A computational fluid dynamics study to assess the impact of coughing on cerebrospinal fluid dynamics in Chiari type 1 malformation.

Chiari type 1 malformation is a neurological disorder characterized by an obstruction of the cerebrospinal fluid (CSF) circulation between the brain (intracranial) and spinal cord (spinal) compartments. Actions such as coughing might evoke spinal cord complications in patients with Chiari type 1 malformation, but the underlying mechanisms are not well understood. More insight into the impact of the obstruction on local and overall CSF dynamics can help reveal these mechanisms. Therefore, our previously developed computational fluid dynamics framework was used to establish a subject-specific model of the intracranial and upper spinal CSF space of a healthy control. In this model, we emulated a single cough and introduced porous zones to model a posterior (OBS-1), mild (OBS-2), and severe posterior-anterior (OBS-3) obstruction. OBS-1 and OBS-2 induced minor changes to the overall CSF pressures, while OBS-3 caused significantly larger changes with a decoupling between the intracranial and spinal compartment. Coughing led to a peak in overall CSF pressure. During this peak, pressure differences between the lateral ventricles and the spinal compartment were locally amplified for all degrees of obstruction. These results emphasize the effects of coughing and indicate that severe levels of obstruction lead to distinct changes in intracranial pressure.

Hemodynamics and wall shear metrics in a pulmonary autograft: Comparing a fluid-structure interaction and computational fluid dynamics approach.

OBJECTIVE: In young patients, aortic valve disease is often treated by placement of a pulmonary autograft (PA) which adapts to its new environment through growth and remodeling. To better understand the hemodynamic forces acting on the highly distensible PA in the acute phase after surgery, we developed a fluid-structure interaction (FSI) framework and comprehensively compared hemodynamics and wall shear-stress (WSS) metrics with a computational fluid dynamic (CFD) simulation. METHODS: The FSI framework couples a prestressed non-linear hyperelastic arterial tissue model with a fluid model using the in-house coupling code CoCoNuT. Geometry, material parameters and boundary conditions are based on in-vivo measurements. Hemodynamics, time-averaged WSS (TAWSS), oscillatory shear index (OSI) and topological shear variation index (TSVI) are evaluated qualitatively and quantitatively for 3 different sheeps. RESULTS: Despite systolic-to-diastolic volumetric changes of the PA in the order of 20 %, the point-by-point correlation of TAWSS and OSI obtained through CFD and FSI remains high (r > 0.9, p < 0.01) for TAWSS and (r > 0.8, p < 0.01) for OSI). Instantaneous WSS divergence patterns qualitatively preserve similarities, but large deformations of the PA leads to a decrease of the correlation between FSI and CFD resolved TSVI (r < 0.7, p < 0.01). Moderate co-localization between FSI and CFD is observed for low thresholds of TAWSS and high thresholds of OSI and TSVI. CONCLUSION: FSI might be warranted if we were to use the TSVI as a mechano-biological driver for growth and remodeling of PA due to varying intra-vascular flow structures and near wall hemodynamics because of the large expansion of the PA.

Variability of computational fluid dynamics solutions for pressure and flow in a giant aneurysm: the ASME 2012 Summer Bioengineering Conference CFD Challenge.

Stimulated by a recent controversy regarding pressure drops predicted in a giant aneurysm with a proximal stenosis, the present study sought to assess variability in the prediction of pressures and flow by a wide variety of research groups. In phase I, lumen geometry, flow rates, and fluid properties were specified, leaving each research group to choose their solver, discretization, and solution strategies. Variability was assessed by having each group interpolate their results onto a standardized mesh and centerline. For phase II, a physical model of the geometry was constructed, from which pressure and flow rates were measured. Groups repeated their simulations using a geometry reconstructed from a micro-computed tomography (CT) scan of the physical model with the measured flow rates and fluid properties. Phase I results from 25 groups demonstrated remarkable consistency in the pressure patterns, with the majority predicting peak systolic pressure drops within 8% of each other. Aneurysm sac flow patterns were more variable with only a few groups reporting peak systolic flow instabilities owing to their use of high temporal resolutions. Variability for phase II was comparable, and the median predicted pressure drops were within a few millimeters of mercury of the measured values but only after accounting for submillimeter errors in the reconstruction of the life-sized flow model from micro-CT. In summary, pressure can be predicted with consistency by CFD across a wide range of solvers and solution strategies, but this may not hold true for specific flow patterns or derived quantities. Future challenges are needed and should focus on hemodynamic quantities thought to be of clinical interest.

