Key result
Including an anatomically accurate trileaflet aortic valve in fluid-structure interaction simulations captures flow features impacting thoracic aorta wall forces, which are underestimated if omitted.
Why the study?
In a normal cardiac cycle, trileaflet aortic valve opening is progressive and correlates with phasic blood flow, prompting evaluation of the impact of including an anatomically accurate reconstructed valve within a fluid-structure interaction simulation model.
Including an anatomically accurate trileaflet aortic valve in computational models is essential for accurately capturing flow features and tissue stress on the thoracic aorta wall.
In a normal cardiac cycle, the trileaflet aortic valve opening is progressive, which correlates with the phasic blood flow. Therefore, we aimed to determine the impact of including an anatomically accurate reconstructed trileaflet aortic valve within a fluid-structure interaction (FSI) simulation model and determine the cyclical hemodynamic forces imposed on the thoracic aortic walls from aortic valve opening to closure. A pediatric patient with a normal trileaflet valve was recruited. Using the Cardiac Magnetic Resonance Data (CMR), a 3D model of the aortic valve and thoracic aorta was reconstructed. FSI simulations were employed to assess the tissue stress during a cardiac cycle as the result of changes in the valve opening. The blood flow was simulated as a mixture of blood plasma and red blood cells to account for non-Newtonian effects. The computation was validated with phase-contrast CMR. Windkessel boundary conditions were employed to ensure physiological pressures during the cardiac cycle. The leaflets' dynamic motion during the cardiac cycle was defined with an analytic grid velocity function. At the beginning of the valve opening a thin jet is developing. From mid-open towards full opening the stress level increases where the jet impinges the convex wall. At peak systole two counter-rotating Dean-like vortex cores manifest in the ascending aorta, which correlates with increased integrated mean stress levels. An accurate trileaflet aortic valve is needed for capturing of both primary and secondary flow features that impact the forces on the thoracic aorta wall. Omitting the aortic valve underestimates the biomechanical response.
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Sundström et al. (2020) studied Normal trileaflet aortic valve (n=1). Inclusion of an anatomically accurate reconstructed trileaflet aortic valve in FSI simulation vs. Omitting the aortic valve was evaluated on Tissue stress and cyclical hemodynamic forces on the thoracic aortic walls. Including an anatomically accurate trileaflet aortic valve in fluid-structure interaction simulations captures flow features impacting thoracic aorta wall forces, which are underestimated if omitted.
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