CFD-based estimation of the impact of transcatheter aortic valve implantation position on thrombosis risk

This study employs computational fluid dynamics simulations to investigate the impact of different transcatheter aortic valve implantation (TAVI) positions on thrombosis risk, with a focus on the sinus and neosinus regions. Patient-specific models were developed using clinically obtained aortic geometries to analyze three distinct TAVI positions: intra-annular, supra-annular, and extreme supra-annular. These models were analyzed to assess flow characteristics, time-averaged wall shear stress (TAWSS), oscillatory shear index, and relative residence time. The results indicate that the intra-annular position exhibits stronger oscillations and higher blood stagnation, leading to an increased thrombosis risk, particularly in the neosinus region. In contrast, the supra-annular and extreme supra-annular positions showed similar flow patterns, with higher TAWSS observed in the extreme supra-annular configuration. This study provides insights into optimizing transcatheter heart valve designs and placement strategies to reduce thrombosis risk and improve patient outcomes in transcatheter valve procedures.