title: Biomechanical comparison between mono-, bi-, and tricuspid valve architectures.
abstract: BACKGROUND
  An understanding of the relationship between venous valve architecture and associated fluid and solid mechanical forces will undoubtedly advance prosthesis design and treatments. The objective of the current study was to compare three valve architectures (mono-, bi-, and tricuspid) and the implications of these designs on the fluid and solid mechanics of the valve leaflets. The hypothesis is that the bi-cuspid valve has the lowest mechanical cost, defined as the ratio of leaflet wall stress and fluid wall shear stress (WSS), for the venous environment as compared with mono- and tricuspid valves.
  
  
  METHODS
  To address this hypothesis, fully coupled, two-way fluid-structure interaction computational models were developed and simulated for the three types of valves.
  
  
  RESULTS
  The numerical simulations showed that the mean fluid WSS of the bicuspid valve was generally higher than the tri-cuspid valve, which was further higher than the monocuspid valve. The mean leaflet wall stress of the bicuspid valve was lower than the tricuspid valve, which was further lower than the monocuspid valve. Therefore, the mechanical cost, which was defined as solid wall stress/fluid WSS, of the bicuspid valve was the lowest.
  
  
  CONCLUSIONS
  The lower mechanical cost may be a reason why the bicuspid valve is the dominant design in the venous system. This knowledge provides guidance for the design of novel venous prosthetic valves and may shed light on venous valve disease when the architecture of the valve is altered.
authors.affiliation: Research Engineering, 3DT Holdings, LLC, Indianapolis, Ind; Department of Biomedical Engineering, Indiana University, Purdue University, Indianapolis, Ind; Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, Ind.
authors.forename: Henry Y
authors.initials: HY
authors.lastname: Chen
authors.affiliation: Research Engineering, 3DT Holdings, LLC, Indianapolis, Ind; Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, Ind.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Berwick
authors.affiliation: Research Engineering, Cook Medical, Bloomington, Ind.
authors.forename: Joshua
authors.initials: J
authors.lastname: Krieger
authors.affiliation: Research Engineering, Cook Medical, Bloomington, Ind.
authors.forename: Sean
authors.initials: S
authors.lastname: Chambers
authors.affiliation: Jobst Vascular Institute, Toledo, Ohio.
authors.forename: Fedor
authors.initials: F
authors.lastname: Lurie
authors.affiliation: Department of Biomedical Engineering, Indiana University, Purdue University, Indianapolis, Ind; Department of Surgery, Indiana University School of Medicine, Indianapolis, Ind; Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, Ind. Electronic address: gkassab@iupui.edu.
authors.forename: Ghassan S
authors.initials: GS
authors.lastname: Kassab