Simulation of personalised haemodynamics by various mounting positions of a prosthetic valve using computational fluid dynamics

2019 ◽  
Vol 64 (2) ◽  
pp. 147-156 ◽  
Author(s):  
Markus Bongert ◽  
Marius Geller ◽  
Werner Pennekamp ◽  
Volkmar Nicolas
Keyword(s):  
Blood Flow ◽  
Aortic Valve ◽  
Three Dimensional ◽  
Maximum Velocity ◽  
Heart Valve Disease ◽  
Patient Specific ◽  
Opening Angle ◽  
The European Union ◽  
Prosthetic Valves ◽  
Magnetic Resonance Imaging Mri

Abstract Diseases of the cardiovascular system account for nearly 42% of all deaths in the European Union. In Germany, approximately 12,000 patients receive surgical replacement of the aortic valve due to heart valve disease alone each year. A three-dimensional (3D) numerical model based on patient-specific anatomy derived from four-dimensional (4D) magnetic resonance imaging (MRI) data was developed to investigate preoperatively the flow-induced impact of mounting positions of aortic prosthetic valves to select the best orientation for individual patients. Systematic steady-state analysis of blood flow for different rotational mounting positions of the valve is only possible using a virtual patient model. A maximum velocity of 1 m/s was used as an inlet boundary condition, because the opening angle of the valve is at its largest at this velocity. For a comparative serial examination, it is important to define the standardised general requirements to avoid impacts other than the rotated implantation of the prosthetic aortic valve. In this study, a uniform velocity profile at the inlet for the inflow of the aortic valve and the real aortic anatomy were chosen for all simulations. An iterative process, with the weighted parameters flow resistance (1), shear stress (2) and velocity (3), was necessary to determine the best rotated orientation. Blood flow was optimal at a 45° rotation from the standard implantation orientation, which will offer a supply to the coronary arteries.

scholarly journals Image-Guided Fluid-Structure Interaction Simulation of Transvalvular Hemodynamics: Quantifying the Effects of Varying Aortic Valve Leaflet Thickness

Fluids ◽  
2019 ◽  
Vol 4 (3) ◽  
pp. 119 ◽  
Author(s):  
Anvar Gilmanov ◽  
Alexander Barker ◽  
Henryk Stolarski ◽  
Fotis Sotiropoulos
Keyword(s):  
Blood Flow ◽  
Aortic Valve ◽  
Heart Valve ◽  
Fluid Structure Interaction ◽  
Maximum Velocity ◽  
Patient Specific ◽  
Hemodynamic Parameters ◽  
Orifice Area ◽  
Fluid Structure ◽  
Structure Interaction

When flow-induced forces are altered at the blood vessel, maladaptive remodeling can occur. One reason such remodeling may occur has to do with the abnormal functioning of the aortic heart valve due to disease, calcification, injury, or an improperly-designed prosthetic valve, which restricts the opening of the valve leaflets and drastically alters the hemodynamics in the ascending aorta. While the specifics underlying the fundamental mechanisms leading to changes in heart valve function may differ from one cause to another, one common and important change is in leaflet stiffness and/or mass. Here, we examine the link between valve stiffness and mass and the hemodynamic environment in aorta by coupling magnetic resonance imaging (MRI) with high-resolution fluid–structure interaction (FSI) computational fluid dynamics to simulate blood flow in a patient-specific model. The thoracic aorta and a native aortic valve were re-constructed in the FSI model from the MRI data and used for the simulations. The effect of valve stiffness and mass is parametrically investigated by varying the thickness (h) of the leaflets (h = 0.6, 2, 4 mm). The FSI simulations were designed to investigate systematically progressively higher levels of valve stiffness by increasing valve thickness and quantifying hemodynamic parameters known to be linked to aortopathy and valve disease. The computed results reveal dramatic differences in all hemodynamic parameters: (1) the geometric orifice area (GOA), (2) the maximum velocity V max of the jet passing through the aortic orifice area, (3) the rate of energy dissipation E ˙ diss ( t ) , (4) the total loss of energy E diss , (5) the kinetic energy of the blood flow E kin ( t ) , and (6) the average magnitude of vorticity Ω a ( t ) , illustrating the change in hemodynamics that occur due to the presence of aortic valve stenosis.

