Synergy between Diastolic Mitral Valve Function and Left Ventricular Flow Aids in Valve Closure and Blood Transport during Systole.

Highly resolved three-dimensional (3D) fluid structure interaction (FSI) simulation using patient-specific echocardiographic data can be a powerful tool for accurately and thoroughly elucidating the biomechanics of mitral valve (MV) function and left ventricular (LV) fluid dynamics. We developed and validated a strongly coupled FSI algorithm to fully characterize the LV flow field during diastolic MV opening under physiologic conditions. Our model revealed that distinct MV deformation and LV flow patterns developed during different diastolic stages. A vortex ring that strongly depended on MV deformation formed during early diastole. At peak E wave, the MV fully opened, with a local Reynolds number of ~5500, indicating that the flow was in the laminar-turbulent transitional regime. Our results  showed that during diastasis, the vortex structures caused the MV leaflets to converge, thus increasing mitral jet's velocity. The vortex ring became asymmetrical, with the vortex structures on the anterior side being larger than on the posterior side. During the late diastolic stages, the flow structures advected toward the LV outflow tract, enhancing fluid transport to the aorta. This 3D-FSI study demonstrated the importance of leaflet dynamics, their effect on the vortex ring, and their influence on MV function and fluid transport within the LV during diastole.

From medical images to flow computations without user-generated meshes.

Biomedical flow computations in patient-specific geometries require integrating image acquisition and processing with fluid flow solvers. Typically, image-based modeling processes involve several steps, such as image segmentation, surface mesh generation, volumetric flow mesh generation, and finally, computational simulation. These steps are performed separately, often using separate pieces of software, and each step requires considerable expertise and investment of time on the part of the user. In this paper, an alternative framework is presented in which the entire image-based modeling process is performed on a Cartesian domain where the image is embedded within the domain as an implicit surface. Thus, the framework circumvents the need for generating surface meshes to fit complex geometries and subsequent creation of body-fitted flow meshes. Cartesian mesh pruning, local mesh refinement, and massive parallelization provide computational efficiency; the image-to-computation techniques adopted are chosen to be suitable for distributed memory architectures. The complete framework is demonstrated with flow calculations computed in two 3D image reconstructions of geometrically dissimilar intracranial aneurysms. The flow calculations are performed on multiprocessor computer architectures and are compared against calculations performed with a standard multistep route.

A numerical and experimental investigation of the effect of false vocal fold geometry on glottal flow.

The false vocal folds are hypothesized to affect the laryngeal flow during phonation. This hypothesis is tested both computationally and experimentally using rigid models of the human larynges. The computations are performed using an incompressible Navier-Stokes solver with a second order, sharp, immersed-boundary formulation, while the experiments are carried out in a wind tunnel with physiologic speeds and dimensions. The computational flow structures are compared with available glottal flow visualizations and are employed to study the vortex dynamics of the glottal flow. Furthermore, pressure data are collected on the surface of the laryngeal models experimentally and computationally. The investigation focuses on three geometric features: the size of the false vocal fold gap; the height between the true and false vocal folds; and the width of the laryngeal ventricle. It is shown that the false vocal fold gap has a significant effect on glottal flow aerodynamics, whereas the second and the third geometric parameters are of lesser importance. The link between pressure distribution on the surface of the larynx and false vocal fold geometry is discussed in the context of vortex evolution in the supraglottal region. It was found that the formation of the starting vortex considerably affects the pressure distribution on the surface of the larynx. The interaction of this vortex structure with false vocal folds creates rebound vortices in the laryngeal ventricle. In the cases of small false vocal fold gap, these rebound vortices are able to reach the true vocal folds during a time period comparable with one cycle of the phonation. Moreover, they can create complex vorticity patterns, which result in significant pressure fluctuations on the surface of the larynx.