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Journal ArticleDOI: 10.1016/J.JBIOMECH.2021.110239

Fluid-structure coupled biotransport processes in aortic valve disease.

05 Mar 2021-Journal of Biomechanics (Elsevier)-Vol. 117, pp 110239
Abstract: Biological transport processes near the aortic valve play a crucial role in calcific aortic valve disease initiation and bioprosthetic aortic valve thrombosis. Hemodynamics coupled with the dynamics of the leaflets regulate these transport patterns. Herein, two-way coupled fluid-structure interaction (FSI) simulations of a 2D bicuspid aortic valve and a 3D mechanical heart valve were performed and coupled with various convective mass transport models that represent some of the transport processes in calcification and thrombosis. Namely, five different continuum transport models were developed to study biochemicals that originate from the blood and the leaflets, as well as residence-time and flow stagnation. Low-density lipoprotein (LDL) and platelet activation were studied for their role in calcification and thrombosis, respectively. Coherent structures were identified using vorticity and Lagrangian coherent structures (LCS) for the 2D and 3D models, respectively. A very close connection between vortex structures and biochemical concentration patterns was shown where different vortices controlled the concentration patterns depending on the transport mechanism. Additionally, the relationship between leaflet concentration and wall shear stress was revealed. Our work shows that blood flow physics and coherent structures regulate the flow-mediated biological processes that are involved in aortic valve calcification and thrombosis, and therefore could be used in the design process to optimize heart valve replacement durability.

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Topics: Aortic valve calcification (70%), Aortic valve (64%), Bicuspid aortic valve (63%) ... read more
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6 results found


Open accessJournal ArticleDOI: 10.3390/MATH9070720
26 Mar 2021-
Abstract: A marked interest has recently emerged regarding the analysis of the wall shear stress (WSS) vector field topological skeleton in cardiovascular flows. Based on dynamical system theory, the WSS topological skeleton is composed of fixed points, i.e., focal points where WSS locally vanishes, and unstable/stable manifolds, consisting of contraction/expansion regions linking fixed points. Such an interest arises from its ability to reflect the presence of near-wall hemodynamic features associated with the onset and progression of vascular diseases. Over the years, Lagrangian-based and Eulerian-based post-processing techniques have been proposed aiming at identifying the topological skeleton features of the WSS. Here, the theoretical and methodological bases supporting the Lagrangian- and Eulerian-based methods currently used in the literature are reported and discussed, highlighting their application to cardiovascular flows. The final aim is to promote the use of WSS topological skeleton analysis in hemodynamic applications and to encourage its application in future mechanobiology studies in order to increase the chance of elucidating the mechanistic links between blood flow disturbances, vascular disease, and clinical observations.

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Topics: Topological skeleton (54%)

6 Citations



Journal ArticleDOI: 10.1007/S10237-021-01527-4
Abstract: The aortic valve is a highly dynamic structure characterized by a transvalvular flow that is unsteady, pulsatile, and characterized by episodes of forward and reverse flow patterns. Calcific aortic valve disease (CAVD) resulting in compromised valve function and increased pressure overload on the ventricle potentially leading to heart failure if untreated, is the most predominant valve disease. CAVD is a multi-factorial disease involving molecular, tissue and mechanical interactions. In this review, we aim at recapitulating the biomechanical loads on the aortic valve, summarizing the current and most recent research in the field in vitro, in-silico, and in vivo, and offering a clinical perspective on current strategies adopted to mitigate or approach CAVD.

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Topics: Aortic valve (68%), Ventricle (52%)

Journal ArticleDOI: 10.1016/J.JBIOMECH.2021.110773
Abstract: Aging and calcific aortic valve disease (CAVD) are the main factors leading to aortic stenosis. Both processes are accompanied by growth and remodeling pathways that play a crucial role in aortic valve pathophysiology. Herein, a computational growth and remodeling (G&R) framework was developed to investigate the effects of aging and calcification on aortic valve dynamics. Particularly, an algorithm was developed to couple the global growth and stiffening of the aortic valve due to aging and the local growth and stiffening due to calcification with the aortic valve transient dynamics. The aortic valve dynamics during baseline were validated with available data in the literature. Subsequently, the changes in aortic valve dynamic patterns during aging and CAVD progression were studied. The results revealed the patterns in geometric orifice area reduction and an increase in the valve stress during local and global growth and remodeling of the aortic valve. The proposed algorithm provides a framework to couple mechanobiology models of disease growth with tissue-scale transient structural mechanics models to study the biomechanical changes during cardiovascular disease growth and aging.

