Transthoracic left ventricular puncture for the assessment of patients with aortic and mitral valve prostheses: The Massachusetts General Hospital experience, 1989-2000

2003 ◽  
Vol 58 (4) ◽  
pp. 539-544 ◽  
Author(s):  
Darren L. Walters ◽  
Pedro L. Sanchez ◽  
Maximo Rodriguez-Alemparte ◽  
Pedro J. Colon-Hernandez ◽  
Lisa A. Hourigan ◽  
...  
Keyword(s):  
Mitral Valve ◽  
General Hospital ◽  
Massachusetts General Hospital ◽  
Left Ventricular ◽  
Hospital Experience ◽  
Ventricular Puncture ◽  
Valve Prostheses

Time-Resolved DPIV Analysis of Vortex Dynamics in a Left Ventricular Model Through Bileaflet Mechanical and Porcine Heart Valve Prostheses

2004 ◽  
Vol 126 (6) ◽  
pp. 714-726 ◽  
Author(s):  
Olga Pierrakos ◽  
Pavlos P. Vlachos ◽  
Demetri P. Telionis
Keyword(s):  
Mitral Valve ◽  
Vortex Formation ◽  
Flow Patterns ◽  
Left Ventricular ◽  
Time Resolved ◽  
Vortical Structures ◽  
Jude Medical ◽  
Image Velocimetry ◽  
Valve Prostheses ◽  
Physical Phenomena

The performance of the heart after a mitral valve replacement operation greatly depends on the flow character downstream of the valve. The design and implanting orientation of valves may considerably affect the flow development. A study of the hemodynamics of two orientations, anatomical and anti-anatomical, of the St. Jude Medical (SJM) bileaflet valve are presented and compared with those of the SJM Biocor porcine valve, which served also to represent the natural valve. We document the velocity field in a flexible, transparent (LV) using time-resolved digital particle image velocimetry (TRDPIV). Vortex formation and vortex interaction are two important physical phenomena that dominate the filling and emptying of the ventricle. For the three configurations, the following effects were examined: mitral valve inlet jet asymmetry, survival of vortical structures upstream of the aortic valve, vortex-induced velocities and redirection of the flow in abidance of the Biot–Savart law, domain segmentation, resonant times of vortical structures, and regions of stagnant flow. The presence of three distinct flow patterns, for the three configurations, was identified by the location of vortical structures and level of coherence corresponding to a significant variation in the turbulence level distribution inside the LV. The adverse effect of these observations could potentially compromise the efficiency of the LV and result in flow patterns that deviate from those in the natural heart.

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