Evaluation of Paravalvular Leakage in Novel Mechanical Heart Valve

2017 ◽  
Author(s):  
Ankit Saxena ◽  
Rohan Shad ◽  
Mrudang Mathur ◽  
Anwesha Chattoraj ◽  
Sujay Shad
Keyword(s):  
Heart Valve ◽  
Heart Valves ◽  
Cardiac Tissue ◽  
Mechanical Heart Valve ◽  
Prosthetic Heart Valve ◽  
3D Printed ◽  
Novel Method ◽  
Novel Devices ◽  
Careful Assessment ◽  
Unique Mechanism

We developed a new mechanical heart valve prototype with a unique mechanism for attachment to cardiac tissue. The development of novel prosthetic heart valve systems requires careful assessment of paravalvular leaks — leakage of fluid that takes place between the valve and the cardiac tissue it is attached to. Traditional methods of testing paravalvular leaks in flow chambers are not ideal for novel devices and may underestimate its true extent. In this paper we developed a novel method of quantifying paravalvular leaks involving the use of 3D printed prototype heart valves and cadaveric bovine hearts, and compared the results with those from commercially available Medtronic ATS mechanical bileaflet valves. The average leak in our final prototype heart valves were found to be 0.13 ml/sec, compared to 0.33 ml/sec in the ATS valve.

scholarly journals Hemodynamic Performance of Dysfunctional Prosthetic Heart Valve with the Concomitant Presence of Subaortic Stenosis: In Silico Study

2020 ◽  
Vol 7 (3) ◽  
pp. 90
Author(s):  
Othman Smadi ◽  
Anas Abdelkarim ◽  
Samer Awad ◽  
Thakir D. Almomani
Keyword(s):  
Early Detection ◽  
Heart Valve ◽  
Heart Valves ◽  
Cfd Simulation ◽  
Treatment Plan ◽  
Mechanical Heart Valve ◽  
Prosthetic Heart Valve ◽  
Subaortic Stenosis ◽  
Prosthetic Heart Valves ◽  
The Impact

The prosthetic heart valve is vulnerable to dysfunction after surgery, thus a frequent assessment is required. Doppler electrocardiography and its quantitative parameters are commonly used to assess the performance of the prosthetic heart valves and provide detailed information on the interaction between the heart chambers and related prosthetic valves, allowing early detection of complications. However, in the case of the presence of subaortic stenosis, the accuracy of Doppler has not been fully investigated in previous studies and guidelines. Therefore, it is important to evaluate the accuracy of the parameters in such cases to get early detection, and a proper treatment plan for the patient, at the right time. In the current study, a CFD simulation was performed for the blood flow through a Bileaflet Mechanical Heart Valve (BMHV) with concomitant obstruction in the Left Ventricle Outflow Tract (LVOT). The current study explores the impact of the presence of the subaortic on flow patterns. It also investigates the accuracy of (BMHV) evaluation using Doppler parameters, as proposed in the American Society of Echocardiography (ASE) guidelines.

Simulations of the Hinge Flow Fields of a Bileaflet Mechanical Heart Valve Under Physiologic Pulsatile Aortic Conditions

2008 ◽  
Author(s):  
Hélène A. Simon ◽  
Liang Ge ◽  
Iman Borazjani ◽  
Fotis Sotiropoulos ◽  
Ajit P. Yoganathan
Keyword(s):  
Heart Valve ◽  
Heart Valves ◽  
Mechanical Heart Valve ◽  
Prosthetic Heart Valve ◽  
Prosthetic Heart Valves ◽  
Valve Design ◽  
Bileaflet Mechanical Heart Valve ◽  
Hinge Flow ◽  
Blood Elements

Native heart valves with limited functionality are commonly replaced by prosthetic heart valves. Since the first heart valve replacement in 1960, more than three million valves have been implanted worldwide. The most widely implanted prosthetic heart valve design is currently the bileaflet mechanical heart valve (BMHV), with more than 130,000 implants every year worldwide. However, studies have shown that this valve design can still cause major complications, including hemolysis, platelet activation, and thromboembolic events. Clinical reports and recent in vitro experiments suggest that these thrombogenic complications are associated with the hemodynamic stresses imposed on blood elements by the complex non-physiologic flow induced by the valve, in particular in the hinge region.