Impact of Patient-Specific Inflow Velocity Profile on Hemodynamics of the Thoracic Aorta

2017 ◽  
Vol 140 (1) ◽  
Author(s):  
Pouya Youssefi ◽  
Alberto Gomez ◽  
Christopher Arthurs ◽  
Rajan Sharma ◽  
Marjan Jahangiri ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Thoracic Aorta ◽  
Complex Structure ◽  
Three Dimensional ◽  
Velocity Profiles ◽  
Patient Specific ◽  
Inflow Velocity ◽  
Valvular Stenosis ◽  
Computational Fluid Dynamics Cfd ◽  
Magnetic Resonance Imaging Mri

Computational fluid dynamics (CFD) provides a noninvasive method to functionally assess aortic hemodynamics. The thoracic aorta has an anatomically complex inlet comprising of the aortic valve and root, which is highly prone to different morphologies and pathologies. We investigated the effect of using patient-specific (PS) inflow velocity profiles compared to idealized profiles based on the patient's flow waveform. A healthy 31 yo with a normally functioning tricuspid aortic valve (subject A), and a 52 yo with a bicuspid aortic valve (BAV), aortic valvular stenosis, and dilated ascending aorta (subject B) were studied. Subjects underwent MR angiography to image and reconstruct three-dimensional (3D) geometric models of the thoracic aorta. Flow-magnetic resonance imaging (MRI) was acquired above the aortic valve and used to extract the patient-specific velocity profiles. Subject B's eccentric asymmetrical inflow profile led to highly complex velocity patterns, which were not replicated by the idealized velocity profiles. Despite having identical flow rates, the idealized inflow profiles displayed significantly different peak and radial velocities. Subject A's results showed some similarity between PS and parabolic inflow profiles; however, other parameters such as Flowasymmetry were significantly different. Idealized inflow velocity profiles significantly alter velocity patterns and produce inaccurate hemodynamic assessments in the thoracic aorta. The complex structure of the aortic valve and its predisposition to pathological change means the inflow into the thoracic aorta can be highly variable. CFD analysis of the thoracic aorta needs to utilize fully PS inflow boundary conditions in order to produce truly meaningful results.

Modeling of aortic valve stenosis using fluid-structure interaction method

Perfusion ◽  
2021 ◽  
pp. 026765912199854
Author(s):  
Mohammad Javad Ghasemi Pour ◽  
Kamran Hassani ◽  
Morteza Khayat ◽  
Shahram Etemadi Haghighi
Keyword(s):  
Blood Flow ◽  
Aortic Valve ◽  
Fluid Structure Interaction ◽  
Three Dimensional ◽  
Fluid Structure ◽  
Structure Interaction ◽  
Relaxation Phase ◽  
Exercise Condition ◽  
Time Dependent Domain ◽  
Comparison Of The Results

Background and objectives: Fluid structure interaction (FSI) is defined as interaction of the structures with contacting fluids. The aortic valve experiences the interaction with blood flow in systolic phase. In this study, we have tried to predict the hemodynamics of blood flow through a normal and stenotic aortic valve in two relaxation and exercise conditions using a three-dimensional FSI method. Methods: The aorta valve was modeled as a three-dimensional geometry including a normal model and two others with 25% and 50% stenosis. The geometry of the aortic valve was extracted from CT images and the models were generated by MMIMCS software and then they were implemented in ANSYS software. The pulsatile flow rate was used for all cases and the numerical simulations were conducted based on a time-dependent domain. Results: The obtained results including the velocity, pressure, and shear stress contours in different systolic time sequences were explained and discussed. The maximum blood flow velocity in relaxation phase was obtained 1.62 m/s (normal valve), 3.78 m/s (25% stenosed valve), and 4.73 m/s (50% stenosed valve). In exercise condition, the maximum velocities are 2.86, 4.32, and 5.42 m/s respectively. The maximum blood pressure in relaxation phase was calculated 111.45 mmHg (normal), 148.66 mmHg (25% stenosed), and 164.21 mmHg (50% stenosed). However, the calculated values in exercise situation were 129.57, 163.58, and 191.26 mmHg. The validation of the predicted results was also conducted using existing literature. Conclusions: We believe that such model are useful tools for biomechanical experts. The further studies should be done using experimental data and the data are implemented on the boundary conditions for better comparison of the results.

