A model of fluid-structure and biochemical interactions for applications to subclinical leaflet thrombosis

Area of Science:

• Biomedical Engineering
• Cardiovascular Research
• Computational Fluid Dynamics

Background:

• Subclinical leaflet thrombosis (SLT) is a complication of bioprosthetic aortic valve replacement, increasing stroke risk and potentially causing valve deterioration.
• Clinical imaging of SLT is challenging, necessitating advanced modeling techniques to understand its mechanisms and predict patient risk.

Purpose of the Study:

• To develop and validate a computational model for simulating leaflet thrombosis in bioprosthetic aortic valves.
• To incorporate fluid-structure interaction and a simplified thrombosis model to capture clot deposition on moving leaflets.

Main Methods:

• Developed a simulation model combining fluid-structure interaction with a simplified thrombosis model for clot deposition on moving leaflets.
• Adapted the model for deposition/absorption on other moving boundaries.
• Presented convergence results and quantified the model's impact on valve opening and pressures.

Main Results:

• The model successfully simulates leaflet thrombosis by incorporating surface adhesion and fluid-structure interaction feedback.
• Demonstrated the model's ability to quantify changes in valve mechanics and hemodynamics due to thrombosis.
• Validated the model's convergence and predictive capabilities.

Conclusions:

• The developed modeling approach represents a significant advancement in simulating thrombosis on moving boundaries, particularly for bioprosthetic heart valves.
• This tool can aid in understanding SLT mechanisms, predicting patient risk, and potentially improving bioprosthetic valve design and patient management.
• The model's adaptability extends its utility to other applications involving deposition or absorption on dynamic surfaces.