Development and Optimization of a Novel Polymeric Prosthetic Heart Valve Using the Device Thrombogenicity Emulation (DTE) Methodology

2012 ◽  
Author(s):  
Thomas E. Claiborne ◽  
Michalis Xenos ◽  
Jawaad Sheriff ◽  
Dinesh Peter ◽  
Yared Alemu ◽  
...  
Keyword(s):  
Heart Valve ◽  
Heart Valves ◽  
Mechanical Heart Valve ◽  
Prosthetic Heart Valve ◽  
Total Artificial Heart ◽  
Circulatory Support ◽  
Calcific Aortic Valve Disease ◽  
Structural Valve Deterioration ◽  
Transcatheter Valve ◽  
Valve Implantation

Calcific aortic valve disease (CAVD) is the most common and life threatening form of valvular heart disease, characterized by stenosis and regurgitation, which is currently treated at the symptomatic end-stages via open-heart surgical replacement of the diseased valve with typically either a xenograft tissue valve or mechanical heart valve. These options offer the clinician a choice between structural valve deterioration and anticoagulant therapy respectively, effectively replacing one disease with another [1]. Polymeric heart valves (PHV) offer the promise of reducing or eliminating these complications [2] and may be efficacious for patients who cannot tolerate cardiothoracic surgery by using instead transcatheter valve implantation (TAVI) [3], where there is evidence that tissue valves are damaged during implantation [4], and in pulsatile circulatory support devices such as the SynCardia Total Artificial Heart. But development of PHVs has been slow due to the lack of sufficiently durable and biocompatible formulations.

Simulations of Flow Through Bileaflet Mechanical Heart Valves With Asymmetric Leaflet Motion

2012 ◽  
Author(s):  
B. Min Yun ◽  
Lakshmi P. Dasi ◽  
Cyrus K. Aidun ◽  
Ajit P. Yoganathan
Keyword(s):  
Heart Valve ◽  
Heart Valves ◽  
Mechanical Heart Valve ◽  
Prosthetic Heart Valve ◽  
Prosthetic Heart Valves ◽  
Thromboembolic Events ◽  
Complex Flow ◽  
Blood Damage ◽  
Flow Through ◽  
Leaflet Motion

Prosthetic heart valves have been used for over 50 years to replace diseased native valves but still lead to severe complications such as platelet aggregation and thromboembolic events. The most widely implanted design is the bileaflet mechanical heart valve (BMHV). Most modern BMHV designs have better flow hemodynamics and blood damage performance than earlier-generation counterparts. However, blood element trauma and thromboembolic events still remain as major complications of current BMHV designs. These problems have been linked to blood damage caused by non-physiological stresses. These stresses are caused by the complex flow fields that arise due to prosthetic heart valve design. In order to reduce the severity of these complications, the blood damage that occurs in flows through prosthetic heart valves must be well understood.

Impact of Aortic Prosthetic Heart Valve Dysfunction on Left Ventricular Afterload and on the Accuracy of Echo-Doppler Measurements

2011 ◽  
Author(s):  
Othman Smadi ◽  
Zahra Keshavarz-Motamed ◽  
Ibrahim Hassan ◽  
Philippe Pibarot ◽  
Lyes Kadem
Keyword(s):  
Left Ventricle ◽  
Heart Valve ◽  
Heart Valves ◽  
Mechanical Heart Valve ◽  
Prosthetic Heart Valve ◽  
Left Ventricular ◽  
Heart Valve Disease ◽  
Thromboembolic Events ◽  
Left Heart ◽  
Ventricular Afterload

Left heart side (left ventricle and left atrium) is responsible for delivering the oxygenated blood to all body organs, where a relatively strong left ventricle contraction is needed to deliver around 5 liters of blood per minute. As a consequence, the left heart side experiences a high pressure (∼150 mmHg). Therefore, the dysfunction (stenosis or incompetence) in the aortic and/or mitral heart valves in the left side of the heart is more common than the dysfunction in the pulmonary and tricuspid heart valves in the right side of the heart (Yoganathan et al., 2004). Heart valve surgical replacement is the most effective solution in severe functional heart valve disease (Pibarot and Dumesnil, 2009). Almost, half of the total implants of prosthetic heart valves (∼300,000) are mechanical (mainly bileaflet). In case of mechanical heart valve (MHV), a lifelong anti-coagulant should be taken to avoid thromboembolic events. Despite the significant improvement in valve design resulting in minimizing prosthetic valve complications (thromboembolic events or pannus formation), these complications are still possible with MHV Implantation.

