Investigations into the effects of transcatheter valve implantations on the cardiac conduction system and cardiac anatomy

Abstract

Investigations into the Effects of Transcatheter Valve Implantations on the Cardiac Conduction System and Cardiac Anatomy Michael G. Bateman MEng.As of 2006, approximately 3 million people in the US alone had been diagnosed with either mitral regurgitation or aortic stenosis. Today, with the increasing prevalence of cardiac diseases, including chronic cardiomyopathies, these values of valvular disease may be gross underestimations of the current patient populations. The work presented here describes the development of a strong foundation of anatomical knowledge to develop a better understanding of the potential complications that transcatheter devices may impose on a patients' cardiac anatomy. Using real-time clinical imaging and Visible Heart® methodologies models of three such disease states were created: 1) aortic stenosis, 2) mitral prolapse and 3) pulmonary valve insufficiency. These simulated disease states are used test the next generation of transcatheter valve replacements. Furthermore to better understand the effect of these therapies on cardiac electrophysiology, several collaborations have been initiated to investigate the anatomical position and the associated activation sequences of the cardiac conduction system in relation to the hearts' four valves. It is considered here that a better understanding of the interactions of novel transcatheter devices and their delivery systems with both the human functional/structural cardiac anatomy and conduction system is critical for the development/advancement of these medical devices.