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Fragmentation of Different Calcification Growth Patterns in Bicuspid Valves During Balloon Valvuloplasty Procedure


Adi Morany(1), Karin Lavon(2), Rotem Halevi(2), and Rami Haj-Ali(1)


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Abstract:

This study focuses on the calcification development and routes of type-1 bicuspid aortic valves based on CT scans and the effect of the unique geometrical shapes of calcium deposits on their fragmentation under balloon valvuloplasty procedures. Towards this goal, the novel Reverse Calcification Technique (RCT), which can predict the calcification progression leading to the current state based on CT scans, is utilized for n = 26 bicuspid aortic valves patients. Two main calcification patterns of type-1 bicuspid aortic valves were identified; asymmetric and symmetric with either partial or full arcs and circles. Subsequently, a calcification fragmentation biomechanical model was introduced to study the balloon valvuloplasty procedure prior to transcatheter aortic valve replacement implantation that allows better device expansion. To achieve this goal, six representative stenotic bicuspid aortic valves of different calcification patterns were investigated. It was found that the distinct geometrical shape of the calcium deposits had a significant effect on the cracks' initiations. Full or partial circle deposits had stronger resistance to fragmentation and mainly remained intact, yet, arc-shaped pattern deposits resulted in multiple cracks in bottleneck regions. The proposed biomechanical computational models could help assess calcification fragmentation patterns toward improving treatment approaches in stenotic bicuspid aortic valve patients, particularly for the off-label use of transcatheter aortic valve replacement.


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Paper Publication


Education

03/2019-02/2024:  Ph.D. in Mechanical Engineering

Mechanical Engineering School, Engineering Faculty, Tel Aviv University 

10/2016-12/2018: M.Sc. in Mechanical Engineering (Magna Cum Laude)

Mechanical Engineering School, Engineering Faculty, Tel Aviv University 

10/2010-04/2015:  B.Sc. in Aerospace Engineering

Faculty of Aerospace Engineering, Technion – Israel Institute of Technology, Haifa


Research Experience

Biomechanics of healthy and diseased aortic valve manners. 

Electromechanical simulation of full heart model.

Computational simulations of structural FEA, CFD 

Fluid-structure interaction (FSI) modeling approach for coupled FE structural analysis with Lattice Boltzmann Method (LBM)

Medical devices simulation; TAVR etc.

Calcific and fibrocalcific aortic valve disease progression; clinical and biomechanical modelling.

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