Fully coupled fluid-structure interaction model of congenital bicuspid aortic valves: Effect of asymmetry on hemodynamics

Gil Marom, Hee Sun Kim, Moshe Rosenfeld, Ehud Raanani, Rami Haj-Ali

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A bicuspid aortic valve (BAV) is a congenital cardiac disorder where the valve consists of only two cusps instead of three, as in a normal tricuspid valve (TAV). Although 97 % of BAVs include asymmetric cusps, little or no prior studies have investigated the blood flow through a three-dimensional BAV and root. The aim of the present study was to characterize the effect of asymmetric BAV on the blood flow using fully coupled fluid-structure interaction (FSI) models with improved boundary conditions and tissue properties. This study presents four FSI models, including a native TAV, asymmetric BAVs with or without a raphe, and an almost symmetric BAV. Cusp tissue is composed of hyperelastic finite elements with collagen fibres embedded in the elastin matrix. A full cardiac cycle is simulated by imposing the same physiological blood pressures for all the TAV and BAV models. The latter have significantly smaller opening areas compared with the TAV. Larger stress values were found in the cusps of BAVs with fused cusps, at both the systolic and diastolic phases. The asymmetric geometry caused asymmetric vortices and much larger flow shear stress on the cusps which could be a potential initiator for early valvular calcification of BAVs.

Original languageEnglish
Pages (from-to)839-848
Number of pages10
JournalMedical and Biological Engineering and Computing
Issue number8
StatePublished - Aug 2013

Bibliographical note

Funding Information:
Acknowledgments This work was partially supported by a grant from the Nicholas and Elizabeth Slezak Super Center for Cardiac Research and Biomedical Engineering at Tel Aviv University. Rami Haj-Ali acknowledges the support from the EU Marie-Curie IRG grant.


  • Asymmetry
  • Composite tissue
  • Native aortic valve
  • Numerical model


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