Comparative hemodynamics in an aorta with bicuspid and trileaflet valves

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Abstract

Bicuspid aortic valve (BAV) is a congenital heart defect that has been associated with serious aortopathies, such as aortic stenosis, aortic regurgitation, infective endocarditis, aortic dissection, calcific aortic valve and dilatation of ascending aorta. There are two main hypotheses to explain the increase prevalence of aortopathies in patients with BAV: the genetic and the hemodynamic. In this study, we seek to investigate the possible role of hemodynamic factors as causes of BAV-associated aortopathy. We employ the curvilinear immersed boundary method coupled with an efficient thin-shell finite-element formulation for tissues to carry out fluid–structure interaction simulations of a healthy trileaflet aortic valve (TAV) and a BAV placed in the same anatomic aorta. The computed results reveal major differences between the TAV and BAV flow patterns. These include: the dynamics of the aortic valve vortex ring formation and break up; the large-scale flow patterns in the ascending aorta; the shear stress magnitude, directions, and dynamics on the heart valve surfaces. The computed results are in qualitative agreement with in vivo magnetic resonance imaging data and suggest that the linkages between BAV aortopathy and hemodynamics deserve further investigation.

Original languageEnglish (US)
Pages (from-to)67-85
Number of pages19
JournalTheoretical and Computational Fluid Dynamics
Volume30
Issue number1-2
DOIs
StatePublished - Apr 1 2016

Keywords

  • Bicuspid valve
  • Finite element
  • Fluid–structure interaction
  • Immersed boundary method
  • Rotation-free approach
  • Thin shell
  • Trileaflet valve

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