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Topics: Aortic valve (69%)

Open accessJournal ArticleDOI: 10.1016/J.CSITE.2021.101496
Yan Cao, Hamdi Ayed1, Hussein Togun2, Hussein Togun3  +5 moreInstitutions (6)
Abstract: The aim of this study is numerically to investigate the effects of local thermal non-equilibrium porous media on the melting process of paraffin with the melting temperature 33 °C . The geometry consists of a half-cylinder containing paraffin with a uniform constant temperature and an insulating wall. Also, Darcy model and buoyant force due to density changes are considered in this simulation. The effects of the presence of aluminum foam with porosity e = 0.8 , a n d 0.95 and difference temperature Δ T = 5 , 10 , a n d 15 have been studied on the melting fraction of PCM, temperature and streamlines contours and heat flux of cylinder's surface. The observations show that enhancement of porosity 0.8 to 0.9 increases the volume of PCM 11.7%, and reduces time of melting process 30.8% for Δ T = 15 . Moreover, increment of Δ T = 5 t o 15 leads to decrease time of melting process 71.8% when porosity is 0.95.

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Topics: Porous medium (54%), Porosity (53%), Metal foam (53%) ... read more

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54 results found


Open accessJournal ArticleDOI: 10.1056/NEJMOA1509233
Abstract: BackgroundA finding of reduced aortic-valve leaflet motion was noted on computed tomography (CT) in a patient who had a stroke after transcatheter aortic-valve replacement (TAVR) during an ongoing clinical trial. This finding raised a concern about possible subclinical leaflet thrombosis and prompted further investigation. MethodsWe analyzed data obtained from 55 patients in a clinical trial of TAVR and from two single-center registries that included 132 patients who were undergoing either TAVR or surgical aortic-valve bioprosthesis implantation. We obtained four-dimensional, volume-rendered CT scans along with data on anticoagulation and clinical outcomes (including strokes and transient ischemic attacks [TIAs]). ResultsReduced leaflet motion was noted on CT in 22 of 55 patients (40%) in the clinical trial and in 17 of 132 patients (13%) in the two registries. Reduced leaflet motion was detected among patients with multiple bioprosthesis types, including transcatheter and surgical bioprostheses. Therapeu...

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Topics: Aortic valve (50%)

684 Citations


Open accessJournal ArticleDOI: 10.1161/HH0801.089861
Joseph Loscalzo1Institutions (1)
Abstract: Nitric oxide (NO) was originally discovered as a vasodilator product of the endothelium. Over the last 15 years, this vascular mediator has been shown to have important antiplatelet actions as well. By activating guanylyl cyclase, inhibiting phosphoinositide 3-kinase, impairing capacitative calcium influx, and inhibiting cyclooxygenase-1, endothelial NO limits platelet activation, adhesion, and aggregation. Platelets are also an important source of NO, and this platelet-derived NO pool limits recruitment of platelets to the platelet-rich thrombus. A deficiency of bioactive NO is associated with arterial thrombosis in animal models, individuals with endothelial dysfunction, and patients with a deficiency of the extracellular antioxidant enzyme glutathione peroxidase-3. This enzyme catalyzes the reduction of hydrogen and lipid peroxides, which limits the availability of these reactive oxygen species to react with and inactivate NO. The complex biochemical reactions that underlie the function and inactivation of NO in the vasculature represent an important set of targets for therapeutic intervention for the prevention and treatment of arterial thrombotic disorders.

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Topics: Platelet activation (60%), Platelet (55%), Endothelial dysfunction (55%) ... read more

501 Citations


Journal ArticleDOI: 10.1016/J.JCP.2005.01.020
Anvar Gilmanov1, Fotis Sotiropoulos1Institutions (1)
Abstract: A numerical method is developed for solving the 3D, unsteady, incompressible Navier-Stokes equations in Cartesian domains containing immersed boundaries of arbitrary geometrical complexity moving with prescribed kinematics. The governing equations are discretized on a hybrid staggered/non-staggered grid layout using second-order accurate finite-difference formulas. The discrete equations are integrated in time via a second-order accurate dual-time-stepping, artificial compressibility iteration scheme. Unstructured, triangular meshes are employed to discretize complex immersed boundaries. The nodes of the surface mesh constitute a set of Lagrangian control points used to track the motion of the flexible body. At every instant in time, the influence of the body on the flow is accounted for by applying boundary conditions at Cartesian grid nodes located in the exterior but in the immediate vicinity of the body by reconstructing the solution along the local normal to the body surface. Grid convergence tests are carried out for the flow induced by an oscillating sphere in a cubic cavity, which show that the method is second-order accurate. The method is validated by applying it to calculate flow in a Cartesian domain containing a rigid sphere rotating at constant angular velocity as well as flow induced by a flapping wing. The ability of the method to simulate flows in domains with arbitrarily complex moving bodies is demonstrated by applying to simulate flow past an undulating fish-like body and flow past an anatomically realistic planktonic copepod performing an escape-like maneuver. euver.

