioprosthesis to the native valve site through a catheter. Stiff guidewires are required to deliver, stabilize and deploy the prosthesis by fitting in the left ventricular apex but they can also damage the ventricular wall of the patient. Nowadays, guidewires of different sizes, stiffness and shapes are available. In order to find the most appropriate guidewire for each patient, modelling could provide a better understanding of the interactions between the guidewire and the patient's left ventricle walls. Our objective was to explore the influence of guidewire shape on the contact conditions using numerical simulations. We have developed a Finite Element model to simulate the stiff guidewire inserted into the left ventricle. The model was solved using the ANSYS software with an implicit resolution scheme. We explored different shapes for the distal end of the guidewire. We observed the distribution of the contact forces. An adequate curvature size resulted in smaller maximum pressure.