Bicuspid Valve Closure and Backflow Prevention: Role of Leaflet Geometry

TL;DR

This study uses numerical simulations to analyze how leaflet length and stiffness influence bicuspid valve efficiency in preventing reflux, providing insights into valve incompetence.

Contribution

It introduces a numerical approach to evaluate the impact of leaflet geometry on valve function and reflux prevention in bicuspid valves.

Findings

Shorter leaflets are associated with increased reflux.

Valve stiffness significantly affects flow transition thresholds.

Numerical results explain experimentally observed valve incompetence.

Abstract

Bicuspid valves with crescent-shaped leaflets are found in lymphatic vessels and veins, where their primary function is to prevent reflux and ensure unidirectional flow toward the heart. These valves are passive, and their functionality emerges spontaneously from a complex interplay between the properties of the valve leaflets and the flow patterns developing within the vessel sinus region surrounding the valve. The main function of the valves is to limit retrograde flow, or reflux, but the optimal valve structure has not been well-characterized. Here we investigate numerically how the length of the leaflets affects the valve efficiency in preventing reflux. The valves are subjected to backward flow, akin to that imposed by gravity. We report the flux through the valve orifice as a function of key parameters: valve length, leaflet length, and leaflet rigidity. We monitor the transition in the flow regime - from reflux to complete flow blockage - by varying only the leaflet length. The transition threshold is found to depend strongly on the valve shape and stiffness. We captured these control parameters numerically to evaluate the ability of the valve to close and prevent reflux. This study allowed us to explain reflux observed experimentally in certain incompetent abnormal and immature valves, particularly those with shorter leaflets.