scholarly journals 1258 Computational Modelling Of 3D Printed Scaffolds for Heart Valve Regeneration

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Georgi ◽  
L Wu ◽  
H Ma ◽  
G Hamilton ◽  
W Song
Keyword(s):  
Heart Valve ◽  
Heart Valves ◽  
Computational Modelling ◽  
Prosthetic Heart Valve ◽  
Compressive Force ◽  
Radial Pressure ◽  
Patient Specific ◽  
Compression Tests ◽  
Element Analysis ◽  
3D Printed

Abstract Aim Prosthetic heart valve replacement remains the gold standard treatment for valvular heart disease. However, its durability is limited and there is thus a need to develop an understanding of the feasibility of alternative replacement therapies. 3-dimensional printing of heart valves has been explored due to its patient-specific design and control of desired biomechanical properties. Computational studies of the synthetic valves will contribute to optimisation of designs, as well as improved understanding of the biomechanical behaviour of the complex structures. Method Aortic valve dimensions at an average of 100mmHg were used for the computerised design of the valves. Fine Element Analysis modelling generated computational experiments alongside predicted results. Simulated radial pressures tests were conducted at pressures from 0mmHg to 140mmHg and compression tests were conducted at displacement levels between 0-10mm. A Young’s modulus of 0.5 MPa was used. All simulations were conducted in a quasi-static manner. Results As the radial pressure on the valves increased, the Mises stresses increased. The maxium Mises stress of the heart valve was 0.09MPa and 0.13MPa under the pressures of 90mmHg and 140mmHg respectively. As valve displacement increased, the Mises stress of the heart valves proportionally rose. In simulated radial pressures tests, the compressive force was 0.19N at 1mm compressive displacment and 1.8N at 10mm compressive displacment. Conclusions The simulations demonstrated that 3D-printed heart valve scaffolds can withstand simulated radial pressure and compression tests. A further mechanical tests of the printed scaffold and understanding of its response to hemodynamic dynamic flow is required for the continuity of further study.

Simulations of Flow Through Bileaflet Mechanical Heart Valves to Assess Platelet Damage

2011 ◽  
Author(s):  
B. Min Yun ◽  
Jingshu Wu ◽  
Cyrus K. Aidun ◽  
Ajit P. Yoganathan
Keyword(s):  
Heart Valve ◽  
Heart Valves ◽  
Mechanical Heart Valve ◽  
Prosthetic Heart Valve ◽  
Prosthetic Heart Valves ◽  
Thromboembolic Events ◽  
Complex Flow ◽  
Valve Design ◽  
Blood Damage ◽  
Flow Through

Prosthetic heart valves have been used for over 50 years to replace diseased native valves but still lead to severe complications such as hemolysis, platelet aggregation, and thromboembolic events. The most widely implanted design is the bileaflet mechanical heart valve (BMHV). Most modern BMHV designs have better flow hemodynamics and blood damage performance than their earlier-generation counterparts. However, blood element trauma and thromboembolic events still remain as major complications of current BMHV designs. These problems have been linked to blood element damage caused by non-physiological stresses. These stresses are caused by the complex flow fields that arise due to prosthetic heart valve design, particularly in the leaflet hinge region. In order to reduce the severity of these complications, the blood damage that occurs in flows through prosthetic heart valves must be well understood.

scholarly journals Adverse Hemodynamic Conditions Associated with Mechanical Heart Valve Leaflet Immobility

2018 ◽  
Vol 5 (3) ◽  
pp. 74 ◽  
Author(s):  
Fardin Khalili ◽  
Peshala Gamage ◽  
Richard Sandler ◽  
Hansen Mansy
Keyword(s):  
Heart Valve ◽  
Heart Valves ◽  
Computational Study ◽  
Cell Damage ◽  
Mechanical Heart Valve ◽  
Flow Characteristics ◽  
Maximal Velocity ◽  
Valve Dysfunction ◽  
Promising Tool ◽  
Artificial Heart Valves

