{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T03:34:59Z","timestamp":1789529699537,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T00:00:00Z","timestamp":1661472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009938","name":"University of Denver","doi-asserted-by":"publisher","award":["84993\u2010142235"],"award-info":[{"award-number":["84993\u2010142235"]}],"id":[{"id":"10.13039\/100009938","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Numer Methods Biomed Eng"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Subclinical leaflet thrombosis has been increasingly recognized following transcatheter aortic valve replacement (TAVR). Determining the risk factors is vital in preventing clinical leaflet thrombosis and ensuring long\u2010term value durability. Clinical data have indicated that regional stent under\u2010expansion of transcatheter aortic valves (TAVs), particularly self\u2010expanding devices, may be associated with an increased risk of subclinical leaflet thrombosis. This study aimed to determine the effects of regional TAV frame under\u2010expansion on leaflet kinematics, leaflet structural characteristics, and explore its impact on the likelihood of leaflet thrombosis. In this study, mild and moderate regional frame under\u2010expansion of a 26\u2010mm CoreValve were examined using experimental testing and computational simulations. The results indicated that regional TAV frame under\u2010expansion impairs leaflet kinematics and reduces the range of motion in leaflets with an angle less than 120\u00b0. The reduced range of motion can increase blood stasis on the surface of the TAV leaflets. The results also demonstrated that regional frame under\u2010expansion induced localized high\u2010stress regions in the leaflets close to the fixed boundary edge. The increased mechanical stress can lead to accelerated tissue degeneration. The study improves our understanding of the effects of regional stent under\u2010expansion in TAVR. Post\u2010procedural balloon dilatation of self\u2010expanding TAVs can potentially be advantageous in reducing leaflet distortion and normalizing leaflet stress distribution. Large\u2010scale, prospective, and well\u2010controlled studies are needed to further investigate regional TAV frame under\u2010expansion effects on subclinical leaflet thrombosis and long\u2010term valve durability.<\/jats:p>","DOI":"10.1002\/cnm.3641","type":"journal-article","created":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T15:35:49Z","timestamp":1660577749000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Structural analysis of regional transcatheter aortic valve underexpansion and its implications for subclinical leaflet thrombosis"],"prefix":"10.1002","volume":"38","author":[{"given":"Dong","family":"Qiu","sequence":"first","affiliation":[{"name":"The DU Cardiovascular Biomechanics Laboratory, Department of Mechanical and Materials Engineering University of Denver  Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9769-9342","authenticated-orcid":false,"given":"Ali N.","family":"Azadani","sequence":"additional","affiliation":[{"name":"The DU Cardiovascular Biomechanics Laboratory, Department of Mechanical and Materials Engineering University of Denver  Denver Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1509233"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30757-2"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2017.02.005"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.114.001779"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2018.03.003"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcct.2017.12.004"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.05.029"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.10.097"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.01.045"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2019.00044"},{"issue":"5","key":"e_1_2_9_12_1","first-page":"927","article-title":"Valve thrombosis following transcatheter aortic valve replacement: significance of blood stasis on the leaflets","volume":"51","author":"Vahidkhah K","year":"2017","journal-title":"Eur J Cardiothorac Surg"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2017.02.052"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.029479"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2020.10.139"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-17-00094"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.27702"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2015.07.022"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.11.009"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivz213"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.029479"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.28388"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-17-00373"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2011.02.317"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/aor.13290"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10439-018-02129-5"},{"key":"e_1_2_9_27_1","doi-asserted-by":"crossref","unstructured":"KimH LuJ SacksMS ChandranKB.Dynamic Simulation Pericardial Bioprosthetic Heart Valve Function; 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