Abstract:
"A Multiscale Computational Comparison of the Bicuspid and Tricuspid Aortic Valves in Relation to Calcific Aoritic Stenosis"
This study performs a multiscale computational analysis to compare the biomechanics of bicuspid (BAV) and tricuspid (TAV) aortic valves to investigate the link between valve geometry and the increased incidence of calcific aortic stenosis (CAS) in BAV patients. Using a multiscale finite-element model, the research isolates the effect of the number of cusps on valve mechanics at the organ, tissue, and cellular scales. The simulations revealed that at the organ scale, the bicuspid valve shows greater flexure in the solid phase and a stronger jet formation in the fluid phase compared to the tricuspid valve. These differences in organ-scale behavior agree with experimental observations and are a direct result of the geometric variation. However, at the cellular level, the study found that the cellular deformations in the region prone to calcification were not significantly different between the two valve types. This is because the wrinkled structure of the fibrosa layer shields the cells from the larger-scale strain. The findings suggest that the increased risk of calcification in bicuspid valves is not primarily due to mechanical differences arising from geometry, but may instead be linked to other factors, such as a genetic predisposition.