scholarly journals P1526 Updated prevalence of lambls excrescences using the latest three-dimensional transesophageal echocardiography

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
T Takahashi ◽  
K Kusunose ◽  
S Hayashi ◽  
S Morita ◽  
Y Torii ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Transesophageal Echocardiography ◽  
Severe Aortic Stenosis ◽  
Cryptogenic Stroke ◽  
Three Dimensional ◽  
Poor Quality ◽  
Prosthetic Valves ◽  
And Gender ◽  
Right Coronary Cusp

Abstract Background Lambl’s excrescences (LEs), filiform strands that occur at sites of cardiac valves, have been suggested the cause cryptogenic stroke. The diagnosis is primarily based upon the echocardiographic study, but conventional two-dimensional transthoracic echocardiography has limitation to detect such as small strands. Latest three dimensional-transesophageal echocardiography (3D-TEE) have high-resolution images with many slices, so small structures are able to be clearly visible and detected. Purpose The aim of this study was to assess the prevalence of LEs using the latest 3D-TEE images. Methods We retrospectively reviewed consecutive 140 patients who underwent 3D-TEE from November 2018 to May 2019. Forty-seven patients were excluded due to unmeasurable, such as mitral valve prolapse, severe aortic stenosis, prosthetic valves and poor-quality images. We carefully evaluated the mitral and aortic valve leaflets in order to find mobile string structure (diameter <1 mm and length 1–20 mm) in each cardiac cycle. Total analyzed images were over 50 slices per one patient. Results Among 93 patients, 83 patients (89%) was detected the presence of LEs. No difference in age and gender were found between patients with LEs and patients without LEs. Of the total 83 patients, there were 35 patients with strands on mitral valve, 32 patients with strands on aortic valve, and 16 patients with strands on both valves. Distribution of LEs at each valve leaflet were shown in Figure. Right coronary cusp of aortic valve (42%) and P2 of mitral valve (35%) were high prevalence among leaflets. Conclusions 3D-TEE provides an update prevalence of LEs. The prevalence of LEs might be potentially high in the real world. Abstract P1526 Figure.

PATIENT-SPECIFIC SIMULATION MODEL TO RESEARCH THE IMPACT OF AORTIC VALVE PROSTHESES ON BLOOD FLOW

2008 ◽  
Vol 41 ◽  
pp. S242
Author(s):  
Markus Bongert ◽  
Marius Geller ◽  
Werner Pennekamp ◽  
Daniela Roggenland ◽  
Volkmar Nicolas
Keyword(s):  
Blood Flow ◽  
Aortic Valve ◽  
Simulation Model ◽  
Patient Specific ◽  
Valve Prostheses ◽  
The Impact

Does the DSA reconstruction kernel affect hemodynamic predictions in intracranial aneurysms? An analysis of geometry and blood flow variations

2017 ◽  
Vol 10 (3) ◽  
pp. 290-296 ◽  
Author(s):  
P Berg ◽  
S Saalfeld ◽  
S Voß ◽  
T Redel ◽  
B Preim ◽  
...  
Keyword(s):  
Blood Flow ◽  
Intracranial Aneurysms ◽  
Three Dimensional ◽  
Patient Specific ◽  
Parent Artery ◽  
Imaging Data ◽  
Specific Flow ◽  
Aneurysm Neck ◽  
Velocity Magnitude ◽  
Reconstruction Kernel

BackgroundComputational fluid dynamics (CFD) blood flow predictions in intracranial aneurysms promise great potential to reveal patient-specific flow structures. Since the workflow from image acquisition to the final result includes various processing steps, quantifications of the individual introduced potential error sources are required.MethodsThree-dimensional (3D) reconstruction of the acquired imaging data as input to 3D model generation was evaluated. Six different reconstruction modes for 3D digital subtraction angiography (DSA) acquisitions were applied to eight patient-specific aneurysms. Segmentations were extracted to compare the 3D luminal surfaces. Time-dependent CFD simulations were carried out in all 48 configurations to assess the velocity and wall shear stress (WSS) variability due to the choice of reconstruction kernel.ResultsAll kernels yielded good segmentation agreement in the parent artery; deviations of the luminal surface were present at the aneurysm neck (up to 34.18%) and in distal or perforating arteries. Observations included pseudostenoses as well as noisy surfaces, depending on the selected reconstruction kernel. Consequently, the hemodynamic predictions show a mean SD of 11.09% for the aneurysm neck inflow rate, 5.07% for the centerline-based velocity magnitude, and 17.83%/9.53% for the mean/max aneurysmal WSS, respectively. In particular, vessel sections distal to the aneurysms yielded stronger variations of the CFD values.ConclusionsThe choice of reconstruction kernel for DSA data influences the segmentation result, especially for small arteries. Therefore, if precise morphology measurements or blood flow descriptions are desired, a specific reconstruction setting is required. Furthermore, research groups should be encouraged to denominate the kernel types used in future hemodynamic studies.

