SUMMARYIn this paper, the influence of the upstream boundary condition in the numerical simulation of an aortic bileaflet mechanical heart valve (BMHV) is studied. Three 3D cases with different upstream boundary conditions are compared. A first case consists of a rigid straight tube with a velocity profile at its inlet. In the second case, the upstream geometry is a contracting left ventricle (LV), positioned symmetrically with respect to the valve. In the last case, the LV is positioned asymmetrical with respect to the valve. The cases are used to simulate the same 3D BMHV. The change in time of the LV volume is calculated such that the flow rate through the valve is identical in each case. The opening dynamics of the BMHV are modelled using fluidstructure interaction (FSI). The simulations show that differences occur in the leaflet movement of the three cases. In particular, with the asymmetric LV, one of the leaflets impacts the blocking mechanism at its open position with a 34% higher velocity than when using the velocity profile, and with an 88% higher velocity than in the symmetric LV case. Therefore, when simulating such an impact, the upstream boundary condition needs to be chosen carefully.