Effects of body posture on aortic valve hemodynamics and biomechanics using the fluid-structure interaction method

Bioprosthetic heart valve (BHV), the most widely and commonly used valves in clinical practice, are susceptible to fatigue damage. Biological valves are always in one or fewer body postures before sampling in pigs and bovines. Nevertheless, human body positions are far more than them. Variations in body position significantly affect the intrinsic environment of blood pressure (BP), heart rate (HR), and peripheral resistance (PR). Such boundary condition changes will inevitably affect the implanted biological valve. In this paper, the immersed boundary method was used to simulate the motion of the aortic valve during the entire cardiac cycle in five postural blood flow environments: upright, sitting, prone, supine and orthostatic hypotension (OH). Several hemodynamic and biomechanical parameters, including the transvalvular pressure gradient and valve displacement, were evaluated. The results showed that the OH group exhibited the worst performance of the valves, accompanied by the greatest regurgitation and high-frequency flutter, predisposing patients to thrombosis and fatigue calcification. For BHVs to serve longer, patients implanted with BHV should avoid OH in their daily routine.