{
    "abstract": "Recent studies suggest that any degree of patient-prosthesis mismatch (PPM) increases morbidity and mortality after surgical aortic valve replacement (SAVR). We used computational fluid dynamics simulations to test the influence of prosthesis size and physical activity after SAVR.\nIn 10 patients with aortic valve stenosis, virtual SAVR was performed. Left ventricular outflow tract stroke volume and flow direction information (4D Flow) were used, and an increase in stroke volume of 25% was chosen for simulating physical activity. Pressure gradients (DP max) across the aortic valve and blood flow profiles in the ascending aorta were calculated and predicted for three different valve sizes at rest and under stress in every patient.\nGradients across the aortic valve were significantly lower using larger valves; however, they were not normalized after SAVR (DP max [mmHg] norm/smaller/reference/larger valve = 6/14/12/9 mmHg, <0.01 compared to norm). Physical activity simulation increased DP max in all patients and across all valve sizes (DP max [mmHg] rest versus stress for the smaller/reference/larger valve = 14 vs. 23, 12 vs. 18, 9 vs. 14). Blood flow profiles did not normalize after SAVR and remained unaffected by physical activity. Gradients differed between mild and moderate stenosis between different therapy options and even showed moderate to severe stenosis under simulated physical activity.\nProsthesis size and physical activity simulation have a significant influence on gradients across the aortic valve. Virtual therapy planning using patient-specific data might help to improve outcomes after SAVR in the future.",
    "authors": [
        {
            "affiliation": "Department of Congenital Heart Disease-Pediatric Cardiology, German Heart Center Charit\u00e9, 13353 Berlin, Germany.\nInstitute of Computer-Assisted Cardiovascular Medicine, German Heart Center Charit\u00e9, 13353 Berlin, Germany.\nBerlin Institute of Health (BIH), 10178 Berlin, Germany.\nDeutsches Zentrum f\u00fcr Herz-Kreislauf-Forschung, German Centre for Cardiovascular Research, Partner Site Berlin, 10785 Berlin, Germany.",
            "firstname": "Marie",
            "initials": "M",
            "lastname": "Schafstedde"
        },
        {
            "affiliation": "Institute of Computer-Assisted Cardiovascular Medicine, German Heart Center Charit\u00e9, 13353 Berlin, Germany.",
            "firstname": "Florian",
            "initials": "F",
            "lastname": "Hellmeier"
        },
        {
            "affiliation": "Institute of Computer-Assisted Cardiovascular Medicine, German Heart Center Charit\u00e9, 13353 Berlin, Germany.",
            "firstname": "Jackie",
            "initials": "J",
            "lastname": "Gr\u00fcnert"
        },
        {
            "affiliation": "Institute of Biometry and Statistical Epidemiology, Charit\u00e9 Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany.",
            "firstname": "Bianca",
            "initials": "B",
            "lastname": "Materne"
        },
        {
            "affiliation": "Department of Congenital Heart Disease-Pediatric Cardiology, German Heart Center Charit\u00e9, 13353 Berlin, Germany.\nInstitute of Computer-Assisted Cardiovascular Medicine, German Heart Center Charit\u00e9, 13353 Berlin, Germany.\nDeutsches Zentrum f\u00fcr Herz-Kreislauf-Forschung, German Centre for Cardiovascular Research, Partner Site Berlin, 10785 Berlin, Germany.",
            "firstname": "Titus",
            "initials": "T",
            "lastname": "Kuehne"
        },
        {
            "affiliation": "Institute of Computer-Assisted Cardiovascular Medicine, German Heart Center Charit\u00e9, 13353 Berlin, Germany.\nEinstein Center Digital Future, 10117 Berlin, Germany.",
            "firstname": "Leonid",
            "initials": "L",
            "lastname": "Goubergrits"
        },
        {
            "affiliation": "Institute of Computer-Assisted Cardiovascular Medicine, German Heart Center Charit\u00e9, 13353 Berlin, Germany.\nDeutsches Zentrum f\u00fcr Herz-Kreislauf-Forschung, German Centre for Cardiovascular Research, Partner Site Berlin, 10785 Berlin, Germany.\nDivision of Pediatric Radiology, Department of Radiology, University Hospital T\u00fcbingen, 72076 T\u00fcbingen, Germany.",
            "firstname": "Sarah",
            "initials": "S",
            "lastname": "Nordmeyer"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": "10.3390/bioengineering12040328",
    "journal": "Bioengineering (Basel, Switzerland)",
    "keywords": [
        "4D flow MRI",
        "CFD",
        "aortic valve replacement",
        "stress simulation",
        "virtual therapy planning"
    ],
    "methods": null,
    "publication_date": "2025-04-26",
    "pubmed_id": "40281688",
    "results": "Gradients across the aortic valve were significantly lower using larger valves; however, they were not normalized after SAVR (DP max [mmHg] norm/smaller/reference/larger valve = 6/14/12/9 mmHg, <0.01 compared to norm). Physical activity simulation increased DP max in all patients and across all valve sizes (DP max [mmHg] rest versus stress for the smaller/reference/larger valve = 14 vs. 23, 12 vs. 18, 9 vs. 14). Blood flow profiles did not normalize after SAVR and remained unaffected by physical activity. Gradients differed between mild and moderate stenosis between different therapy options and even showed moderate to severe stenosis under simulated physical activity.",
    "title": "Virtual Therapy Planning of Aortic Valve Replacement for Preventing Patient-Prosthesis Mismatch.",
    "xml": "<Element 'PubmedArticle' at 0x7885039392b0>"
}