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Fluid–structure interaction modeling of calcific aortic valve disease using patient-specific three-dimensional calcification scans

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Abstract

Calcific aortic valve disease (CAVD) is characterized by calcification accumulation and thickening of the aortic valve cusps, leading to stenosis. The importance of fluid flow shear stress in the initiation and regulation of CAVD progression is well known and has been studied recently using fluid–structure interaction (FSI) models. While cusp calcifications are three-dimensional (3D) masses, previously published FSI models have represented them as either stiffened or thickened two-dimensional (2D) cusps. This study investigates the hemodynamic effect of these calcifications employing FSI models using 3D patient-specific calcification masses. A new reverse calcification technique (RCT) is used for modeling different stages of calcification growth based on the spatial distribution of calcification density. The RCT is applied to generate the 3D calcification deposits reconstructed from a patient-specific CT scans. Our results showed that consideration of 3D calcification deposits led to both higher fluid shear stresses and unique fluid shear stress distribution on the aortic side of the cusps that may have an impact on the calcification growth rate. However, the flow did not seem to affect the geometry of the calcification during the growth phase.

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Acknowledgments

This work was partially supported by grants from the Nicholas and Elizabeth Slezak Super Center for Cardiac Research and Biomedical Engineering at Tel Aviv University, Seymour Pyper Research Fund at Sheba Medical Center, and National Institutes of Health: NIBIB Quantum Award: Implementation Phase II U01 EB012487-0.

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Authors and Affiliations

  1. The Fleischman Faculty of Engineering, School of Mechanical Engineering, Tel Aviv University, 69978, Tel Aviv, Ramat Aviv, Israel

    Rotem Halevi, Karin Lavon & Rami Haj-Ali

  2. Cardiothoracic Surgery Department, Chaim Sheba Medical Center, 52621, Tel Hashomer, Israel

    Ehud Raanani

  3. Nuclear Cardiology Unit, Heart Institute, Chaim Sheba Medical Center, 52621, Tel Hashomer, Israel

    Ashraf Hamdan & Sagit Ben-Zekry

  4. Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11794, USA

    Gil Marom & Danny Bluestein

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  1. Rotem Halevi
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Correspondence to Rami Haj-Ali.

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Halevi, R., Hamdan, A., Marom, G. et al. Fluid–structure interaction modeling of calcific aortic valve disease using patient-specific three-dimensional calcification scans. Med Biol Eng Comput 54, 1683–1694 (2016). https://doi.org/10.1007/s11517-016-1458-0

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