Bicuspid aortic valve aortopathies: An hemodynamics characterization in dilated aortas. Issue 8 (11th June 2019)

• Record Type: Journal Article
• Authors: Oliveira, Diana; Rosa, Sílvia Aguiar; Tiago, Jorge; Ferreira, Rui Cruz; Agapito, Ana Figueiredo; Sequeira, Adélia
• Is Part Of: Computer methods in biomechanics and biomedical engineering. Volume 22:Issue 8(2019)
• Page Start: 815
• Page End: 826
• Publication Date: 2019-06-11
• Subjects: aortic dilation -- aorthopathy -- bicuspid aortic valve -- fluid-structure interaction; Biomechanics -- Data processing -- Periodicals; Biomedical engineering -- Periodicals; Biomechanics -- Periodicals; Biomedical Engineering -- methods -- Periodicals; Computing Methodologies -- Periodicals; 612.7
• DOI: 10.1080/10255842.2019.1597860
• Languages: English
• ISSNs: 1025-5842

Abstract

Abstract: Bicuspid aortic valve (BAV) aortopathy remains of difficult clinical management due to its heterogeneity and further assessment of related aortic hemodynamics is necessary. The aim of this study was to assess systolic hemodynamic indexes and wall stresses in patients with diverse BAV phenotypes and dilated ascending aortas. The aortic geometry was reconstructed from patient-specific images while the aortic valve was generated based on patient-specific measurements. Physiologic material properties and boundary conditions were applied and fully coupled fluid-structure interaction (FSI) analysis were conducted. Our dilated aortic models were characterized by the presence of abnormal hemodynamics with elevated degrees of flow skewness and eccentricity, regardless of BAV morphotype. Retrograde flow was also present. Both features, predicted by flow angle and flow reversal ratios, were consistently higher than those reported for non-dilated aortas. Right-handed helical flow was present, as well as elevated wall shear stress (WSS) on the outer ascending aortic wall. Our results suggest that the abnormal flow associated with BAV may play a role in aortic enlargement and progress it further on already dilated aortas.