title: Fluid-structure interaction modeling of calcific aortic valve disease using patient-specific three-dimensional calcification scans.
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.
authors.affiliation: The Fleischman Faculty of Engineering, School of Mechanical Engineering, Tel Aviv University, 69978, Tel Aviv, Ramat Aviv, Israel.
authors.forename: Rotem
authors.initials: R
authors.lastname: Halevi
authors.affiliation: Nuclear Cardiology Unit, Heart Institute, Chaim Sheba Medical Center, 52621, Tel Hashomer, Israel.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Hamdan
authors.affiliation: Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11794, USA.
authors.forename: Gil
authors.initials: G
authors.lastname: Marom
authors.affiliation: The Fleischman Faculty of Engineering, School of Mechanical Engineering, Tel Aviv University, 69978, Tel Aviv, Ramat Aviv, Israel.
authors.forename: Karin
authors.initials: K
authors.lastname: Lavon
authors.affiliation: Nuclear Cardiology Unit, Heart Institute, Chaim Sheba Medical Center, 52621, Tel Hashomer, Israel.
authors.forename: Sagit
authors.initials: S
authors.lastname: Ben-Zekry
authors.affiliation: Cardiothoracic Surgery Department, Chaim Sheba Medical Center, 52621, Tel Hashomer, Israel.
authors.forename: Ehud
authors.initials: E
authors.lastname: Raanani
authors.affiliation: Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, 11794, USA.
authors.forename: Danny
authors.initials: D
authors.lastname: Bluestein
authors.affiliation: The Fleischman Faculty of Engineering, School of Mechanical Engineering, Tel Aviv University, 69978, Tel Aviv, Ramat Aviv, Israel. rami98@tau.ac.il.
authors.forename: Rami
authors.initials: R
authors.lastname: Haj-Ali
mesh_terms: D001021:Aortic Valve / Q000473:pathology* / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000503:physiopathology*; D001696:Biomechanical Phenomena; D001783:Blood Flow Velocity; D002114:Calcinosis / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D021621:Imaging, Three-Dimensional; D008955:Models, Cardiovascular; D013314:Stress, Mechanical
keywords: Aortic valve; Calcification; Flow; Fluid–structure interaction; Hemodynamics; Stenosis