Author + information
- Chris Reiff,
- Santiago Garcia,
- Lars Mattison,
- Paul Iaizzo,
- Jorge D. Zhingre Sanchez,
- Ganesh Raveendran and
- Sergey Gurevich
Paravalvular leak (PVL) carries a high morbidity and mortality after transcatheter aortic valve replacement (TAVR), but there is no effective method to predict PVL prior to valve implantation.
Using pre-TAVR computed tomography (CT) scans, 3-dimensional (3D) aortic root models were printed for 16 patients who underwent TAVR for severe, calcific aortic stenosis. Models were printed using thermoplastic polyurethane (TPU) (Ninjatek, Manheim, PA) and TPU 95A on Ultimaker 3 Extended 3D printer (Ultimaker, Netherlands). Models were implanted at nominal pressure with same sized Sapien XT frames (Edwards Lifesciences, CA) as received in-vivo. Ex-vivo implanted models (eTAVR) were scanned using Siemens SOMATOM flash dual source CT (Siemens, Malvern, PA) and then analyzed with Mimics software (Materialise NV, Belgium) to evaluate stent apposition. Each patient’s eTAVR was then compared to post-TAVR echocardiogram to assess for correlation of PVL location.
Sixteen patients (69% male) with a mean (±SD) age of 78 (8) years were included, 6 of which developed mild PVL after TAVR. eTAVR 3D models correctly predicted the site of PVL in all 6 patients based on post-TAVR echocardiography (Figure 1, patients 1–3). In patients without PVL, eTAVR 3D models correctly predicted lack of PVL in 10/10 patients (Figure 1, patients 7–9).
3D printing may help predict the location of PVL post-TAVR, which may have implications for aiding in optimal valve sizing and stent frame apposition.