journal article·2020-02-19Open access

Numerical Investigation of the Effects of Prosthetic Aortic Valve Design on Aortic Hemodynamic Characteristics

Guang-Yu Zhu, Hai Huang, Ya-Li Su, Joon-Hock Yeo, Xiao-Qin Shen, Cheng-Fu Yang

Applied Sciences· Volume 10· Issue 4

Abstract

The superior performance of single-point attached commissures (SPAC) molded valve design has been validated by several numerical, in vitro and in vivo animal studies. However, the impacts of the SPAC molded valve design on aortic hemodynamic environments are yet to be investigated. In this study, multiscale computational models were prepared by virtually implanting prosthetic aortic valves with SPAC tubular, SPAC molded and conventional designs into a patient-specific aorta, respectively. The impacts of the valve designs on efferent flow distribution, flow pattern and hemodynamic characteristics in the aorta were numerically investigated. The results showed that despite the overall flow phenomena being similar, the SPAC tubular valve exhibited a suboptimal performance in terms of higher spatially averaged wall shear stress (SAWSS) in ascending aorta (AAo), higher helix grade, stronger secondary flow mean secondary velocity in descending aorta, as well as more complex vortex distribution. The results from the current study extend the understanding of hemodynamic impacts of the valve designs, which would further benefit the optimization of the prosthetic aortic valve.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Cardiac Valve Diseases and Treatments · Coronary Interventions and Diagnostics · Mechanical Circulatory Support Devices

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

School of Energy and Power Engineering, Xi’an Jiaotong University, Xi’an 710049, China

School of Sciences, Xi’an University of Technology, Xi’an 710054, China

School of Mechanical Engineering, Xi’an Shiyou University, Xi’an 710065, China

School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore 639798, Singapore

Department of Chemical and Materials Engineering, National University of Kaohsiung, No. 700, Kaohsiung University Rd., Nan-Tzu District, Kaohsiung 811, Taiwan

Funding

National Natural Science Foundation of China

References (100+)

