Computational modeling of thrombosis after transcatheter aortic valve implantation: A systematic review of hemodynamic and mechanical risk metrics.

In 30 seconds

This systematic review analyzed 68 computational studies on hemodynamics and thrombosis following transcatheter aortic valve implantation (TAVI). It highlights that while direct thrombus formation simulations are limited, indirect metrics are commonly used to assess thrombogenic risk. Key risk factors identified include paravalvular leaks and valve implantation depth.

Key findings

• Most studies utilize indirect hemodynamic and mechanical proxies to evaluate thrombogenic risk.
• Key risk factors include paravalvular leaks, valve implantation depth, and asymmetric stent expansion.
• Research is shifting towards a mechanistic understanding of thrombogenic risk rather than solely descriptive analyses.
• Modern in silico methods allow for quantitative comparisons of implantation techniques and valve designs regarding thrombogenic risk.

Why it matters

Understanding the hemodynamic and mechanical factors influencing thrombosis after TAVI is crucial for improving patient outcomes and valve durability. This review underscores the importance of advancing computational modeling to better predict and mitigate thrombotic complications.