Computational fluid dynamics model to predict the dynamical behavior of the cerebrospinal fluid through implementation of physiological boundary conditions.

Cerebrospinal fluid (CSF) dynamics play an important role in maintaining a stable central nervous system environment and are influenced by different physiological processes. Multiple studies have investigated these processes but the impact of each of them on CSF flow is not well understood. A deeper insight into the CSF dynamics and the processes impacting them is crucial to better understand neurological disorders such as hydrocephalus, Chiari malformation, and intracranial hypertension. This study presents a 3D computational fluid dynamics (CFD) model which incorporates physiological processes as boundary conditions. CSF production and pulsatile arterial and venous volume changes are implemented as inlet boundary conditions. At the outlets, 2-element windkessel models are imposed to simulate CSF compliance and absorption. The total compliance is first tuned using a 0D model to obtain physiological pressure pulsations. Then, simulation results are compared with in vivo flow measurements in the spinal subarachnoid space (SAS) and cerebral aqueduct, and intracranial pressure values reported in the literature. Finally, the impact of the distribution of and total compliance on CSF pressures and velocities is evaluated. Without respiration effects, compliance of 0.17 ml/mmHg yielded pressure pulsations with an amplitude of 5 mmHg and an average value within the physiological range of 7-15 mmHg. Also, model flow rates were found to be in good agreement with reported values. However, when adding respiration effects, similar pressure amplitudes required an increase of compliance value to 0.51 ml/mmHg, which is within the range of 0.4-1.2 ml/mmHg measured in vivo. Moreover, altering the distribution of compliance over the four different outlets impacted the local flow, including the flow through the foramen magnum. The contribution of compliance to each outlet was directly proportional to the outflow at that outlet. Meanwhile, the value of total compliance impacted intracranial pressure. In conclusion, a computational model of the CSF has been developed that can simulate CSF pressures and velocities by incorporating boundary conditions based on physiological processes. By tuning these boundary conditions, we were able to obtain CSF pressures and flows within the physiological range.

A CFD study on the interplay of torsion and vortex guidance by the mitral valve on the left ventricular wash-out making use of overset meshes (Chimera technique).

Cardiovascular disease often occurs with silent and gradual alterations of cardiac blood flow that can lead to the onset of chronic pathological conditions. Image-based patient-specific Computational Fluid Dynamics (CFD) models allow for an extensive quantification of the flow field beyond the direct capabilities of medical imaging techniques that could support the clinicians in the early diagnosis, follow-up, and treatment planning of patients. Nonetheless, the large and impulsive kinematics of the left ventricle (LV) and the mitral valve (MV) pose relevant modeling challenges. Arbitrary Lagrangian-Eulerian (ALE) based computational fluid dynamics (CFD) methods struggle with the complex 3D mesh handling of rapidly moving valve leaflets within the left ventricle (LV). We, therefore, developed a Chimera-based (overset meshing) method to build a patient-specific 3D CFD model of the beating LV which includes a patient-inspired kinematic model of the mitral valve (LVMV). Simulations were performed with and without torsion. In addition, to evaluate how the intracardiac LV flow is impacted by the MV leaflet kinematics, a third version of the model without the MV was generated (LV with torsion). For all model versions, six cardiac cycles were simulated. All simulations demonstrated cycle-to-cycle variations that persisted after six cycles but were albeit marginal in terms of the magnitude of standard deviation of velocity and vorticity which may be related to the dissipative nature of the numerical scheme used. The MV was found to have a crucial role in the development of the intraventricular flow by enhancing the direct flow, the apical washout, and the propagation of the inlet jet towards the apical region. Consequently, the MV is an essential feature in the patient-specific CFD modeling of the LV. The impact of torsion was marginal on velocity, vorticity, wall shear stress, and energy loss, whereas it resulted to be significant in the evaluation of particle residence times. Therefore, including torsion could be considered in patient-specific CFD models of the LV, particularly when aiming to study stasis and residence time. We conclude that, despite some technical limitations encountered, the Chimera technique is a promising alternative for ALE methods for 3D CFD models of the heart that include the motion of valve leaflets.