Show source-provided references
1. European Society of Cardiology: Cardiovascular Disease Statistics 201710.1093/eurheartj/ehx628 ↗
2. The year in cardiology 2017: Valvular heart disease10.1093/eurheartj/ehx772 ↗
3. Pulsatile interaction between the macro-vasculature and micro-vasculature: Proof-of-concept among patients with type 2 diabetes10.1007/s00421-018-3972-2 ↗
4. Aortic Bioprosthetic Valve Durability10.1016/j.jacc.2017.07.715 ↗
5. A comparison of valve-in-valve transcatheter aortic valve replacement in failed stentless versus stented surgical bioprosthetic aortic valves10.1002/ccd.28039 ↗
6. Pledget-Armed Sutures Affect the Haemodynamic Performance of Biologic Aortic Valve Substitutes: A Preliminary Experimental and Computational Study10.1007/s13239-016-0284-8 ↗
7. The cryolife-O’Brien composite aortic stentless xenograft: Surgical technique of implantation10.1016/0003-4975(95)00267-O ↗
8. Aortic Leaflet Replacement With the New 3F Stentless Aortic Bioprosthesis10.1016/j.athoracsur.2003.10.106 ↗
9. Tubular heart valves: A new tissue prosthesis design—Preclinical evaluation of the 3F aortic bioprosthesis10.1016/j.jtcvs.2004.12.054 ↗
10. Truly stentless molded autologous pericardial aortic valve prosthesis with single point attached commissures in a sheep model10.1016/j.ejcts.2007.12.044 ↗
11. Aortic Valve Replacement with Autologous Pericardium: Surgical Technique10.1111/j.1540-8191.1995.tb00582.x ↗
12. Finite element investigation of stentless pericardial aortic valves: Relevance of leaflet geometry10.1007/s10439-010-9940-6 ↗
13. Forces at single point attached commissures (SPAC) in pericardial aortic valve prosthesis10.1016/j.ejcts.2005.12.002 ↗
14. In Vivo Quantification of Helical Blood Flow in Human Aorta by Time-Resolved Three-Dimensional Cine Phase Contrast Magnetic Resonance Imaging10.1007/s10439-008-9609-6 ↗
15. Mechanistic insight into the physiological relevance of helical blood flow in the human aorta: An in vivo study10.1007/s10237-010-0238-2 ↗
16. Physiological Significance of Helical Flow in the Arterial System and its Potential Clinical Applications10.1007/s10439-014-1097-2 ↗
17. A rational approach to defining principal axes of multidirectional wall shear stress in realistic vascular geometries, with application to the study of the influence of helical flow on wall shear stress directionality in aorta10.1016/j.jbiomech.2015.02.027 ↗
18. The Atheroprotective Nature of Helical Flow in Coronary Arteries10.1007/s10439-018-02169-x ↗
19. Bicuspid Aortic Valve Is Associated With Altered Wall Shear Stress in the Ascending Aorta10.1161/CIRCIMAGING.112.973370 ↗
20. Quantification of Hemodynamic Wall Shear Stress in Patients with Bicuspid Aortic Valve Using Phase-Contrast MRI10.1007/s10439-009-9854-3 ↗
21. Assessment of Hemodynamic Conditions in the Aorta Following Root Replacement with Composite Valve-Conduit Graft10.1007/s10439-015-1453-x ↗
22. Blood flow characteristics in the ascending aorta after TAVI compared to surgical aortic valve replacement10.1007/s10554-015-0792-x ↗
23. Bicuspid aortic valves are associated with increased wall and turbulence shear stress levels compared to trileaflet aortic valves10.1007/s10237-014-0623-3 ↗
24. Patient-specific computational fluid dynamics—Assessment of aortic hemodynamics in a spectrum of aortic valve pathologies10.1016/j.jtcvs.2016.09.040 ↗
25. Platelet activation of mechanical versus bioprosthetic heart valves during systole10.1016/j.jbiomech.2017.03.002 ↗
26. Khalili, F., Gamage, P., Sandler, R., and Mansy, H. (2018). Adverse Hemodynamic Conditions Associated with Mechanical Heart Valve Leaflet Immobility. Bioengineering, 5.10.3390/bioengineering5030074 ↗
27. Thubrikar, M. (2018). The Aortic Valve, Routledge.10.4324/9780203737163 ↗
28. SimVascular: An Open Source Pipeline for Cardiovascular Simulation10.1007/s10439-016-1762-8 ↗
29. Computational Investigation of a Self-Powered Fontan Circulation10.1007/s13239-018-0342-5 ↗
30. Patient-Specific Multi-Scale Model Analysis of Hemodynamics Following the Hybrid Norwood Procedure for Hypoplastic Left Heart Syndrome: Effects of Reverse Blalock–Taussig Shunt Diameter10.1007/s13239-018-00396-w ↗
31. Outflow boundary conditions for three-dimensional finite element modeling of blood flow and pressure in arteries
32. Reduction of aberrant aortic haemodynamics following aortic root replacement with a mechanical valved conduit†10.1093/icvts/ivw173 ↗
33. The influence of the angle of confluence on the flow in a vertebro-basilar junction model10.1016/0021-9290(95)00064-X ↗
34. Study of vortex in flow fields induced by surface dielectric barrier discharge actuator at low pressure based on Q criterion10.1088/2058-6272/aa8e95 ↗
