The study of the relationship between unicuspid aortic valve insufficiency and heart disease by fluid-structure interaction modeling

Abstract

Unicuspid aortic valve (UAV) is a rare congenital malformation that affects 5% of patients undergoing aortic stenosis surgery. It has two subtypes, acommissural and unicommissural. By computational modeling with the fluid-structure interaction (FSI) method, it is possible to predict diseases related to the unicuspid aortic valve and treat them before they progress. Without it, the cost and time of treatment and the risk of failure increase. Previously, only statistical studies on unicuspid valve patients and diseases caused by it had been conducted. Modeling was performed using information from articles on patients with unicuspid aortic valves. The acommissural type, without lateral slits, had the highest grade of stenosis and the highest potential for aortic dilation compared to unicommissural. In both models, an unusually high-pressure gradient occurred, which caused peak strain on the raphes and edges of the leaflets. The presence of the vortex upstream led to the acceleration and increase of calcification. The findings of this study suggest specific differences in hemodynamic characteristics and valve mechanics for different UAV phenotypes, including the severity of stenosis and leaflet strain, which may be critical for predicting subsequent aortic diseases and differential treatment strategies.