Aortic Biological Prosthetic Valve for Open-Surgery and Percutaneous Implant: Procedure Simulation and Performance Assessment - Cardiovascular and Cardiac Therapeutic Devices - page 152

Fig. 12 von Mises stress pattern at the end of diastole: a isotropic material model; b fibre-
reinforced model. A cut view is adopted to highlight the coaptation. Vector plot of the maximum
principal stress of the closed leaflets at the end of diastole: c isotropic material model;
d anisotropic Holzapfel material model. The bigger arrows close to the commissures show a
stress concentration in that region

significantly influences the performance of the implanted valve and, therefore, it
represents a crucial issue when performing numerical simulations.

4.2 Transcatheter Aortic Valve Implant

4.2.1 Clinical Procedure and Simulation Strategy

In this section we focus on one of the currently available percutaneous aortic valve
prosthesis, i.e., the balloon expandable Edwards Lifescience Sapien valve which is
basically composed of three flexible biological leaflets sutured on a stainless steel
balloon-expandable stent. Sapien placement can be achieved by either a