Transcatheter aortic valve implantation (TAVI) is becom- ing the standard choice of care for non-operable patients suffering from severe aortic valve stenosis. As there is no direct view or access to the af- fected anatomy, accurate preoperative planning is crucial for a successful outcome. The most important decision during planning is selecting the proper implant type and size. Due to the wide variety in device sizes and types and non-circular annulus shapes, there is often no obvious choice for the specific patient. Most clinicians base their final decision on their previous experience. As a first step towards a more predictive planning, we propose an integrated method to estimate the aortic apparatus from CT images and compute implant deployment. Aortic anatomy, which in- cludes aortic root, leaflets and calcifications, is automatically extracted using robust modeling and machine learning algorithms. Then, the finite element method is employed to calculate the deployment of a TAVI im- plant inside the patient-specific aortic anatomy. The anatomical model was evaluated on 198 CT images, yielding an accuracy of 1.30±0.23mm. In eleven subjects, pre- and post-TAVI CT images were available. Errors in predicted implant deployment were of 1.74 ± 0.40 mm in average and 1.32 mm in the aortic valve annulus region, which is almost three times lower than the average gap of 3 mm between consecutive implant sizes. Our framework may thus constitute a surrogate tool for TAVI planning.     «

Transcatheter aortic valve implantation (TAVI) is becom- ing the standard choice of care for non-operable patients suffering from severe aortic valve stenosis. As there is no direct view or access to the af- fected anatomy, accurate preoperative planning is crucial for a successful outcome. The most important decision during planning is selecting the proper implant type and size. Due to the wide variety in device sizes and types and non-circular annulus shapes, there is often no obvious choi...     »