3D simulation of a viscous flow past a compliant model of arteriovenous-graft annastomosis

Hemodialysis is a common treatment for end-stage renal-disease patients to manage their renal failure while awaiting kidney transplant. Arteriovenous graft (AVG) is a major vascular access for hemodialysis but often fails due to the thrombosis near the vein-graft anastomosis. Almost all of the existing computational studies involving AVG assume that the vein and graft are rigid. As a first step to include vein/graft flexibility, we consider an ideal vein-AVG anastomosis model and apply the lattice Boltzmann-immersed boundary (LB-IB) framework for fluid-structure-interaction. The framework is extended to the case of non-uniform Lagrangian mesh for complex structure. After verification and validation of the numerical method and its implementation, many simulations are performed to simulate a viscous incompressible flow past the anastomosis model under pulsatile flow condition using various levels of vein elasticity. Our simulation results indicate that vein compliance may lessen flow disturbance and a more compliant vein experiences less wall shear stress (WSS)

Fluid-structure interaction analysis of the aortic valve in young healthy, ageing and post treatment conditions

Optimal aortic valve function, limitation of blood damage, and frequency of thromboembolic events are all dependent upon the haemodynamics within the aortic root. Improved understanding of the young healthy physiological state via investigation of the fluid dynamics around and through the aortic valve is essential to identify detrimental changes leading to pathologies and develop novel therapeutic procedures. The aim of this study is to develop a numerical model that can support a better comprehension of the valve function and serve as a reference to identify the changes produced by specific pathologies and treatments. A Fluid-structure interaction (FSI) numerical model was developed and adapted to accurately replicate the conditions of a previous in vitro investigation into aortic valve dynamics, performed by means of particle image velocimetry (PIV). The model was validated on equivalent physical settings, in a pulse duplicator replicating the physiological healthy flow and pressure experienced in the left heart chambers. The resulting velocity fields and hydrodynamic valve performance indicators of the two analyses were qualitatively and quantitatively compared to validate the numerical model. The validated FSI model was then used to describe realistic young healthy, ageing and post treatment conditions, by eliminating the experimental and methodological limitations and approximations. In detail, in terms of treatments, both surgical and transcatheter valve replacement procedures were investigated. In terms of pathologies, typical alterations frequently due to ageing, namely thickening of the valve leaflets and progressive dilation of the aortic chamber, were studied. The analysis was performed by comparing the data obtained for the ageing and post treatment configurations with those of the young healthy root environment. The results were analysed in terms of leaflets kinematics, flow dynamics, pressure and valve performance parameters. The study suggests a new operating mechanism for the young healthy aortic valve leaflets considerably different from what reported in the literature to date and largely more efficient in terms of hydrodynamic performance

Platelet Activation in Artificial Heart Valves

A numerical framework is developed to perform multi-scale (hinge-to valve-scale) flow simulation and quantify the thrombogenic performance of prosthetic heart valves. This aim is achieved by 1) developing a parallel dynamic overset grid and combining it with the curvilinear immersed boundary (overset-CURVIB) method to reduce the computational cost; and 2) developing a framework for evaluating the thrombogenic performance of heart valves in terms of platelet activation. The dynamic overset grids are used to locally increase the grid resolution near immersed bodies, which are handled using a sharp interface immersed boundary method, undergoing large movements as well as arbitrary relative motions. The new framework extends the previous overset-CURVIB method with fixed overset grids and a sequential grid assembly to moving overset grids with an efficient parallel grid assembly. In addition, a new method for the interpolation of variables at the grid boundaries is developed which can drastically decrease the execution time and increase the parallel efficiency. This overset grid framework is integrated with a framework to quantify the platelet activation which is developed using a Eulerian frame of reference which calculates the activation over the whole computational domain (contrary to Largrangian methods which use limited number of particles). The new framework is verified and validated against experimental data, and analytical/benchmark solutions. This framework is used to compare the role of systole phase in the poor performance of bileaflet mechanical heart (BMHV) valve by using the bioprothtetic heart valve as a control. The results show that the activation in the bulk flow during the systole phase might play an essential role in poor hemodynamic performance of BMHVs. In addition, the contribution of bulk and hinge flows to the activation of platelets in BMHVs is quantified for the first time by performing simulations of the flow through a BMHV and resolving the hinge by overset grids. The total activation by the bulk flow is found to be several folds higher than that by the hinge/leakage flow. This is mainly due to the higher flow rate of the bulk flow which exposes much more platelets to shear stress than the leakage flow. For the future work, this framework is going to be applied for thrombogenic optimization of new designs of mechanical heart valves including trileaflet ones as well as patient-specific hemodynamic analysis of heart valves using fluid-structure interaction in more realistic geometries extracted from the medical images such as echocardiography

