An engineering approach to the study of percutaneous pulmonary valve implantation

Silvia Schievano (University College London)

Thursday 22nd January, 2009 14:00-15:00 Mathematics Building, 325


Percutaneous pulmonary valve implantation (PPVI) is nowadays a realistic alternative to surgical treatment of right ventricular outflow tract (RVOT) dysfunction. The procedure involves transcatheter placement of a valved stent within the existing dysfunctional RVOT [1]. The device is constructed using the valve from a bovine jugular vein, sewn into an expandable stent (Fig. 1) and mounted on a balloon catheter for delivery. Once at the desired implantation site, inflation of the balloon deploys the valved stent and anchors it within the RVOT. At present, only a limited number of patients can benefit from this procedure due to the current device design, only suitable for patients with RVOT diameter <22mm, and to variations in individual patient anatomy and loading conditions. Selection of patients for this procedure is critical to ensure procedural success and to guarantee long-term positive outcome, with no stent fracture occurrence. The aim of this work was to improve the understanding of the three-dimensional (3D) RVOT morphology and the mechanisms of PPVI, in order to extend the indications of the percutaneous approach to the whole anatomic spectrum of possible RVOTs, and to enhance the results of this minimally invasive technique. FE modelling, along with 3D imaging elaboration and RP techniques, can be used to characterize RVOT morphology, enable better selection of patients for PPVI, and study the interaction between stent and implantation site in order to accelerate the development of a new design for PPVI stent.

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