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Effect of Aortic Wall Deformation with Healthy and Calcified Annulus on Hemodynamic Performance of Implanted On-X Valve

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Abstract

Introduction

In this research, the hemodynamic performance of a 23-mm On-X bileaflet mechanical heart valve (BMHV) was investigated with the realistic geometry model of the valve and the deformable aorta in accelerating systole. In addition, the effect of ascending aorta flexibility and aortic annulus calcification on the complex blood flow characteristics were investigated.

Methods

The geometry of the aorta is derived from the medical images, and the Ogden model has been utilized for the mechanical behavior of the ascending aorta. The 3D numerical simulation by a two-way Fluid-Structure Interaction (FSI) analysis using the Arbitrary Lagrangian–Eulerian (ALE) method was performed throughout the accelerating systolic phase.

Results

The dynamics of the leaflets are investigated, and blood flow characteristics such as velocities, vorticities as well as viscous and turbulent shear stress were precisely captured in the flow domain specifically in the hinge region. Streamline results are in accordance with the previously reported data, which show that the flared On-X valves inlet yields a more uniform flow in accelerating systole. Simulations show that aorta flexibility or valve annulus calcification causes variations up to 7% in maximum fluid velocity and 20% in Turbulence Kinetic Energy (TKE).

Conclusions

In this study, the complex flow field characteristics in the new generation of BMHVs considering aorta flexibility with healthy and calcified annulus were investigated. It was found that the blood flow around the hinges region is in the danger of hemolysis and platelet activation and subsequently thromboembolism. Furthermore, the results show that similar to vessel wall deformation, considering the probable annulus calcification after valve replacement is also essential.

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Authors and Affiliations

  1. School of Mechanical Engineering, College of Engineering, University of Tehran, Tehran, Iran

    Masod Sadipour, Pedram Hanafizadeh, Keyvan Sadeghy & Amirmohammad Sattari

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  1. Masod Sadipour
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Correspondence to Pedram Hanafizadeh.

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Appendix

Appendix

See Fig. 24, Fig.25 and Table 7.

Figure 24
figure 24

CTA images of the person with aortic On-X valve.

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Figure 25
figure 25

CTA images of the person with a healthy valve.

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Table 7 Solution methods in fluent (Spatial discretization).
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Sadipour, M., Hanafizadeh, P., Sadeghy, K. et al. Effect of Aortic Wall Deformation with Healthy and Calcified Annulus on Hemodynamic Performance of Implanted On-X Valve. Cardiovasc Eng Tech 11, 141–161 (2020). https://doi.org/10.1007/s13239-019-00453-y

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