A simulation environment for validating ultrasonic blood flow and vessel wall imaging based on fluid-structure interaction simulations: ultrasonic assessment of arterial distension and wall shear rate.

PURPOSE: Ultrasound (US) is a commonly used vascular imaging tool when screening for patients at high cardiovascular risk. However, current blood flow and vessel wall imaging methods are hampered by several limitations. When optimizing and developing new ultrasound modalities, proper validation is required before clinical implementation. Therefore, the authors present a simulation environment integrating ultrasound and fluid-structure interaction (FSI) simulations, allowing construction of synthetic ultrasound images based on physiologically realistic behavior of an artery. To demonstrate the potential of the model for vascular ultrasound research, the authors studied clinically relevant imaging modalities of arterial function related to both vessel wall deformation and arterial hemodynamics: Arterial distension (related to arterial stiffness) and wall shear rate (related to the development of atherosclerosis) imaging. METHODS: An in-house code ("TANGO") was developed to strongly couple the flow solver FLUENT and structural solver ABAQUS using an interface quasi-Newton technique. FIELD II was used to model realistic transducer and scan settings. The input to the FSI-US model is a scatterer phantom on which the US waves reflect, with the scatterer displacement derived from the FSI flow and displacement fields. The authors applied the simulation tool to a 3D straight tube, representative of the common carotid artery (length: 5 cm; and inner and outer radius: 3 and 4 mm). A mass flow inlet boundary condition, based on flow measured in a healthy subject, was applied. A downstream pressure condition, based on a noninvasively measured pressure waveform, was chosen and scaled to simulate three different degrees of arterial distension (1%, 4%, and 9%). The RF data from the FSI-US coupling were further processed for arterial wall and flow imaging. Using an available wall tracking algorithm, arterial distensibility was assessed. Using an autocorrelation estimator, blood velocity and shear rate were obtained along a scanline. RESULTS: The authors obtained a very good agreement between the flow and the distension as obtained from the FSI-US model and the reference FSI values. The wall application showed a high sensitivity of distension measurements to the measurement location, previously reported based on in vivo data. Interestingly, the model indicated that strong reflections between tissue transitions can potentially cloud a correct measurement. The flow imaging application demonstrated that maximum shear rate was underestimated for a relevant simulation setup. Moreover, given the difficulty of measuring near-wall velocities with ultrasound, maximal shear rate was obtained at a distance from the wall [0.812 mm for the anterior and 0.689 mm for the posterior side (9% distension case)]. However, ultrasound shear rates correlated well with the FSI ground truth for all distension degrees, suggesting that correction of the severe underestimation by ultrasound might be feasible in certain flow conditions. CONCLUSIONS: The authors demonstrated a simulation environment to validate and develop ultrasonic vascular imaging. An elaborate technique to integrate FSI and FIELD II ultrasound simulations was presented. This multiphysics simulation tool was applied to two imaging applications where distensible ultrasound phantoms are indispensable: Wall distension and shear rate measurement. Results showed that the method to couple fluid-structure interaction and ultrasound simulations provides realistic RF signals from the tissue and the blood pool.

