TY - JOUR
T1 - Dynamics of Blood Flows in Aortic Stenosis
T2 - Mild, Moderate, and Severe
AU - Jhun, Choon Sik
AU - Newswanger, Raymond
AU - Cysyk, Joshua P.
AU - Ponnaluri, Sailahari
AU - Good, Bryan
AU - Manning, Keefe B.
AU - Rosenberg, Gerson
N1 - Funding Information:
From the *Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, Pennsylvania; and †Department of Biomedical Engineering, College of Engineering, The Pennsylvania State University, University Park, Pennsylvania. Submitted for consideration February 2020; accepted for publication in revised form August 2020. Disclosure: The authors have no conflicts of interest to report. This work is partially supported by grants from the National Institutes of Health, R01 HL136369, PSU College of Engineering Instrumentation Grant, and Barsumian Trust Fund. Presented at the 66th Annual ASAIO Conference; June 10–13, 2020; Chicago, IL. Correspondence: Choon-Sik Jhun, Division of Applied Biomedical Engineering, Department of Surgery, College of Medicine, The Pennsylvania State University, 500 University Drive, Hershey, PA 17033. Email: cjhun@pennstatehealth.psu.edu. Copyright © ASAIO 2020
Publisher Copyright:
© 2021 Journal of Physical Chemistry. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Supraphysiologic high shear stresses created in calcific aortic stenosis (AS) are known to cause hemostatic abnormalities, however, the relationship between the complex blood flows over the severity of AS and hemostatic abnormalities still remains unclear. This study systematically characterized the blood flow in mild, moderate, and severe AS. A series of large eddy simulations (LES) validated by particle image velocimetry were performed on physiologically representative AS models with a peak physiologic flow condition of 18 liter per minute. Time-accurate velocity fields, transvalvular pressure gradient, and laminar viscous - and turbulent (or Reynolds) shear stresses (RSSmax) were evaluated for each degree of severity. The peak velocities of mild, moderate, and severe AS were on the order of 2.0, 4.0, and 8.0 m/s, respectively. Jet velocity in severe AS was highly skewed with extremely high velocity (as high as 8 m/s) and mainly traveled through the posterior aortic wall up to the aortic arch while still carrying a relatively high velocity, that is, >4 m/s. The mean laminar viscous wall shear stresses (WSS) for mild, moderate, and severe AS were on the order of 40, 100, and 180 Pa, respectively. The RSSmaxwere on the order of 260, 490, and 2,500 Pa for mild, moderate, and severe AS, respectively. This study may provide a link between altered flows in AS and hemostatic abnormalities such as acquired von Willebrand syndrome and hemolysis, thus, help diagnosing and timing of the treatment.
AB - Supraphysiologic high shear stresses created in calcific aortic stenosis (AS) are known to cause hemostatic abnormalities, however, the relationship between the complex blood flows over the severity of AS and hemostatic abnormalities still remains unclear. This study systematically characterized the blood flow in mild, moderate, and severe AS. A series of large eddy simulations (LES) validated by particle image velocimetry were performed on physiologically representative AS models with a peak physiologic flow condition of 18 liter per minute. Time-accurate velocity fields, transvalvular pressure gradient, and laminar viscous - and turbulent (or Reynolds) shear stresses (RSSmax) were evaluated for each degree of severity. The peak velocities of mild, moderate, and severe AS were on the order of 2.0, 4.0, and 8.0 m/s, respectively. Jet velocity in severe AS was highly skewed with extremely high velocity (as high as 8 m/s) and mainly traveled through the posterior aortic wall up to the aortic arch while still carrying a relatively high velocity, that is, >4 m/s. The mean laminar viscous wall shear stresses (WSS) for mild, moderate, and severe AS were on the order of 40, 100, and 180 Pa, respectively. The RSSmaxwere on the order of 260, 490, and 2,500 Pa for mild, moderate, and severe AS, respectively. This study may provide a link between altered flows in AS and hemostatic abnormalities such as acquired von Willebrand syndrome and hemolysis, thus, help diagnosing and timing of the treatment.
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U2 - 10.1097/MAT.0000000000001296
DO - 10.1097/MAT.0000000000001296
M3 - Article
C2 - 33164999
AN - SCOPUS:85098748087
SP - 666
EP - 674
JO - ASAIO Journal
JF - ASAIO Journal
SN - 1058-2916
ER -