Abstract

Leaflet thrombosis is a typical secondary valvular disease after aortic valve replacement, and abnormal hemodynamic characteristics are crucial in its development. In this study, the effects of angle between the longitudinal axis of the aortic valve and that of the ascending aorta ($\alpha =0^\circ$, $\alpha =5^\circ$, $\alpha =10^\circ$ and $\alpha =15^\circ$) on the velocity, vorticity and viscous shear stress distribution are investigated using particle image velocimetry (PIV). It is of great significance to understand the hemodynamic mechanism of thrombosis after aortic valve replacement. The results show that the transvalvular flow in the aortic root is centrosymmetric flow when $\alpha =0^\circ$, while it tilts to the side of left coronary artery when $\alpha =5^\circ$, $\alpha =10^\circ$ and $\alpha =15^\circ$. The transvalvular flow tilts with the increasing of tilted angle and impacts on the wall of the ascending aorta, damaging the endothelial cells and causing thrombosis. In addition, the velocity within the aortic sinus increases and the vortex also moves toward the bottom of the aortic sinus with aortic valve tilted, which is unfavorable for the blood flowing from the coronary artery ostium to the myocardium for blood supply. Meanwhile, the high vorticity and high viscous shear stress area of the aortic root also tilts to the side of left coronary artery. And the high vorticity area of the aortic sinus is located at the bottom of the aortic sinus and the high viscous shear stress area is distributed at the wall of the aortic sinus. The vorticity and viscous shear stress are realy high when there is a mismatch between the ascending aorta longitudinal axis and that of the aortic valve, especially $\alpha =10^\circ$ and $\alpha =15^\circ$, providing a favorable environment for thrombosis. The results benefit to contribute theoretical bases and technical reference for the selection of clinical aortic valve replacement surgical parameters and that of the avoidance of secondary valvular disease.

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