Mixed impact of torsion on LV hemodynamics: A CFD study based on the Chimera technique.

Image-based patient-specific Computational Fluid Dynamics (CFD) models of the Left Ventricle (LV) can be used to quantify hemodynamics-based biomarkers that can support the clinicians in the early diagnosis, follow-up and treatment planning of patients, beyond the capabilities of the current imaging modalities. We propose a workflow to build patient-specific CFD models of the LV with moving boundaries based on the Chimera technique to overcome the convergence issues previously encountered by means of the Arbitrarian Lagrangian Eulerian approach. The workflow was tested while investigating whether the torsional motion has an impact on LV fluid dynamics. Starting from 3D cine MRI scans of a healthy volunteer, six cardiac cycles were simulated in three CFD LV models: with no, physiological, and exaggerated torsion. The Chimera technique was robust in handling the impulsive motion of the LV endocardium, allowing to notice cycle-to-cycle variations in every simulated case. Torsion affected slightly velocity, vorticity, WSS. It did not affect energy loss and induced a double-sided effect in terms of residence time: the particles ejected in one beat decreased, whereas the motility of the particles remaining in the LV was affected only in the exaggerated torsion case, indicating that implementation of torsion can be discarded in case of physiological levels. Nonetheless, caution is warranted when interpreting these results given the absence of the mitral valve, the papillary muscles, and the trabeculae. The effects of the mitral valve will be evaluated within an Fluid Structure Interaction simulation framework as further development of the current model.

Fluid-Structure Interaction Simulation of Prosthetic Aortic Valves: Comparison between Immersed Boundary and Arbitrary Lagrangian-Eulerian Techniques for the Mesh Representation.

In recent years the role of FSI (fluid-structure interaction) simulations in the analysis of the fluid-mechanics of heart valves is becoming more and more important, being able to capture the interaction between the blood and both the surrounding biological tissues and the valve itself. When setting up an FSI simulation, several choices have to be made to select the most suitable approach for the case of interest: in particular, to simulate flexible leaflet cardiac valves, the type of discretization of the fluid domain is crucial, which can be described with an ALE (Arbitrary Lagrangian-Eulerian) or an Eulerian formulation. The majority of the reported 3D heart valve FSI simulations are performed with the Eulerian formulation, allowing for large deformations of the domains without compromising the quality of the fluid grid. Nevertheless, it is known that the ALE-FSI approach guarantees more accurate results at the interface between the solid and the fluid. The goal of this paper is to describe the same aortic valve model in the two cases, comparing the performances of an ALE-based FSI solution and an Eulerian-based FSI approach. After a first simplified 2D case, the aortic geometry was considered in a full 3D set-up. The model was kept as similar as possible in the two settings, to better compare the simulations' outcomes. Although for the 2D case the differences were unsubstantial, in our experience the performance of a full 3D ALE-FSI simulation was significantly limited by the technical problems and requirements inherent to the ALE formulation, mainly related to the mesh motion and deformation of the fluid domain. As a secondary outcome of this work, it is important to point out that the choice of the solver also influenced the reliability of the final results.

Differential impact of local stiffening and narrowing on hemodynamics in repaired aortic coarctation: an FSI study.

Even after successful treatment of aortic coarctation, a high risk of cardiovascular morbidity and mortality remains. Uncertainty exists on the factors contributing to this increased risk among which are the presence of (1) a residual narrowing leading to an additional resistance and (2) a less distensible zone disturbing the buffer function of the aorta. As the many interfering factors and adaptive physiological mechanisms present in vivo prohibit the study of the isolated impact of these individual factors, a numerical fluid-structure interaction model is developed to predict central hemodynamics in coarctation treatment. The overall impact of a stiffening on the hemodynamics is limited, with a small increase in systolic pressure (up to 8 mmHg) proximal to the stiffening which is amplified with increasing stiffening and length. A residual narrowing, on the other hand, affects the hemodynamics significantly. For a short segment (10 mm), the combination of a stiffening and narrowing (coarctation index 0.5) causes an increase in systolic pressure of 58 mmHg, with 31 mmHg due to narrowing and an additional 27 mmHg due to stiffening. For a longer segment (25 mm), an increase in systolic pressure of 50 mmHg is found, of which only 9 mmHg is due to stiffening.

