Hemodynamic study of the effect of the geometric height of leaflets on the performance of the aortic valve under aortic valve reconstruction

Xinrui Ma; Bin Gao; Liang Tao; Jinli Ding; Shu Li; Aike Qiao; Yu Chang

doi:10.21037/jtd-22-425

Hemodynamic study of the effect of the geometric height of leaflets on the performance of the aortic valve under aortic valve reconstruction

J Thorac Dis. 2022 May;14(5):1515-1525. doi: 10.21037/jtd-22-425.

Authors

Xinrui Ma¹, Bin Gao¹, Liang Tao², Jinli Ding³, Shu Li⁴, Aike Qiao¹, Yu Chang⁵

Affiliations

¹ Faculty of Environment and Life, Beijing University of Technology, Beijing, China.
² Department of Cardiovascular Surgery, Wuhan Asia Heart Hospital, Wuhan, China.
³ Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
⁴ Optical Electromechanical Laboratory, National Institutes for Food and Drug Control Institute for Medical Device Control, Beijing, China.
⁵ National Clinical Research Center for Child Health, The Children's Hospital Zhejiang University School of Medicine, Hangzhou, China.

Abstract

Background: Although aortic valve reconstruction has become an alternative treatment for aortic valve disease, the design of the geometric parameters of the reconstructed leaflet still mainly depends on the experience of doctors. The present study investigates the effects of the height of the leaflets on the performance and biomechanical states of the reconstructed aortic valve.

Methods: This numerical study was carried out using the finite element approach and the lattice Boltzmann method. The dynamic and biomechanical characteristics of the leaflets were evaluated by using the finite element approach, while the blood flow in the aortic sinus was evaluated by applying the lattice Boltzmann method. Three types of leaflets with different heights were designed. Then the dynamic characteristics, stress distribution, and effective orifice area (EOA) of the aortic valve and flow pattern were calculated as the indicators.

Results: The results demonstrated that the height of the leaflets could indeed regulate the performance and the biomechanical states of the aortic valve. The rapid valve opening times of the 3 types of leaflets gradually reduced along with the decrease of the height ratio (HR_0.8: 120 ms vs. HR_1.0: 68 ms vs. HR_1.2: 31 ms), while the rapid valve closing times (RVCTs) of the 3 types of leaflets were similar to each other (approximately 75 ms). Moreover, the radial displacement of the leaflet at the fully open time increased along with the decrease of the HR of the leaflets (HR_0.8: 8 mm vs. HR_1.0: 6 mm vs. HR_1.2: 4 mm). In addition, the stress level of the leaflets also increased with the increase of the height of the leaflets (max stress, HR_0.8: 0.5 MPa, vs. HR_1.0: 1.1 MPa, vs. HR_1.2: 1.8 MPa). Similarly, the low velocity region near the ascending aortic wall and the wall shear stress (WSS) level on the ventricular side of the leaflets also increased along with the increase of the HR of the leaflets.

Conclusions: In short, the height of the leaflets mainly affects the opening performance of the reconstructed aortic leaflets. The HR of the reconstructed leaflets for adults should be less than 1.0 to balance the opening and closing performance of aortic leaflets.

Keywords: Aortic valve reconstruction; biomechanics; fluid-structure interaction; hemodynamics; lattice Boltzmann method.