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Spatiotemporal Complexity of the Aortic Sinus Vortex as a Function of Leaflet Calcification

  • Hoda Hatoum
  • Lakshmi Prasad DasiEmail author
Article
  • 53 Downloads

Abstract

Several studies have shown the variation of aortic sinus structures’ hemodynamics with different flow and geometric characteristics. They have also correlated aortic sinus hemodynamics with the progression and evolution of calcific aortic valve disease (CAVD). This study aims at visualizing aortic sinus fluid structure variations as functions of different leaflet calcification degrees and assessing their potential relationship with CAVD. A degenerated 23 mm Carpentier-Edwards Perimount Magna valve extracted from a redo-surgery patient was implanted in an aortic root model and tested in a pulse duplicator left heart simulator. The valve has 3 leaflets with 3 different levels of calcium distribution: mild, moderate and severe. High-speed imaging and particle image velocimetry were performed to assess sinus vortices, leaflet tip position and velocity along with shear stress. Results have shown that (a) aortic sinus vortices initiation, entrapment and evolution varied with different calcified leaflet exposure; (b) higher velocities in the sinus were calculated with the mildly calcified leaflet compared to the moderately and severely calcified ones; (c) during systole, the mildly calcified leaflet sinus case shows the most spread-out and higher ranges of shear stress probabilities and highest magnitudes going from (− 1.5 to + 1.8 Pa) compared with (− 1.0 to + 1.0 Pa) for moderately and severely calcified leaflets. The higher the calcification degree the lower the shear stress range and likelihoods of having higher shear stress. This holds in diastole as well. This study shows the impact of calcification on the aortic sinus flow structures.

Keywords

Calcific aortic valve disease CAVD Sinus hemodynamics Aortic sinus vortex Shear stress 

Notes

Conflict of interest

Dr. Dasi reports having a patent application filed on novel polymeric valves, vortex generators and superhydrophobic surfaces.

Funding

The research done was partly supported by National Institutes of Health (NIH) under Award Number R01HL119824.

Supplementary material

Video 1: Streak plots of the 3 different sinuses throughout the cardiac cycle. Supplementary material 1 (MP4 3787 kb)

Video 2: En-face imaging of the valve throughout the cardiac cycle. Supplementary material 2 (MP4 4031 kb)

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Copyright information

© Biomedical Engineering Society 2019

Authors and Affiliations

  1. 1.Department of Biomedical EngineeringThe Ohio State UniversityColumbusUSA
  2. 2.Division of Cardiac SurgeryThe Ohio State UniversityColumbusUSA

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