Assessment of shear stress related parameters in the carotid bifurcation using mouse-specific FSI simulations.

The ApoE(-)(/)(-) mouse is a common small animal model to study atherosclerosis, an inflammatory disease of the large and medium sized arteries such as the carotid artery. It is generally accepted that the wall shear stress, induced by the blood flow, plays a key role in the onset of this disease. Wall shear stress, however, is difficult to derive from direct in vivo measurements, particularly in mice. In this study, we integrated in vivo imaging (micro-Computed Tomography-µCT and ultrasound) and fluid-structure interaction (FSI) modeling for the mouse-specific assessment of carotid hemodynamics and wall shear stress. Results were provided for 8 carotid bifurcations of 4 ApoE(-)(/)(-) mice. We demonstrated that accounting for the carotid elasticity leads to more realistic flow waveforms over the complete domain of the model due to volume buffering capacity in systole. The 8 simulated cases showed fairly consistent spatial distribution maps of time-averaged wall shear stress (TAWSS) and relative residence time (RRT). Zones with reduced TAWSS and elevated RRT, potential indicators of atherosclerosis-prone regions, were located mainly at the outer sinus of the external carotid artery. In contrast to human carotid hemodynamics, no flow recirculation could be observed in the carotid bifurcation region.

The aortic reservoir-wave as a paradigm for arterial haemodynamics: insights from three-dimensional fluid-structure interaction simulations in a model of aortic coarctation.

BACKGROUND: The reservoir-wave paradigm considers aortic pressure as the superposition of a 'reservoir pressure', directly related to changes in reservoir volume, and an 'excess' component ascribed to wave dynamics. The change in reservoir pressure is assumed to be proportional to the difference between aortic inflow and outflow (i.e. aortic volume changes), an assumption that is virtually impossible to validate in vivo. The aim of this study is therefore to apply the reservoir-wave paradigm to aortic pressure and flow waves obtained from three-dimensional fluid-structure interaction simulations in a model of a normal aorta, aortic coarctation (narrowed descending aorta) and stented coarctation (stiff segment in descending aorta). METHOD AND RESULTS: We found no unequivocal relation between the intraaortic volume and the reservoir pressure for any of the simulated cases. When plotted in a pressure-volume diagram, hysteresis loops are found that are looped in a clockwise way indicating that the reservoir pressure is lower than the pressure associated with the change in volume. The reservoir-wave analysis leads to very high excess pressures, especially for the coarctation models, but to surprisingly little changes of the reservoir component despite the impediment of the buffer capacity of the aorta. CONCLUSION: With the observation that reservoir pressure is not related to the volume in the aortic reservoir in systole, an intrinsic assumption in the wave-reservoir concept is invalidated and, consequently, also the assumption that the excess pressure is the component of pressure that can be attributed to wave travel and reflection.

An animal-specific FSI model of the abdominal aorta in anesthetized mice.

Recent research has revealed that angiotensin II-induced abdominal aortic aneurysm in mice can be related to medial ruptures occurring in the vicinity of abdominal side branches. Nevertheless a thorough understanding of the biomechanics near abdominal side branches in mice is lacking. In the current work we present a mouse-specific fluid-structure interaction (FSI) model of the abdominal aorta in ApoE(-/-) mice that incorporates in vivo stresses. The aortic geometry was based on contrast-enhanced in vivo micro-CT images, while aortic flow boundary conditions and material model parameters were based on in vivo high-frequency ultrasound. Flow waveforms predicted by FSI simulations corresponded better to in vivo measurements than those from CFD simulations. Peak-systolic principal stresses at the inner and outer aortic wall were locally increased caudal to the celiac and left lateral to the celiac and mesenteric arteries. Interestingly, these were also the locations at which a tear in the tunica media had been observed in previous work on angiotensin II-infused mice. Our preliminary results therefore suggest that local biomechanics play an important role in the pathophysiology of branch-related ruptures in angiotensin-II infused mice. More elaborate follow-up research is needed to demonstrate the role of biomechanics and mechanobiology in a longitudinal setting.

