Computational fluid dynamics assessment of hemodynamic effects of catheter navigation during transcatheter aortic valve implantation.

BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a widely adopted, minimally invasive alternative to surgical aortic valve replacement. Despite its clinical success, TAVI can induce hemodynamic complications, which can be investigated using computational fluid dynamics (CFD). In this study, CFD was applied to evaluate the hemodynamic impact of catheter insertion during the TAVI procedure. METHODS: CFD simulations were conducted in SimVascular to assess blood flow alterations at different stages of catheter insertion, from the iliac access to the ascending aorta, focusing on four critical phases of catheter advancement. Hemodynamic parameters were systematically analyzed across all simulated models. RESULTS: Catheter insertion induced a pronounced local pressure drop and elevated wall shear stress (WSS) at the access-side iliac artery. Outlet flow analysis showed redistribution across branches, with reduced flow on the access side and compensatory increases in the contralateral femoral artery and the other branches. Oscillatory shear index (OSI) and turbulent kinetic energy (TKE) were reduced at the access site, whereas higher OSI and TKE were observed in the contralateral iliac artery. Local hemodynamics and WSS near the catheter tip were found to be sensitive to the catheter's longitudinal position. CONCLUSION: This proof-of-concept study demonstrates that CFD can effectively capture catheter-induced hemodynamic disturbances during TAVI delivery, providing a foundation for patient-specific risk assessment and procedural optimization.