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Topics: Immersed boundary method (61%), Navier–Stokes equations (56%), Flow (mathematics) (54%) ... read more

483 Citations


Open accessJournal ArticleDOI: 10.1016/J.CMA.2014.10.040
Abstract: In this paper, we develop a geometrically flexible technique for computational fluid–structure interaction (FSI). The motivating application is the simulation of tri-leaflet bioprosthetic heart valve function over the complete cardiac cycle. Due to the complex motion of the heart valve leaflets, the fluid domain undergoes large deformations, including changes of topology. The proposed method directly analyzes a spline-based surface representation of the structure by immersing it into a non-boundary-fitted discretization of the surrounding fluid domain. This places our method within an emerging class of computational techniques that aim to capture geometry on non-boundary-fitted analysis meshes. We introduce the term “immersogeometric analysis” to identify this paradigm. The framework starts with an augmented Lagrangian formulation for FSI that enforces kinematic constraints with a combination of Lagrange multipliers and penalty forces. For immersed volumetric objects, we formally eliminate the multiplier field by substituting a fluid–structure interface traction, arriving at Nitsche’s method for enforcing Dirichlet boundary conditions on object surfaces. For immersed thin shell structures modeled geometrically as surfaces, the tractions from opposite sides cancel due to the continuity of the background fluid solution space, leaving a penalty method. Application to a bioprosthetic heart valve, where there is a large pressure jump across the leaflets, reveals shortcomings of the penalty approach. To counteract steep pressure gradients through the structure without the conditioning problems that accompany strong penalty forces, we resurrect the Lagrange multiplier field. Further, since the fluid discretization is not tailored to the structure geometry, there is a significant error in the approximation of pressure discontinuities across the shell. This error becomes especially troublesome in residual-based stabilized methods for incompressible flow, leading to problematic compressibility at practical levels of refinement. We modify existing stabilized methods to improve performance. To evaluate the accuracy of the proposed methods, we test them on benchmark problems and compare the results with those of established boundary-fitted techniques. Finally, we simulate the coupling of the bioprosthetic heart valve and the surrounding blood flow under physiological conditions, demonstrating the effectiveness of the proposed techniques in practical computations.

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Topics: Augmented Lagrangian method (58%), Fluid–structure interaction (58%), Penalty method (57%) ... read more

315 Citations


Open accessJournal ArticleDOI: 10.1016/J.JCP.2007.02.017
Liang Ge1, Fotis Sotiropoulos1Institutions (1)
Abstract: A novel numerical method is developed that integrates boundary-conforming grids with a sharp interface, immersed boundary methodology. The method is intended for simulating internal flows containing complex, moving immersed boundaries such as those encountered in several cardiovascular applications. The background domain (e.g. the empty aorta) is discretized efficiently with a curvilinear boundary-fitted mesh while the complex moving immersed boundary (say a prosthetic heart valve) is treated with the sharp-interface, hybrid Cartesian/immersed-boundary approach of Gilmanov and Sotiropoulos [A. Gilmanov, F. Sotiropoulos, A hybrid cartesian/immersed boundary method for simulating flows with 3d, geometrically complex, moving bodies, Journal of Computational Physics 207 (2005) 457-492.]. To facilitate the implementation of this novel modeling paradigm in complex flow simulations, an accurate and efficient numerical method is developed for solving the unsteady, incompressible Navier-Stokes equations in generalized curvilinear coordinates. The method employs a novel, fully-curvilinear staggered grid discretization approach, which does not require either the explicit evaluation of the Christoffel symbols or the discretization of all three momentum equations at cell interfaces as done in previous formulations. The equations are integrated in time using an efficient, second-order accurate fractional step methodology coupled with a Jacobian-free, Newton-Krylov solver for the momentum equations and a GMRES solver enhanced with multigrid as preconditioner for the Poisson equation. Several numerical experiments are carried out on fine computational meshes to demonstrate the accuracy and efficiency of the proposed method for standard benchmark problems as well as for unsteady, pulsatile flow through a curved, pipe bend. To demonstrate the ability of the method to simulate flows with complex, moving immersed boundaries we apply it to calculate pulsatile, physiological flow through a mechanical, bileaflet heart valve mounted in a model straight aorta with an anatomical-like triple sinus.

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Topics: Immersed boundary method (65%), Multigrid method (58%), Navier–Stokes equations (56%) ... read more

307 Citations