Fiber-reinforced computational model of the aortic root incorporating thoracic aorta and coronary structures.

Abstract

Cardiovascular diseases are still the leading causes of death in the developed world. The decline in the mortality associated with circulatory system diseases is accredited to development of new diagnostic and prognostic tools. It is well known that there is an inter relationship between the aortic valve impairment and pathologies of the aorta and coronary vessels. However, due to the limitations of the current tools, the possible link is not fully elucidated. Following our previous model of the aortic root including the coronaries, in this study, we have further developed the global aspect of the model by incorporating the anatomical structure of the thoracic aorta. This model is different from all the previous studies in the sense that inclusion of the coronary structures and thoracic aorta into the natural aortic valve introduces the notion of globality into the model enabling us to explore the possible link between the regional pathologies. The developed model was first validated using the available data in the literature under physiological conditions. Then, to provide a support for the possible association between the localized cardiovascular pathologies and global variations in hemodynamic conditions, we simulated the model for two pathological conditions including moderate and severe aortic valve stenoses. The findings revealed that malformations of the aortic valve are associated with development of low wall shear stress regions and helical blood flow in thoracic aorta that are considered major contributors to aortic pathologies.