Transcatheter aortic valve implantation (TAVI) and thoracic endovascular aortic repair (TEVAR) are minimally invasive procedures for treating aortic valves and diseases. Finite element simulations have proven to be valuable tools in predicting device-related complications. In the literature, the inclusion of aortic pre-stress has not been widely investigated. It plays a crucial role in determining the biomechanical response of the vessel and the device–tissue interaction. This study aims at demonstrating how and when to include the aortic pre-stress in patient-specific TAVI and TEVAR simulations. A percutaneous aortic valve and a stent-graft were implanted in aortic models reconstructed from patient-specific CT scans. Two scenarios for each patient were compared, i.e., including and neglecting the wall pre-stress. The neglection of pre-stress underestimates the contact pressure of 48% and 55%, the aorta stresses of 162% and 157%, the aorta strains of 77% and 21% for TAVI and TEVAR models, respectively. The stent stresses are higher than 48% with the pre-stressed aorta in TAVI simulations; while, similar results are obtained in TEVAR cases. The distance between the device and the aorta is similar with and without pre-stress. The inclusion of the aortic wall pre-stress has the capability to give a better representation of the biomechanical behavior of the arterial tissues and the implanted device. It is suggested to include this effect in patient-specific simulations replicating the procedures.

经导管主动脉瓣植入术 (TAVI) 和胸腔主动脉腔内修复术 (TEVAR) 是治疗主动脉瓣和疾病的微创手术。有限元模拟已被证明是预测设备相关并发症的宝贵工具。在文献中，主动脉预应力的纳入尚未得到广泛研究。它在确定血管的生物力学响应以及装置与组织的相互作用方面发挥着至关重要的作用。本研究旨在展示如何以及何时将主动脉预应力纳入患者特异性 TAVI 和 TEVAR 模拟中。将经皮主动脉瓣和支架移植物植入根据患者特异性 CT 扫描重建的主动脉模型中。比较了每位患者的两种情况，即包括和忽略壁预应力。对于 TAVI 和 TEVAR 模型，忽略预应力分别低估了 48% 和 55% 的接触压力、162% 和 157% 的主动脉应力、77% 和 21% 的主动脉应变。TAVI模拟中预应力主动脉支架应力高于48%；同时，在 TEVAR 案例中也得到了类似的结果。在有预应力和没有预应力的情况下，装置和主动脉之间的距离相似。包含主动脉壁预应力能够更好地表示动脉组织和植入装置的生物力学行为。建议将这种效果包含在复制程序的患者特定模拟中。