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Influence of the aortic valve leaflets on the fluid-dynamics in aorta in presence of a normally functioning bicuspid valve

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Abstract

In this work, we consider the blood fluid-dynamics in the ascending aorta in presence of a normally functioning bicuspid aortic valve (BAV). In particular, we perform an unsteady finite element study in real geometries with physiological velocity boundary conditions at the inlet to assess the effect of the inclusion of the leaflets on the fluid-dynamic abnormalities characterizing BAV cases. To this aim, we perform a comparison in two geometries (a dilated and a non-dilated ones) among three scenarios which are built up for each geometry: BAV without leaflets, BAV with leaflets, and tricuspid case with leaflets. For each case, we compute four indices quantifying flow asymmetry, reversal flows, helical patterns, and wall shear stresses. Our results show that the inclusion of the leaflets increases the fluid-dynamics abnormalities, especially for the non-dilated configuration, which presents a greater increment of the indices. In particular, we observe that the values of the time-averaged wall shear stress and of the systolic jet asymmetry increase by approximatively 100 and 40 %, respectively, when considering the leaflets.

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Acknowledgments

This work has been partially supported the Italian MIUR PRIN12 project n. 201289A4LX. The numerical simulations have been performed at CINECA Consortium through the LISA Projects LI02p-FSIA2 and Lisa Project LI02p- LEScarot.

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Authors and Affiliations

  1. MOX, Dipartimento di Matematica, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133, Milan, Italy

    D. Bonomi, C. Vergara, E. Faggiano & L. Formaggia

  2. LaBS, Dipartimento di Chimica, Materiali e Ingegneria Chimica, Politecnico di Milano, Milan, Italy

    E. Faggiano

  3. Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy

    M. Stevanella & A. Redaelli

  4. EnginSoft SpA, Parco Scientifico Tecnologico Kilometro Rosso, Bergamo, Italy

    C. Conti

  5. Department of Radiology, Azienda Ospedaliera Universitaria Integrata di Verona, Polo Confortini, Verona, Italy

    G. Puppini

  6. Division of Cardiac Surgery, Department of Surgery, University of Verona, Verona, Italy

    G. Faggian & G. B. Luciani

Authors
  1. D. Bonomi
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  2. C. Vergara
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  3. E. Faggiano
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  4. M. Stevanella
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  5. C. Conti
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  8. G. Faggian
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  9. L. Formaggia
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  10. G. B. Luciani
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Corresponding author

Correspondence to C. Vergara.

Appendix

Appendix

We provide here some technical details on the 2D CINE PC-MRI acquisition made for Patient 2 at the PC-slice. A 1.5 Tesla system (Magnetom Symphony, Siemens Medical Systems, Erlangen, Germany) has been used. The temporal resolution was characterized by 20 phases in one cardiac cycle with a pixel resolution of \(1.17 \times 1.17\) mm. Velocity encoding values were chosen to optimize the velocity map resolution with a value equal to \(150\) cm/s. The following parameters were also used: TE (echo time) = 6.4 ms; flip angle = \( 15^{\circ }\); slice thickness = 5 mm; acquisition matrix = \(256 \times 256\).

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Bonomi, D., Vergara, C., Faggiano, E. et al. Influence of the aortic valve leaflets on the fluid-dynamics in aorta in presence of a normally functioning bicuspid valve. Biomech Model Mechanobiol 14, 1349–1361 (2015). https://doi.org/10.1007/s10237-015-0679-8

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  • DOI: https://doi.org/10.1007/s10237-015-0679-8

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