scholarly journals Two-Phase Non-Newtonian Pulsatile Blood Flow Simulations in a Rigid and Flexible Patient-Specific Left Coronary Artery (LCA) Exhibiting Multi-Stenosis

2021 ◽  
Vol 11 (23) ◽  
pp. 11361
Author(s):  
Abdulgaphur Athani ◽  
Nik Nazri Nik Ghazali ◽  
Irfan Anjum Badruddin ◽  
Abdullah Y. Usmani ◽  
Sarfaraz Kamangar ◽  
...  
Keyword(s):  
Blood Flow ◽  
Coronary Artery ◽  
Left Coronary Artery ◽  
Solid Wall ◽  
Three Dimensional ◽  
Patient Specific ◽  
Maximum Pressure ◽  
Three Dimensional Model ◽  
Two Phase ◽  
Pressure Drops

Coronary artery disease (CAD) is stated as one of the most common causes of death all over the world. This article explores the influence of multi stenosis in a flexible and rigid left coronary artery (LCA) model using a multiphase blood flow system which has not yet been studied. Two-way fluid–solid interaction (FSI) is employed to achieve flow within the flexible artery model. A realistic three-dimensional model of multi-stenosed LCA was reconstructed based on computerized tomography (CT) images. The fluid domain was solved using a finite volume-based commercial software (FLUENT 2020). The fluid (blood) and solid (wall) domains were fully coupled by using the ANSYS Fluid-Structure Interaction solver. The maximum pressure drops, and wall shear stress was determined across the sever stenosis (90% AS). The higher region of displacement occurs at the pre-stenosis area compared to the other area of the left coronary artery model. An increase in blood flow velocity across the restricted regions (stenosis) in the LCA was observed, whereas the recirculation zone at the post-stenosis and bifurcation regions was noted. An overestimation of hemodynamic descriptors for the rigid models was found as compared to the FSI models.

scholarly journals Patient-Specific Aortic Phantom With Tunable Compliance

2019 ◽  
Vol 2 (4) ◽  
Author(s):  
Antonio Gallarello ◽  
Andrea Palombi ◽  
Giacomo Annio ◽  
Shervanthi Homer-Vanniasinkam ◽  
Elena De Momi ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Computational Models ◽  
Three Dimensional ◽  
Complex Interventions ◽  
Patient Specific ◽  
Arch Model ◽  
Magnetic Resonance Imaging Mri ◽  
Variable Wall ◽  
Silicone Model

Abstract Validation of computational models using in vitro phantoms is a nontrivial task, especially in the replication of the mechanical properties of the vessel walls, which varies with age and pathophysiological state. In this paper, we present a novel aortic phantom reconstructed from patient-specific data with variable wall compliance that can be tuned without recreating the phantom. The three-dimensional (3D) geometry of an aortic arch was retrieved from a computed tomography angiography scan. A rubber-like silicone phantom was manufactured and connected to a compliance chamber in order to tune its compliance. A lumped resistance was also coupled with the system. The compliance of the aortic arch model was validated using the Young's modulus and characterized further with respect to clinically relevant indicators. The silicone model demonstrates that compliance can be finely tuned with this system under pulsatile flow conditions. The phantom replicated values of compliance in the physiological range. Both, the pressure curves and the asymmetrical behavior of the expansion, are in agreement with the literature. This novel design approach allows obtaining for the first time a phantom with tunable compliance. Vascular phantoms designed and developed with the methodology proposed in this paper have high potential to be used in diverse conditions. Applications include training of physicians, pre-operative trials for complex interventions, testing of medical devices for cardiovascular diseases (CVDs), and comparative Magnetic-resonance-imaging (MRI)-based computational studies.

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