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Influence of aortic valve morphology on vortical structures and wall shear stress

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Abstract

The aim of this paper is to assess the association between valve morphology and vortical structures quantitatively and to highlight the influence of valve morphology/orientation on aorta’s susceptibility to shear stress, both proximal and distal. Four-dimensional phase-contrast magnetic resonance imaging (4D PCMRI) data of 6 subjects, 3 with tricuspid aortic valve (TAV) and 3 with functionally bicuspid aortic values (BAV) with right-left coronary leaflet fusion, were processed and analyzed for vorticity and wall shear stress trends. Computational fluid dynamics (CFD) has been used with moving TAV and BAV valve designs in patient-specific aortae to compare with in vivo shear stress data. Vorticity from 4D PCMRI data about the aortic centerline demonstrated that TAVs had a higher number of vortical flow structures than BAVs at peak systole. Coalescing of flow structures was shown to be possible in the arch region of all subjects. Wall shear stress (WSS) distribution from CFD results at the aortic root is predominantly symmetric for TAVs but highly asymmetric for BAVs with the region opposite the raphe (fusion location of underdeveloped leaflets) being subjected to higher WSS. Asymmetry in the size and number of leaflets in BAVs and TAVs significantly influence vortical structures and WSS in the proximal aorta for all valve types and distal aorta for certain valve orientations of BAV.

Graphical Abstract

Analysis of vortical structures using 4D PCMRI data (on the left side) and wall shear stress data using CFD (on the right side).

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Funding

The authors acknowledge the support from the Swedish Research Council, grant no. 2021–04894.

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Authors and Affiliations

  1. Department of Aerospace Engineering and Engineering Mechanics, University of Cincinnati, Cincinnati, OH, 45221, USA

    Raghuvir Jonnagiri & Ephraim Gutmark

  2. Department of Engineering Mechanics, Royal Institute of Technology, 10044, Stockholm, Sweden

    Elias Sundström

  3. Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, 45229, USA

    Shae Anderson, Michael D. Taylor & Justin T. Tretter

  4. Division of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, 45229, USA

    Amol S. Pednekar

  5. Department of Pediatrics, University of Cincinnati, Cincinnati, OH, 45267, USA

    Michael D. Taylor, Justin T. Tretter & Iris Gutmark-Little

  6. Division of Endocrinology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, 45229, USA

    Iris Gutmark-Little

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  1. Raghuvir Jonnagiri
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Contributions

All authors contributed to the study’s conception and design. Data collection and material preparation were done by Shae Anderson and Amol S. Pednekar. Modeling, simulation, and analysis were performed by Raghuvir Jonnagiri with support from Elias Sundström. The first draft of the manuscript was written by Raghuvir Jonnagiri, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Raghuvir Jonnagiri.

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Only de-identified data was used. Cincinnati Children’s Hospital Medical Center’s (CCHMC) Ethics Committee has confirmed that no ethical approval is required.

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Appendix

Appendix

Fig. 14
figure 14

Sensitivity analysis for number of flow structures as defined by vorticity direction method at peak systole. Images a, b, c, and d represent data with different threshold values of vorticities as percentage of maximum vorticity ignored as noise

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Fig. 15
figure 15

Sensitivity analysis for size of flow structures as defined by vorticity direction method at peak systole. Images a, b, c, and d represent data with different threshold values of vorticities as percentage of maximum vorticity ignored as noise

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Jonnagiri, R., Sundström, E., Gutmark, E. et al. Influence of aortic valve morphology on vortical structures and wall shear stress. Med Biol Eng Comput 61, 1489–1506 (2023). https://doi.org/10.1007/s11517-023-02790-6

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