Abstract

Calcification and bicuspid valve formation are important aortic valve disorders that disturb the hemodynamics and the valve function. The detailed analysis of aortic valve hemodynamics would lead to a better understanding of the disease’s etiology. We computationally modeled the aortic valve using simplified three-dimensional geometry and inlet velocity conditions obtained via echocardiography. We examined various calcification severities and bicuspid valve formation. Fluid-structure interaction (FSI) analyses were adapted using ANSYS Workbench to incorporate both flow dynamics and leaflet deformation accurately. Simulation results were validated by comparing leaflet movements in B-mode echo recordings. Results indicate that the biomechanical environment is significantly changed for calcified and bicuspid valves. High flow jet velocities are observed in the calcified valves which results in high transvalvular pressure difference (TPG). Wall shear stresses (WSS) increased with the calcification on both fibrosa (aorta side) and ventricularis (left ventricle side) surfaces of the leaflet. The WSS distribution is regular on the ventricularis, as the WSS values proportionally increase from the base to the tip of the leaflet. However, WSS patterns are spatially complex on the fibrosa side. Low WSS levels and spatially complex WSS patterns on the fibrosa side are considered as promoting factors for further calcification and valvular diseases.

Highlights

  • Published: 16 August 2021Aortic valve disease is one of the most common cardiovascular disorders, affecting25% of the population over 65 years of age [1,2]

  • Our results show that calcification leads to increased wall shear stress (WSS) on both sides of the leaflets and the disruption of regular Wall shear stresses (WSS) patterns on the aortic fibrosa side might contribute to further calcification

  • We investigated the effect of valve calcification and bicuspid valve formation on the hemodynamics of aortic valve leaflets

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Summary

Introduction

Published: 16 August 2021Aortic valve disease is one of the most common cardiovascular disorders, affecting25% of the population over 65 years of age [1,2]. Valve disorders may be innate as in the case of a bicuspid valve formation or may develop later in a lifetime as the leaflet calcification. The aortic valve separates the left ventricle from the aortic vessel and consists of three half-moon-shaped leaflets and three slot-like sinus cavities on the aortic root. The valve leaflets are the most dynamic structures in the valve, and the sinuses are the gaps corresponding to the back of the leaflets. The aortic root acts as a bridge between the left ventricle and the ascending aorta, creating a region for the blood to be pumped out of the heart. An aortic valve opens and closes approximately 3 billion times throughout its lifetime [4]. The aortic valve is opened during the ventricle contraction and closed during the ventricle relaxation

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