Pre-operative simulation of trans-catheter valve implantation
Inventors
Mortier, Peter • De Santis, Gianluca
Assignees
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Publication Number
US-10789772-B2
Publication Date
2020-09-29
Expiration Date
Abstract
In a first aspect, the present invention relates to a method for patient-specific virtual percutaneous implantation, comprising estimating a patient-specific anatomical model of a patient-specific aorta based on cardiovascular 2D or 3D medical image data and virtually deploying an implant model representing an implant into said patient-specific anatomical model. In a second aspect, the present invention provides a method for patient-specific virtual percutaneous implantation. In a third aspect, the present invention provides an implant for virtual percutaneous implantation. In a fourth aspect, the present invention provides a system for virtual percutaneous implantation.
Core Innovation
The disclosed method provides a pre-operative patient-specific virtual percutaneous implant deployment workflow for implanting a heart valve implant in a patient. The method obtains 2D or 3D medical image data of an aorta and aortic valve and estimates a patient-specific anatomical model of the aorta and aortic valve based on the image data. An aortic mesh is generated using segmentation techniques so the mesh represents the aorta and the aortic valve, including 2 or 3 valve leaflets.
For each valve leaflet, leaflet attachment points and leaflet points are selected and mapped to a transformed leaflet mesh, where the elements of the transformed leaflet mesh are featured by normal or aberrant tissue parameters. The implant deployment takes into account the impact of surrounding anatomical structures by adding springs on an aortic surface of the aortic mesh that represent stiffness or resistance of the surrounding structures and the aorta, and then determining deformation of the implant model and the aortic mesh.
A blood mesh is created as a finite volume mesh representing the volume within the aortic mesh comprising the deployed implant model. Blood flow is calculated for the blood mesh using computational fluid dynamics analysis, and the method determines a likelihood of blood backflow or regurgitation based on the calculated blood flow and on the deformation. Based on a determination of a lower likelihood of blood backflow or regurgitation by the heart valve implant using a clinically used scale to grade blood backflow or regurgitation, the method selects a heart valve implant having a size adapted to the anatomy of the patient and implants the heart valve implant in the patient.
Claims Coverage
The partial content includes one independent claim describing a full virtual planning and selection workflow with predictive deformation and computational fluid dynamics-based regurgitation likelihood.
Patient-specific anatomical model from 2D/3D medical image data
Obtaining 2D or 3D medical image data of an aorta and aortic valve of the patient and estimating a patient-specific anatomical model of the aorta and aortic valve based on the 2D or 3D medical image data.
Finite-element aortic mesh with tissue-dependent parameter variations
Generating an aortic mesh using segmentation techniques, wherein the aortic mesh comprises a finite number of elements representing the aorta and the aortic valve with mutually-shared nodes, and wherein at least some elements differ in tissue dependent parameters from an adjacent element.
Transformed leaflet mesh with normal or aberrant tissue parameters
Mapping leaflet points and leaflet attachment points to a transformed leaflet mesh for each valve leaflet, wherein elements of the transformed leaflet mesh are featured by normal or aberrant tissue parameters.
Implant model deployment with surrounding-structure impact modeled by springs
Deploying an implant model representing implantation of the heart valve implant into the aortic mesh using three-dimensional finite element analysis, wherein deploying comprises employing a virtual percutaneous implant deployment step that takes into account impact of surrounding anatomical structures by adding springs on an aortic surface of the aortic mesh representing stiffness or resistance of surrounding structures and structures of the aorta.
Deformation-determined blood flow simulation with CFD
Determining deformation of the implant model and the aortic mesh; creating a blood mesh comprising a finite volume mesh representing the volume within the aortic mesh comprising the deployed implant model; calculating blood flow for the blood mesh using computational fluid dynamics analysis.
Regurgitation likelihood determination to select an implant size on a clinically used grading scale
Determining a likelihood of blood backflow or regurgitation based on the calculated blood flow based on deformation of the implant model and the aortic mesh; selecting a heart valve implant having a size adapted to an anatomy of the patient based on a determination of a lower likelihood of blood backflow or regurgitation by the heart valve implant based on a clinically used scale to grade blood backflow or regurgitation; and implanting the heart valve implant in the patient.
The claim coverage centers on constructing patient-specific finite-element anatomical models from 2D/3D image data, virtually deploying an implant with surrounding-structure impact modeled via springs, simulating deformation and computational fluid dynamics blood flow in a finite-volume blood mesh, predicting likelihood of blood backflow or regurgitation, and selecting an implant size adapted to patient anatomy based on a clinically used grading scale.
Stated Advantages
Not explicitly described in patent.
Documented Applications
Not explicitly described in patent.
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