Modeling hemodynamics in vascular networks using a geometrical multiscale approach: numerical aspects.

On the one hand the heterogeneity of the circulatory system requires the use of different models in its different compartments, featuring different assumptions on the spatial degrees of freedom. On the other hand, the mutual interactions between its compartments imply that these models should preferably not be considered separately. These requirements have led to the concept of geometrical multiscale modeling, where the main idea is to couple 3D models with reduced 1D and/or 0D models. As such detailed information on the flow field in a specific region of interest can be obtained while accounting for the global circulation. However, the combination of models with different mathematical features gives rise to many difficulties such as the assignment of boundary conditions at the interface between two models and the development of robust coupling algorithms, as the subproblems are usually solved in a partitioned way. This review aims to give an overview of the most important aspects concerning 3D-1D-0D coupled models. In addition, some applications are presented in order to illustrate the potentialities of these coupled models.

Comparison of non-invasive methods for measurement of local pulse wave velocity using FSI-simulations and in vivo data.

In the search for better predictors of cardiovascular events, pulse wave velocity (PWV) has gained considerable interest. We compared three single-location methods to locally estimate PWV based on simultaneous measurements of pressure (P), velocity (U) or arterial diameter (D): the PU, ln(D)U and QA-method. First, the performance of these methods was analyzed using 3D fluid-structure interaction simulations (FSI) in a tube and patient-specific carotid artery. We demonstrated that the outcome was dependent on whether the methods were tested in the ideal conditions of a 3D axisymmetrical and reflection-free tube or in the more realistic setup of a carotid artery. The three single-location PWV methods performed similarly in the tube (4.29 m/s for PU, 4.44 m/s for ln(D)U and 4.38 m/s for QA) while the carotid data showed that the PU-method dramatically overestimates PWV (9.16 m/s), and the ln(D)U and QA-method underestimate (3.86 and 3.84 m/s, respectively). The erroneously high wavespeeds from the PU-method were attributed to wave reflections, which was confirmed by measurements in 37 healthy adults. This in vivo study showed similar discrepancies between the 3 single-location techniques as present in the carotid simulations, with the difference between the PU- and ln(D)U-method related to the magnitude of wave reflection.

Velocity profiles in the human ductus venosus: a numerical fluid structure interaction study.

The veins distributing oxygenated blood from the placenta to the fetal body have been given much attention in clinical Doppler velocimetry studies, in particular the ductus venosus. The ductus venosus is embedded in the left liver lobe and connects the intra-abdominal portion of the umbilical vein (IUV) directly to the inferior vena cava, such that oxygenated blood can bypass the liver and flow directly to the fetal heart. In the current work, we have developed a mathematical model to assist the clinical assessment of volumetric flow rate at the inlet of the ductus venosus. With a robust estimate of the velocity profile shape coefficient (VC), the volumetric flow rate may be estimated as the product of the time-averaged cross-sectional area, the time-averaged cross-sectional maximum velocity and the VC. The time average quantities may be obtained from Doppler ultrasound measurements, whereas the VC may be estimated from numerical simulations. The mathematical model employs a 3D fluid structure interaction model of the bifurcation formed by the IUV, the ductus venosus and the left portal vein. Furthermore, the amniotic portion of the umbilical vein, the right liver lobe and the inferior vena cava were incorporated as lumped model boundary conditions for the fluid structure interaction model. A hyperelastic material is used to model the structural response of the vessel walls, based on recently available experimental data for the human IUV and ductus venous. A parametric study was constructed to investigate the VC at the ductus venosus inlet, based on a reference case for a human fetus at 36 weeks of gestation. The VC was found to be [Formula: see text] (Mean [Formula: see text] SD of parametric case study), which confirms previous studies in the literature on the VC at the ductus venosus inlet. Additionally, CFD simulations with rigid walls were performed on a subsection of the parametric case study, and only minor changes in the predicted VCs were observed compared to the FSI cases. In conclusion, the presented mathematical model is a promising tool for the assessment of ductus venosus Doppler velocimetry.

