PhD T.W. (Thijmen) Hokken

Below is a brief summary of the dissertation:

Aortic stenosis is the most common heart valve disease in the Western world. Transcatheter aortic valve implantation (TAVI) is an aortic valve replacement in which the aortic valve is replaced percutaneously, meaning through an artery and using a catheter. TAVI is a recommended therapy in the European guideline in elderly patients with symptomatic aortic stenosis. This dissertation focuses on gaining practical insights to develop a patient-tailored strategy to reduce the risk of complications. In particular, it looked at how we can use the CT scan, performed prior to the TAVI procedure, to choose the appropriate TAVI valve for each patient-specific anatomy. Hereby, we looked at how to predict the risk of a pacemaker or the risk of blood leakage past the TAVI valve using anatomical features and the amount of calcium. In addition, we looked at whether computer simulations could predict complications. We also looked at procedural features to make the procedure shorter and safer. For example, we have seen that it is not necessary to place an external pacemaker for safety, while reducing the risk of bleeding and degrading the procedure time. We have also seen that coagulation monitoring with the conventional way is often inaccurate. Finally, we have investigated the differences in implantation depth between CT-scan and angiography. We saw a significant difference between those two modalities.