35. Notch1 inhibition reduces low shear stress-induced plaque formation10.1016/j.biocel.2016.01.007 ↗
36. Autologous pericardial pulmonary conduit with single point attached commissures in a sheep model10.1016/j.ejcts.2007.10.012 ↗
37. Flow–Structure Interaction Simulations of the Aortic Heart Valve at Physiologic Conditions: The Role of Tissue Constitutive Model10.1115/1.4038885 ↗
38. Study on the Accuracy of Structural and FSI Heart Valves Simulations10.1007/s13239-018-00373-3 ↗
39. Fully-coupled fluid-structure interaction simulation of the aortic and mitral valves in a realistic 3D left ventricle model10.1371/journal.pone.0184729 ↗
40. Dynamic and fluid? structure interaction simulations of bioprosthetic heart valves using parametric design with T-splines and Fung-type material models10.1007/s00466-015-1166-x ↗
41. Transient fluid–structure coupling for simulation of a trileaflet heart valve using weak coupling10.1007/s10047-006-0365-9 ↗
42. On the Modeling of Patient-Specific Transcatheter Aortic Valve Replacement: A Fluid–Structure Interaction Approach10.1007/s13239-019-00427-0 ↗
43. Review of patient-specific simulations of transcatheter aortic valve implantation10.1007/s12572-015-0139-9 ↗
44. A computational study of the three-dimensional fluid–structure interaction of aortic valve10.1016/j.jfluidstructs.2018.04.009 ↗
45. A three-dimensional computational analysis of fluid–structure interaction in the aortic valve10.1016/S0021-9290(02)00244-0 ↗
46. A coupled fluid-structure finite element model of the aortic valve and root
47. Fluid–structure interaction of an aortic heart valve prosthesis driven by an animated anatomic left ventricle10.1016/j.jcp.2012.08.036 ↗
48. 3D Fluid-Structure Interaction Simulation of Aortic Valves Using a Unified Continuum ALE FEM Model10.3389/fphys.2018.00363 ↗
49. Evaluation of an aortic valve prosthesis: Fluid-structure interaction or structural simulation?10.1016/j.jbiomech.2017.04.004 ↗
50. Role of Computational Simulations in Heart Valve Dynamics and Design of Valvular Prostheses10.1007/s13239-010-0002-x ↗
51. Toward patient-specific simulations of cardiac valves: State-of-the-art and future directions10.1016/j.jbiomech.2012.10.026 ↗
52. Fluid–Structure Interaction Model of a Percutaneous Aortic Valve: Comparison with an In Vitro Test and Feasibility Study in a Patient-Specific Case10.1007/s10439-015-1429-x ↗
53. Fluid–Structure Interaction Models of Bicuspid Aortic Valves: The Effects of Nonfused Cusp Angles10.1115/1.4038329 ↗
54. Kamensky, D.M. (2016). Immersogeometric Fluid—Structure Interaction Analysis of Bioprosthetic Heart Valves. [Doctoral Thesis, The University of Texas at Austin].
55. Fluid–Structure Interaction Study of Transcatheter Aortic Valve Dynamics Using Smoothed Particle Hydrodynamics10.1007/s13239-016-0285-7 ↗
56. Fluid structure interaction modeling of aortic valve stenosis at different heart rates
57. Numerical simulation of patient-specific left ventricular model with both mitral and aortic valves by FSI approach10.1016/j.cmpb.2013.11.009 ↗
58. Comparative Fluid–Structure Interaction Analysis of Polymeric Transcatheter and Surgical Aortic Valves’ Hemodynamics and Structural Mechanics10.1115/1.4040600 ↗
59. Lagrangian-Eulerian finite element formulation for incompressible viscous flows10.1016/0045-7825(81)90049-9 ↗
60. Flow patterns around heart valves: A numerical method10.1016/0021-9991(72)90065-4 ↗
61. Smoothed Particle Hydrodynamics and Its Diverse Applications10.1146/annurev-fluid-120710-101220 ↗
62. Accuracy vs. computational time: Translating aortic simulations to the clinic10.1016/j.jbiomech.2011.11.041 ↗
63. Chen, H.Y., and Kassab, G.S. (2010). Computational Modeling in Biomechanics, Springer.
64. Fluid–structure interaction, immersed boundary-finite element method simulations of bio-prosthetic heart valves10.1016/j.cma.2013.01.010 ↗
65. van Estimation of valvular resistance of segmented aortic valves using computational fluid dynamics10.1016/j.jbiomech.2019.07.010 ↗
66. Quasi-Steady Flow Dynamics Study of Human Aortic Valve with Numerical Techniques10.1017/jmech.2012.105 ↗
67. Blood flow in the rabbit aortic arch and descending thoracic aorta10.1098/rsif.2011.0116 ↗
68. De Nisco, G., Zhang, P., Gallo, D., Liu, X., Deng, X., Ponzini, R., Rizzo, G., and Morbiducci, U. (2016, January 20–22). On the Impact of Modeling Assumptions in Subject-Specific Hemodynamic Simulations of Low-Density Lipoproteins Transport in Aorta. Proceedings of the GNB2016, Naples, Italy.
69. Flow in a mechanical bileaflet heart valve at laminar and near-peak systole flow rates: CFD simulations and experiments10.1115/1.1993665 ↗
70. Flow through a defective mechanical heart valve: A steady flow analysis10.1016/j.medengphy.2008.07.003 ↗
