Comparison of vortex formation in expanded and curved aortic sinuses: The effect of sinus curvature

Abstract

Aortic valve disease is a significant health issue. Research on the effects of aortic sinus geometry and aortic valve motion during a heartbeat is imperative, as numerous valvular diseases are associated with blood flow near the heart valve. Changes in the internal space of the sinus and the formation of blood clots have been reported after the implantation of a transcatheter aortic valve, an artificial heart valve. Although the sinus shape and leaflet motion significantly affect the hemodynamic characteristics and platelet aggregation, the blood flow behaviors near the heart valve associated with clot formation have not been fully elucidated. This study conducted in vitro experiments to investigate the flow behavior near an aortic sinus model based on the sinus shape. Additionally, hemodynamic changes associated with variations in the aortic sinus geometry and leaflet length within an aortic sinus model under pulsatile-flow conditions were elucidated. In a curved sinus model, a large single vortex formed near the center of the sinus region. Meanwhile, the center of the vortex in the sinus region shifted during a cycle in an expanded sinus model. Furthermore, a small vortex remained where the leaflet was initiated, thus increasing the likelihood of thrombus formation. Thus, the curved sinus model is advantageous for preventing material accumulation by maintaining a large vortex structure. The experimental results confirmed that the aortic sinus shape and leaflet length affect the likelihood of thrombus formation inside the aortic sinus.