Grafts used in aortic valve-sparing procedures should ideally not only reproduce the geometry of the natural aortic root but also its material properties. Indeed, a number of studies using the finite element method have shown the importance of the natural sinus shape of the root in the functioning of the normal aortic valve, and the relative increase in stresses due to the replacement of the valve by a stiffer synthetic graft. Because of the wide range in experimentally measured values of aortic wall and leaflet material properties, studies by different research groups have incorporated very different material properties in their models. The aim of the present study was to investigate the influence of material properties on aortic wall displacements, and to determine which material properties would most closely match reported experimental data. Two geometrically accurate 3D models corresponding to the closed and open valve configurations were created in Pro/Engineer CAD software. Loads corresponding to systolic and diastolic pressures were specified and large-displacement structural analyses were carried out using the ANSYS package. Results have indicated that the closest match to experiments using isotropic material properties occurred for a Young's modulus of about 2000 KPa. Nonlinear models based on experimental stress-strain curves have shown similar displacements, but altered strain distribution patterns and significantly lower stresses. These results suggest that an accurate comparison of potential new graft models would have to be made with natural aortic valve models incorporating nonlinear material behavior.
The rupture of coronary atherosclerotic plaque fibrous caps has been associated with acute myocardial infarctions. Collagen fibers, the main structural component of vascular tissue, have been observed to change orientation and align themselves with the principal stress direction. This study compared the principal stress direction in stenosed coronary arteries obtained from 3D fluid-structure interaction simulations to the orientation of collagen fibers in the fibrous cap of human specimens. The principal stress direction at the peak of the stenosis was found to be axially oriented and correlated well with the determined orientation of the collagen fibers in the fibrous cap specimens.
The fibrous cap is a protective layer of connective tissue that covers the core of an atherosclerotic plaque. The rupture of this layer has been commonly associated with acute myocardial infarctions. The thickness of the fibrous cap, the percentage of stenosed area, and the stiffness of the core were studied (commonly associated with vulnerable plaque characteristics) to quantify their effects on the cap's mechanical stress state by performing analyses using computational fluid-structure interaction (FSI) methods. The mechanical stress levels are significantly increased within the fibrous cap structure at the upstream side of the plaque. As expected, the highest stresses occurred for a severe stenosis and a thin fibrous cap. Interestingly, a weak structural support such as a soft lipid pool beneath the fibrous cap allowed for the hemodynamic pressure gradient forces to displace the fibrous cap in the direction of the flow, resulting in higher strains and thus higher mechanical stresses in the upstream portion of the plaque cap, potentially increasing the risk of cap rupture. The peak stress behavior of the most critical cases (thin fibrous cap and soft lipid core) at various degrees of stenosis was analyzed. For mid-range stenosis from 43% to 75%, there was a plateau region revealing that mild and moderate plaques were quickly exposed to the high stress condition of severe plaques. In conclusion, the particular combination of a mild to severe stenosis, a thin fibrous cap and a soft lipid core resulted in the highest mechanical stresses calculated at the proximal side of the plaque. Mild and moderate plaques can be subjected to stresses similar to severe plaques, possibly contributing to their rupture.
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