71. A Review on Computational Fluid Dynamics Modelling in Human Thoracic Aorta10.1007/s13239-013-0146-6 ↗
72. Impact of patient-specific LVOT inflow profiles on aortic valve prosthesis and ascending aorta hemodynamics10.1016/j.jocs.2017.11.005 ↗
73. Pulsatile flow and atherosclerosis in the human carotid bifurcation. Positive correlation between plaque location and low oscillating shear stress
74. Analysis of flow and vascular resistance in a model of the circle of Willis10.1016/0021-9290(88)90013-9 ↗
75. Flow patterns and velocity distributions in the human vertebrobasilar arterial system. Laboratory investigation10.3171/2010.1.JNS09575 ↗
76. Chen, L. (2005). Hemodynamics in the Cerebral Circulation: Numerical Studies and Experimetal Investigation. [Doctoral Thesis, Nanyang Technological University].
77. An experimental investigation of the hemodynamic variations due to aplastic vessels within three-dimensional phantom models of the circle of Willis10.1007/s10439-013-0905-4 ↗
78. Numerical simulation of non-Newtonian blood flow dynamics in human thoracic aorta10.1080/10255842.2014.887698 ↗
79. Simulation of blood flow in human aorta with emphasis on outlet boundary conditions10.1016/j.apm.2010.12.022 ↗
80. Inflow boundary conditions for image-based computational hemodynamics: Impact of idealized versus measured velocity profiles in the human aorta10.1016/j.jbiomech.2012.10.012 ↗
81. Youssefi, P., Gomez, A., Arthurs, C., Sharma, R., Jahangiri, M., and Alberto Figueroa, C. (2018). Impact of Patient-Specific Inflow Velocity Profile on Hemodynamics of the Thoracic Aorta. J. Biomech. Eng., 140.10.1115/1.4037857 ↗
82. On the Use of In Vivo Measured Flow Rates as Boundary Conditions for Image-Based Hemodynamic Models of the Human Aorta: Implications for Indicators of Abnormal Flow10.1007/s10439-011-0431-1 ↗
83. The impact of the aortic valve impairment on the distant coronary arteries hemodynamics: A fluid–structure interaction study10.1007/s11517-017-1636-8 ↗
84. Aortic flow patterns before and after personalised external aortic root support implantation in Marfan patients10.1016/j.jbiomech.2015.11.040 ↗
85. Computational study of aortic hemodynamics for patients with an abnormal aortic valve: The importance of secondary flow at the ascending aorta inlet10.1063/1.5011960 ↗
86. Evaluation of a fictitious domain method for predicting dynamic response of mechanical heart valves10.1016/j.jfluidstructs.2004.04.007 ↗
87. Computational Fluid Dynamics Assessment Associated with Transcatheter Heart Valve Prostheses: A Position Paper of the ISO Working Group10.1007/s13239-018-0349-y ↗
88. Time-resolved three-dimensional magnetic resonance velocity mapping of aortic flow in healthy volunteers and patients after valve-sparing aortic root replacement10.1016/j.jtcvs.2004.08.056 ↗
89. Comparison of flow patterns in ascending aortic aneurysms and volunteers using four-dimensional magnetic resonance velocity mapping10.1002/jmri.21082 ↗
90. Effect of non-Newtonian and pulsatile blood flow on mass transport in the human aorta10.1016/j.jbiomech.2011.01.024 ↗
91. A numerical study on the flow of blood and the transport of LDL in the human aorta: The physiological significance of the helical flow in the aortic arch10.1152/ajpheart.00266.2009 ↗
92. Effect of spiral flow on the transport of oxygen in the aorta: A numerical study10.1007/s10439-009-9878-8 ↗
93. Effect of swirling flow on platelet concentration distribution in small-caliber artificial grafts and end-to-end anastomoses10.1007/s10409-011-0486-0 ↗
94. A new imaging method for assessment of aortic dissection using four-dimensional phase contrast magnetic resonance imaging10.1016/j.jvs.2011.11.005 ↗
95. Helical and retrograde secondary flow patterns in the aortic arch studied by three-directional magnetic resonance velocity mapping10.1161/01.CIR.88.5.2235 ↗
96. Oechtering, T.H., Sieren, M.M., Hunold, P., Hennemuth, A., Huellebrand, M., Scharfschwerdt, M., Richardt, D., Sievers, H.-H., Barkhausen, J., and Frydrychowicz, A. (2019). Time-resolved 3-dimensional magnetic resonance phase contrast imaging (4D Flow MRI) reveals altered blood flow patterns in the ascending aorta of patients with valve-sparing aortic root replacement. J. Thorac. Cardiovasc. Surg.10.1016/j.jtcvs.2019.02.127 ↗
97. Hemodynamic Evaluation of a Biological and Mechanical Aortic Valve Prosthesis Using Patient-Specific MRI-Based CFD10.1111/aor.12955 ↗
98. Influence of Bicuspid Valve Geometry on Ascending Aortic Fluid Dynamics: A Parametric Study10.1111/j.1525-1594.2011.01356.x ↗
99. Fluid Mechanics of Heart Valves and Their Replacements10.1146/annurev-fluid-122414-034314 ↗
100. Physiological vortices in the sinuses of Valsalva: An in vitro approach for bio-prosthetic valves10.1016/j.jbiomech.2016.05.027 ↗