Numerical investigation of calcification effects on aortic valve motions and ambient flow characteristics

The pathogenesis and progression of calcific aortic stenosis pose a significant challenge in medical science due to the intricate nature of blood fluid dynamics. To better understand this crucial phenomenon, this study investigates the physiological behaviors of aortic valves with varying degrees of lesions and ambient flow conditions using an in-house CFD solver, CgLES-Y code. The code is validated by simulating two-dimensional valve opening and closure, followed by the extension to three-dimensional symmetrically simplified valve dynamics. The simulation results exhibit great agreement with other numerical, experimental and clinical data. Patient-specific models of the aortic root and inner valve geometries are developed based on CT images. Analysis of fluid dynamics traits, configuration properties and leaflet stress is performed for both normal and calcified aortic valves during the systolic and diastolic periods. The study further examines the impact of calcium deposition on abnormal flow fields and leaflet motion, which indicates that calcium deposition increases the tensional burden on healthy leaflets, therefore, the microcosmic increase in valve modulus leads to global damage extending from the root to the tip, whereas macroscopic calcification primarily induces damage in the vicinity of the calcium compound. Additionally, the generation of additional vortices on the valve surface and sinus lumen heightens the likelihood of calcium accumulation.