AorticVirtu_et_al project

Cardiovascular disease (CVD) is the leading cause of death in the Occident. Among the responsible heart diseases, aortic valve diseases constitute a major cause of cardiac dysfunction in elderly patients. Percutaneous aortic replacement (without sternal opening, without extracorporeal circulation) has become in 15 years a standard treatment. Initially reserved for patients contraindicated to conventional surgery, TAVI or TAVR (Trans Aortic Valve Implantation or Replacement) has become an acceptable treatment in patients at intermediate-risk, or even at low-risk, by the Haute Autorité de Santé (HAS) . This evolution towards low-risk requires the patient to be implanted with the valve most respectful of cardiac hemodynamics and the most suitable for his valve and aortic anatomy. While the valve anatomy and its level of calcification (among other parameters) mainly guide the choice of the valve family, this choice is strongly guided by the practices of the surgeon.

Valve thrombosis is a recent discovery for which it can be suspected that changes in local hemodynamics associated with implantation of the valve after TAVI stand as a contributing factor. No independent studies are currently published on changes in aortic hemodynamics after TAVI depending on the patient's aortic anatomy, valve type and size. The objective of this personalized medicine project is to develop an accurate virtual aortic surgery platform to assist the surgeon/doctor as a necessary aid to decision-making and reduction of postoperative risks. One of the main difficulties in this process is the accurate simulation of the blood-valve coupled interactions, which remains very challenging. Innovative simulation techniques based on the SPH and the LBM methods will be used to that aim. As inputs of the model, accurate patient anatomy measurements and careful biomechanical properties assessment of the patient tissues and valves will be also required.