Geometric modeling of functional trileaflet aortic valves: development and clinical applications

The dimensions of the aortic valve components condition its ability to prevent blood from flowing back into the heart. While the theoretical parameters for best trileaflet valve performance have already been established, an effective approach to describe other less optimal, but functional models has been lacking. Our goal was to establish a method to determine by how much the dimensions of the aortic valve components can vary while still maintaining proper function. Measurements were made on silicone rubber casts of human aortic valves to document the range of dimensional variability encountered in normal adult valves. Analytical equations were written to describe a fully three-dimensional geometric model of a trileaflet valve in both the open and closed positions. A complete set of analytical, numerical and graphical tools was developed to explore a range of component dimensions within functional aortic valves. A list of geometric guidelines was established to ensure safe operation of the valve during the cardiac cycle, with practical safety margins. The geometry-based model presented here allows determining quickly if a certain set of valve component dimensions results in a functional valve. This is of great interest to designers of new prosthetic heart valve models, as well as to surgeons involved in valve-sparing surgery.