摘要：Background Tetralogy of Fallot(TOF)is the most common cyanotic heart defect,accounting for 10%of all congenital defects.Pulmonary valve stenosis(PVS)is one common right ventricular outflow tract obstruction problem in patients with TOF.Congenital bicuspid pulmonary valve(BPV)is a condition of valvular stenosis,which morphologic feature is the presence of only two pulmonary leaflets instead of the normal tri-leaflet.Congenitally BPV are uncommon and the occurrence is often associated with TOF.Methods The three-dimensional geometric reconstruction of pulmonary root(PR)were based on well-accepted mathematical analytic models with physiological parameters obtained from a typical sample of the pulmonary root used in clinical surgery.The PR geometry included valvular leaflets,sinuses,interleaflet triangles and annulus.The dynamic computational models of normal PR with tri-leaflet and PR with BPV in patients with TOF were developed to investigate the effect of geometric structure of BPV on valve stress and strain distributions and the geometric orifice area.Mechanical properties of pulmonary valve leaflet were obtained from biaxial testing of human pulmonary valve left leaflet,and characterized by an anisotropic Mooney-Rivlin model.The complete cardiac cycle was simulated to observe valve leaflet dynamic stress and strain behaviors.Results Our results indicated that stress/strain distribution patterns of normal tri-leaflet pulmonary valve(TPV)and the BPV were different on valve leaflets when the valve was fully open,but they were similar when valves were completely closed.When the valve was fully open,the BPV maximum stress value on the leaflets was 218.1 kPa,which was 128.0%higher than of the normal TPV value(95.6 kPa),and BPV maximum strain value on the leaflets was 70.7%higher than of the normal TPV.The location of the maximum stress from TPV and BPV were also different,which were found at the bottom of the valve near the leaflet attachment for TPV and the vicinity of cusp of the fusion of two leaflets for BPV,respec
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