Movement Effects on the Flow Physics and Nutrient Delivery in Engineered Valvular Tissues

Mechanical conditioning has been shown to promote tissue formation in a wide variety of tissue engineering efforts. However the underlying mechanisms by which external mechanical stimuli regulate cells and tissues are not known. This is particularly relevant in the area of heart valve tissue engineering (HVTE) owing to the intense hemodynamic environments that surround native valves. Some studies suggest that oscillatory shear stress (OSS) caused by steady flow and scaffold flexure play a critical role in engineered tissue formation derived from bone marrow derived stem cells (BMSCs). In addition, scaffold flexure may enhance nutrient (e.g. oxygen, glucose) transport. In this study, we computationally quantified the i) magnitude of fluid-induced shear stresses; ii) the extent of temporal fluid oscillations in the flow field using the oscillatory shear index (OSI) parameter, and iii) glucose and oxygen mass transport profiles. Noting that sample cyclic flexure induces a high degree of oscillatory shear stress (OSS), we incorporated moving boundary computational fluid dynamic simulations of samples housed within a bioreactor to consider the effects of: 1) no flow, no flexure (control group), 2) steady flow-alone, 3) cyclic flexure-alone and 4) combined steady flow and cyclic flexure environments. We also coupled a diffusion and convention mass transport equation to the simulated system. We found that the coexistence of both OSS and appreciable shear stress magnitudes, described by the newly introduced parameter OSI-t , explained the high levels of engineered collagen previously observed from combining cyclic flexure and steady flow states. On the other hand, each of these metrics on its own showed no association. This finding suggests that cyclic flexure and steady flow synergistically promote engineered heart valve tissue production via OSS, so long as the oscillations are accompanied by a critical magnitude of shear stress. In addition, our simulations showed that mass transport of glucose and oxygen is enhanced by sample movement at low sample porosities, but did not play a role in highly porous scaffolds. Preliminary in-house in vitro experiments showed that cell proliferation and phenotype is enhanced in OSI-t environments

Integrated Heart - Coupling multiscale and multiphysics models for the simulation of the cardiac function

Mathematical modelling of the human heart and its function can expand our understanding of various cardiac diseases, which remain the most common cause of death in the developed world. Like other physiological systems, the heart can be understood as a complex multiscale system involving interacting phenomena at the molecular, cellular, tissue, and organ levels. This article addresses the numerical modelling of many aspects of heart function, including the interaction of the cardiac electrophysiology system with contractile muscle tissue, the sub-cellular activation-contraction mechanisms, as well as the hemodynamics inside the heart chambers. Resolution of each of these sub-systems requires separate mathematical analysis and specially developed numerical algorithms, which we review in detail. By using specific sub-systems as examples, we also look at systemic stability, and explain for example how physiological concepts such as microscopic force generation in cardiac muscle cells, translate to coupled systems of differential equations, and how their stability properties influence the choice of numerical coupling algorithms. Several numerical examples illustrate three fundamental challenges of developing multiphysics and multiscale numerical models for simulating heart function, namely: (i) the correct upscaling from single-cell models to the entire cardiac muscle, (ii) the proper coupling of electrophysiology and tissue mechanics to simulate electromechanical feedback, and (iii) the stable simulation of ventricular hemodynamics during rapid valve opening and closure

The discrete multi-physics method applied to biomechanics

In this thesis, a fully Lagrangian approach called the Discrete Multi-Physics is adopted and applied to biomechanics. The Discrete Multi-Physics combines the Smoothed Particle Hydrodynamics, the Mass and Spring Model and the Discrete Element Method in a common particle-based framework. In the Discrete Multi-Physics, high deformations and contact of solid structures (e.g. valve’s leaflets during closing phase or colloid contact) can be easily modelled. In biological valve simulations, for instance, we were able to account for repeated opening-closing cycles and to introduce an agglomeration algorithm to model clotting. Besides cardiovascular and venous flows, we also applied the Discrete Multi-Physics to respiratory tracts for modelling (i) cilia motion and drug diffusion in the periciliary layer (ciliated epithelium) and (ii) the release of active ingredients in powder inhalers for drug delivery in the lungs