Instantaneous streamlines at peak of the systole.

<p>In the case of a normal aorta, the flow is laminar and fully attached to the wall. The presence of a COA significantly alters the flow dynamics in the aorta. The flow detaches from the aortic wall and develops into a high-speed eccentric jet downstream of the COA and the BAV.</p

Oscillatory shear index (OSI) distribution.

<p>Downstream of the aortic valve (section F) and downstream of the COA (section C).</p

Pulsatile flow rate waveform used as inlet condition for the numerical simulations.

<p>Pulsatile flow rate waveform used as inlet condition for the numerical simulations.</p

Three different geometries considered for the numerical simulations.

<p>a normal tricuspid aortic valve and a normal aorta representing normal case, a normal aortic tricuspid valve and an aorta with COA (75% by area), representing isolated COA, a bicuspid aortic valve and an aorta with COA (75% by area), representing complex COA.</p

Axial velocity contours at cross sections B (upstream from COA) and C (downstream of COA).

<p>Results obtained numerically and measured with MRI at peak of the systole.</p

Pressure in complex COA.

<p>First row: unfiltered pressure wave forms obtained from <i>in vitro</i> model in complex COA, second row: sketch of the pressure variation along the aorta, third row: pressure loss variation at the peak of the systole along the aorta obtained numerically.</p

Secondary flow obtained numerically at different cross-sections at the peak of the systole.

<p>The presence of both BAV and COA significantly intensifies the amplitude of the secondary flow mainly downstream of COA.</p

Axial velocity contours at cross section B (upstream from COA) during acceleration and cross section C (downstream of COA) during deceleration.

<p>Results obtained numerically and measured with MRI.</p

Calculation of discretization errors for three cases simulated in this study.

<p>The calculations were performed for the wall shear stress at the neck of the complex COA (inner wall). , , , and represent the wall shear stress, the extrapolated wall shear stress value, the approximate relative error, the extrapolated relative error and the fine-grid convergence index, respectively.</p

Velocity profiles along diameter at cross section B (upstream from COA) during acceleration and cross section C (downstream of COA) during deceleration.

<p>Velocity profiles along diameter at cross section B (upstream from COA) during acceleration and cross section C (downstream of COA) during deceleration.</p