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research-article

Fluid-Structure Interaction Models of Bicuspid Aortic Valves: The Effects of Non-Fused Cusp Angles

[+] Author and Article Information
Karin Lavon

School of Mechanical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
karinlavon@gmail.com

Rotem Halevi

School of Mechanical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
halevi.rotem@gmail.com

Gil Marom

Biomedical Engineering Department, Stony Brook University, 11794, NY, USA
gilmarom@gmail.com

Sagit Ben Zekry

Echocardiography Laboratory, Chaim Sheba Medical Center, Tel Hashomer, 52621, Israel
Sagit.Benzekry@sheba.health.gov.il

Ashraf Hamdan

Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel
hamdashraf@gmail.com

Hans Joachim Schäfers

Department of Thoracic and Cardiovascular Surgery, University Hospitals of Saarland, Homburg, Germany
h-j.schaefers@uniklinikum-saarland.de

Ehud Raanani

Department of Cardio- thoracic Surgery, Chaim Sheba Medical Center, Tel Hashomer, 52621, Israel
Ehud.Raanani@sheba.health.gov.il

Rami Haj-Ali

School of Mechanical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
rami98@tau.ac.il

1Corresponding author.

ASME doi:10.1115/1.4038329 History: Received March 20, 2017; Revised October 16, 2017

Abstract

Bicuspid aortic valve (BAV) is the most common type of congenital heart disease, occurring in 0.5-2% of the population, where the valve has only two rather than the three normal cusps. Valvular pathologies, such as aortic regurgitation and aortic stenosis, are associated with BAVs, thereby increasing the need for a better understanding of BAV kinematics and geometrical characteristics. The aim of this study is to investigate the influence of the non-fused cusp (NFC) angle in BAV type-1 configuration on the valve's structural and hemodynamic performance. Towards that goal, a parametric fluid-structure interaction (FSI) modeling approach of BAVs is presented. Four FSI models were generated with varying NFC angles between 120° and 180°. The FSI simulations were based on fully-coupled structural and fluid dynamic solvers and corresponded to physiologic values, including the anisotropic hyper-elastic behavior of the tissue. The simulated angles led to different mechanical behavior, such as eccentric jet flow direction with a wider opening shape that was found for the smaller NFC angles, while a narrower opening orifice followed by increased jet flow velocity was observed for the larger NFC angles. Smaller NFC angles led to higher concentrated flow shear stress on the NFC during peak systole, while higher maximal principal stresses were found in the raphe region during diastole. The proposed biomechanical models could explain the early failure of BAVs with decreased NFC angles, and suggests that a larger NFC angle is preferable in suture annuloplasty BAV repair surgery.

Copyright (c) 2017 by ASME
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