Artificial heart valves may dysfunction, leading to thrombus and/or pannus formations. Computational fluid dynamics is a promising tool for improved understanding of heart valve hemodynamics that quantify detailed flow velocities and turbulent stresses to complement Doppler measurements. This combined information can assist in choosing optimal prosthesis for individual patients, aiding in the development of improved valve designs, and illuminating subtle changes to help guide more timely early intervention of valve dysfunction. In this computational study, flow characteristics around a bileaflet mechanical heart valve were investigated. The study focused on the hemodynamic effects of leaflet immobility, specifically, where one leaflet does not fully open. Results showed that leaflet immobility increased the principal turbulent stresses (up to 400%), and increased forces and moments on both leaflets (up to 600% and 4000%, respectively). These unfavorable conditions elevate the risk of blood cell damage and platelet activation, which are known to cascade to more severe leaflet dysfunction. Leaflet immobility appeared to cause maximal velocity within the lateral orifices. This points to the possible importance of measuring maximal velocity at the lateral orifices by Doppler ultrasound (in addition to the central orifice, which is current practice) to determine accurate pressure gradients as markers of valve dysfunction.

scholarly journals Stereoscopic PIV of Steady Flow Through a Bileaflet Mechanical Heart Valve

2008 ◽  
Author(s):  
C. Hutchison ◽  
P. E. Sullivan ◽  
C. R. Ethier
Keyword(s):  
Steady Flow ◽  
Heart Valve ◽  
Heart Valves ◽  
Mechanical Heart Valve ◽  
Three Dimensional ◽  
Flow Characteristics ◽  
Shear Stresses ◽  
Stereoscopic Piv ◽  
Bileaflet Mechanical Heart Valve ◽  
Component Particle

Each year over 180,000 mechanical heart valves are implanted worldwide, with the bileaflet mechanical heart valve (BiMHV) accounting for approximately 85% of all valve replacements [1,2]. Although much improved from previous valve designs, aortic BiMHV design is far from ideal, and serious complications such as thromboembolism and hemolysis often result. Hemolysis and platelet activation are thought to be caused by turbulent Reynolds shear stresses in the flow [1]. Numerous previous studies have examined aortic BiMHV flow using LDA and two component Particle Image Velocimetry (PIV), and have shown the flow to be complex and three-dimensional [3,4]. Stereoscopic PIV (SPIV) can obtain all three velocity components on a flow plane, and hence has the potential to provide better understanding of three dimensional flow characteristics. The objective of the current study was to use SPIV to measure steady flow, including turbulence properties, downstream of a BiMHV in a modeled aorta. The resulting dataset will be useful for CFD model validation, and the intent is to make it publicly available.

Finite Element Analysis of a Mechanical Heart Valve in Assembly

2012 ◽  
Vol 569 ◽  
pp. 487-490
Author(s):  
Liang Liang Wu ◽  
Guo Jiang Wan ◽  
Feng Zhou ◽  
Jie Yang ◽  
Nan Huang
Keyword(s):  
Heart Valve ◽  
Heart Valves ◽  
Mechanical Heart Valve ◽  
Mechanical Valve ◽  
Mechanical Method ◽  
Assembly Quality ◽  
Element Analysis ◽  
Bileaflet Mechanical Heart Valve ◽  
Valve Assembly ◽  
Ansys Workbench

The Bileaflet Mechanical Heart Valve (BMHV) has been the most successful replacement mechanical heart valve, and is currently the most commonly implanted mechanical valve. Although the BMHV is an improvement over previous mechanical heart valves, there are still serious associated complications with its use that must be eliminated. After the completion of the processing and surface modification, heart valve ring and heart valve leaflets constitute a single whole with mechanical method to achieve its function process. In order to ensure that the heart valve is stable and reliable in service, it is particularly important to improve the assembly quality. The theoretical analysis and simulation used of ANSYS Workbench software for the behavior of the heart valve assembly have been done, the experimental results were verified by testing apparatus, which is a helpful tool used to simulate the new structure of the heart valve assembly, and play a certain significance to improve the accuracy of the assembly.

Sign in / Sign up

Export Citation Format

Share Document