Accuracy of carotid strain estimates from ultrasonic wall tracking: a study based on multiphysics simulations and in vivo data.

We used a multiphysics model to assess the accuracy of carotid strain estimates derived from a 1-D ultrasonic wall tracking algorithm. The presented tool integrates fluid-structure interaction (FSI) simulations with an ultrasound simulator (Field II), which allows comparison of the ultrasound (US) images with a ground truth. Field II represents tissue as random points on which US waves reflect and whose position can be updated based on the flow field and vessel wall deformation from FSI. We simulated the RF-signal of a patient-specific carotid bifurcation, including the blood pool as well as the vessel wall and surrounding tissue. Distension estimates were obtained from a wall tracking algorithm using tracking points at various depths within the wall, and further processed to assess radial and circumferential strain. The simulated data demonstrated that circumferential strain can be estimated with reasonable accuracy (especially for the common carotid artery and at the lumen-intima and media-adventitia interface), but the technique does not allow to reliably assess intra-arterial radial strain. These findings were supported by in vivo data of 10 healthy adults, showing similar circumferential and radial strain profiles throughout the arterial wall. We concluded that these deviations are present due to the complex 3-D vessel wall deformation, the presence of specular reflections and, to a lesser extent, the spatially varying beam profile, with the error depending on the phase in the cardiac cycle and the scanning location.

The upstream boundary condition influences the leaflet opening dynamics in the numerical FSI simulation of an aortic BMHV.

In this paper, the influence of the upstream boundary condition in the numerical simulation of an aortic bileaflet mechanical heart valve (BMHV) is studied. Three three-dimensional cases with different upstream boundary conditions are compared. The first case consists of a rigid straight tube with a velocity profile at its inlet. In the second case, the upstream geometry is a contracting left ventricle (LV), positioned symmetrically with respect to the valve. In the last case, the LV is positioned asymmetrical with respect to the valve. The cases are used to simulate the same three-dimensional BMHV. The change in time of the LV volume is calculated such that the flow rate through the valve is identical in each case. The opening dynamics of the BMHV are modelled using fluid-structure interaction. The simulations show that differences occur in the leaflet movement of the three cases. In particular, with the asymmetric LV, one of the leaflets impacts the blocking mechanism at its open position with a 34% higher velocity than when using the velocity profile, and with an 88% higher velocity than in the symmetric LV case. Therefore, when simulating such an impact, the upstream boundary condition needs to be chosen carefully.

A fast strong coupling algorithm for the partitioned fluid-structure interaction simulation of BMHVs.

The numerical simulation of Bileaflet Mechanical Heart Valves (BMHVs) has gained strong interest in the last years, as a design and optimisation tool. In this paper, a strong coupling algorithm for the partitioned fluid-structure interaction simulation of a BMHV is presented. The convergence of the coupling iterations between the flow solver and the leaflet motion solver is accelerated by using the Jacobian with the derivatives of the pressure and viscous moments acting on the leaflets with respect to the leaflet accelerations. This Jacobian is numerically calculated from the coupling iterations. An error analysis is done to derive a criterion for the selection of useable coupling iterations. The algorithm is successfully tested for two 3D cases of a BMHV and a comparison is made with existing coupling schemes. It is observed that the developed coupling scheme outperforms these existing schemes in needed coupling iterations per time step and CPU time.