Fluid–structure interaction modeling of calcific aortic valve disease using patient-specific three-dimensional calcification scans

Rotem Halevi, Ashraf Hamdan, Gil Marom, Karin Lavon, Sagit Ben-Zekry, Ehud Raanani, Danny Bluestein, Rami Haj-Ali*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Calcific aortic valve disease (CAVD) is characterized by calcification accumulation and thickening of the aortic valve cusps, leading to stenosis. The importance of fluid flow shear stress in the initiation and regulation of CAVD progression is well known and has been studied recently using fluid–structure interaction (FSI) models. While cusp calcifications are three-dimensional (3D) masses, previously published FSI models have represented them as either stiffened or thickened two-dimensional (2D) cusps. This study investigates the hemodynamic effect of these calcifications employing FSI models using 3D patient-specific calcification masses. A new reverse calcification technique (RCT) is used for modeling different stages of calcification growth based on the spatial distribution of calcification density. The RCT is applied to generate the 3D calcification deposits reconstructed from a patient-specific CT scans. Our results showed that consideration of 3D calcification deposits led to both higher fluid shear stresses and unique fluid shear stress distribution on the aortic side of the cusps that may have an impact on the calcification growth rate. However, the flow did not seem to affect the geometry of the calcification during the growth phase.

Original languageEnglish
Pages (from-to)1683-1694
Number of pages12
JournalMedical and Biological Engineering and Computing
Issue number11
StatePublished - 1 Nov 2016


FundersFunder number
Sheba Medical Center
National Institutes of Health
National Institute of Biomedical Imaging and BioengineeringII U01 EB012487-0
Tel Aviv University
Nicholas and Elizabeth Slezak Super Center for Cardiac Research and Biomedical Engineering


    • Aortic valve
    • Calcification
    • Flow
    • Fluid–structure interaction
    • Hemodynamics
    • Stenosis


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