Objective:

To evaluate modeling approaches addressing TAVR complications and procedural planning, particularly for high-risk scenarios, through a systematic review.

Key Findings:

• Patient-specific digital simulation can enhance TAVR planning by simulating valve deployment and device-tissue interactions.
• Current pre-procedural planning is primarily based on CT imaging, which does not fully capture dynamic processes relevant to complications.
• Computational modeling has potential to reduce complication risks by providing mechanistic insights and exploring alternative procedural strategies.
• Clinical translation of modeling is limited due to small study populations, heterogeneous methodologies, and lack of integration into routine workflows.

Interpretation:

Limitations:

• Models differ in inputs, assumptions, and validation methods, limiting comparability.
• Feasibility of real-world application is rarely addressed in studies.
• Limited patient-specific validation and integration into clinical workflows.

Conclusion:

Future progress in computational modeling for TAVR requires validation against clinically meaningful endpoints and collaboration between clinicians and engineers.