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A Design-Based Model of the Aortic Valve for Fluid-Structure Interaction

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 Added by Alexander Kaiser
 Publication date 2020
  fields Biology
and research's language is English




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This paper presents a new method for modeling the mechanics of the aortic valve, and simulates its interaction with blood. As much as possible, the model construction is based on first principles, but such that the model is consistent with experimental observations. We require that tension in the leaflets must support a pressure, then derive a system of partial differential equations governing its mechanical equilibrium. The solution to these differential equations is referred to as the predicted loaded configuration; it includes the loaded leaflet geometry, fiber orientations and tensions needed to support the prescribed load. From this configuration, we derive a reference configuration and constitutive law. In fluid-structure interaction simulations with the immersed boundary method, the model seals reliably under physiological pressures, and opens freely over multiple cardiac cycles. Further, model closure is robust to extreme hypo- and hypertensive pressures. Then, exploiting the unique features of this model construction, we conduct experiments on reference configurations, constitutive laws, and gross morphology. These experiments suggest the following conclusions, which are directly applicable to the design of prosthetic aortic valves. (i) The loaded geometry, tensions and tangent moduli primarily determine model function. (ii) Alterations to the reference configuration have little effect if the predicted loaded configuration is identical. (iii) The leaflets must have sufficiently nonlinear material response to function over a variety of pressures. (iv) Valve performance is highly sensitive to free edge length and leaflet height. For future use, our aortic valve modeling framework offers flexibility in patient-specific models of cardiac flow.



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The aortic valve is a three-leaflet passive structure that, driven by pressure differences between the left ventricle and the aorta, opens and closes during the heartbeat to ensure the correct stream direction and flow rate. In elderly individuals or because of particular pathologies, the valve leaflets can stiffen thus impairing the valve functioning and, in turn, the pumping efficiency of the heart. Using a multi-physics left heart model accounting for the electrophysiology, the active contraction of the myocardium, the hemodynamics and the related fluid-structure-interaction, we have investigated the changes in the flow features for different severities of the aortic valve stenosis. We have found that, in addition to the increase of the transvalvular pressure drop and of the systolic jet velocity, a stenotic aortic valve significantly alters the wall shear stresses and their spatial distribution over the aortic arch and valve leaflets, which may induce a remodelling process of the ventricular myocardium. The numerical results from the multi-physics model are fully consistent with the clinical experience, thus further opening the way for computational engineering aided medical diagnostic.
This work is concerned with modeling and simulation of the mitral valve, one of the four valves in the human heart. The valve is composed of leaflets, the free edges of which are supported by a system of chordae, which themselves are anchored to the papillary muscles inside the left ventricle. First, we examine valve anatomy and present the results of original dissections. These display the gross anatomy and information on fiber structure of the mitral valve. Next, we build a model valve following a design-based methodology, meaning that we derive the model geometry and the forces that are needed to support a given load, and construct the model accordingly. We incorporate information from the dissections to specify the fiber topology of this model. We assume the valve achieves mechanical equilibrium while supporting a static pressure load. The solution to the resulting differential equations determines the pressurized configuration of the valve model. To complete the model we then specify a constitutive law based on a stress-strain relation consistent with experimental data that achieves the necessary forces computed in previous steps. Finally, using the immersed boundary method, we simulate the model valve in fluid in a computer test chamber. The model opens easily and closes without leak when driven by physiological pressures over multiple beats. Further, its closure is robust to driving pressures that lack atrial systole or are much lower or higher than normal.
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