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

Author(s):  
B. Min Yun ◽  
Lakshmi P. Dasi ◽  
Cyrus K. Aidun ◽  
Ajit P. Yoganathan

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.

Author(s):  
B. Min Yun ◽  
Jingshu Wu ◽  
Cyrus K. Aidun ◽  
Ajit P. Yoganathan

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.


2020 ◽  
Vol 7 (3) ◽  
pp. 90
Author(s):  
Othman Smadi ◽  
Anas Abdelkarim ◽  
Samer Awad ◽  
Thakir D. Almomani

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.


2014 ◽  
Vol 136 (10) ◽  
Author(s):  
B. Min Yun ◽  
Cyrus K. Aidun ◽  
Ajit P. Yoganathan

Bileaflet mechanical heart valves (BMHVs) are among the most popular prostheses to replace defective native valves. However, complex flow phenomena caused by the prosthesis are thought to induce serious thromboembolic complications. This study aims at employing a novel multiscale numerical method that models realistic sized suspended platelets for assessing blood damage potential in flow through BMHVs. A previously validated lattice-Boltzmann method (LBM) is used to simulate pulsatile flow through a 23 mm St. Jude Medical (SJM) Regent™ valve in the aortic position at very high spatiotemporal resolution with the presence of thousands of suspended platelets. Platelet damage is modeled for both the systolic and diastolic phases of the cardiac cycle. No platelets exceed activation thresholds for any of the simulations. Platelet damage is determined to be particularly high for suspended elements trapped in recirculation zones, which suggests a shift of focus in blood damage studies away from instantaneous flow fields and toward high flow mixing regions. In the diastolic phase, leakage flow through the b-datum gap is shown to cause highest damage to platelets. This multiscale numerical method may be used as a generic solver for evaluating blood damage in other cardiovascular flows and devices.


Author(s):  
Hélène A. Simon ◽  
Liang Ge ◽  
Iman Borazjani ◽  
Fotis Sotiropoulos ◽  
Ajit P. Yoganathan

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.


SIMULATION ◽  
2019 ◽  
Vol 96 (5) ◽  
pp. 459-469
Author(s):  
Belkhiri Khellaf ◽  
Boumeddane Boussad

In this paper, we perform a numerical analysis for simulating steady, two-dimensional, laminar blood flow through our proposed design, known as the Butterfly mechanical heart valve, where the leaflets are fully opened. Blood has been assumed to be Newtonian and non-Newtonian fluid using the Casson model for shear-thinning behavior. A non-uniform Cartesian grid generation technique is presented to generate a two-dimensional grid for the irregular geometry of the Butterfly valve. The governing Navier–Stokes equations of flow, written in a stream function–vorticity formulation, are solved by the finite difference method with hybrid differencing of the convective terms. The computed results show that the blood’s non-Newtonian nature significantly affects the flow field with the existence of recirculation and consequently stagnation causing thrombus formation, as well as an increase of the shear stress along the wall, which contributes to hemolytic blood damage. The results demonstrate that the model is capable of predicting the hemodynamic features most interesting to physiologists. It can be used to assess thromboembolic problems occurring with heart valves and in the design of cardiac prostheses.


Author(s):  
Othman Smadi ◽  
Zahra Keshavarz-Motamed ◽  
Ibrahim Hassan ◽  
Philippe Pibarot ◽  
Lyes Kadem

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.


Author(s):  
Caitlin Martin ◽  
Wei Sun

Bio-prosthetic heart valves (BHVs) with leaflets made of glutaraldehyde-treated bovine pericardium (GLBP), have been used extensively to replace diseased heart valves. BHVs display superior hemodynamics to mechanical valves and eliminate the need for anticoagulant therapy; however, they exhibit poor durability resulting from in vivo degradation and fatigue damage of the leaflets.


2012 ◽  
Vol 569 ◽  
pp. 521-524
Author(s):  
Feng Zhou ◽  
Yuan Yuan Cui ◽  
Liang Liang Wu ◽  
Yin Chen ◽  
Jie Yang ◽  
...  

Artificial mechanical heart valve (MHV) replacement is the common cardiovascular surgical procedure, yet its effect is far from satisfaction. Most important reasons lie in the model design and choice of the materials in the fabrication of the prosthetic heart valves. Based on systematic design methodology of TRIZ theory (Russian acronym for Theory of Solving Inventive Problem), the device structure is analyzed by comparing the past successful designs generated during the evolution of MHV. This paper represents a modeling technique integrating the well-established TRIZ with the conflict and contradiction modeling, substance-field and product functional analysis tools and provides some important trends in evolutionary development of production systems in MHV design. By analyzing the structural behavior and material performance, a complex case study from the research of different structural patterns and characteristics of current tri-leaflet modeling shows the validity of TRIZ theory to guide MHV design.


Author(s):  
M J King ◽  
T David ◽  
J Fisher

The effect of leaflet opening angle on flow through a bileaflet mechanical heart valve has been investigated using computational fluid dynamics (CFD). Steady state, laminar flow for a Newtonian fluid at a Reynolds number of 1500 was used in the two-dimensional model of the valve, ventricle, sinus and aorta. This computational model was verified using one-dimensional laser Doppler velocimetry (LDV). Although marked differences in the flow fields and energy dissipation of the jets downstream of the valve were found between the CFD predictions and the three-dimensional experimental model, both methods showed similar trends in the changes of the flow fields as the leaflet opening angle was altered. As the opening angle increased the area of recirculating fluid downstream of the leaflets, the pressure drop across the valve and the volumetric flow rate through the outer orifice decreased. For opening angles greater than 80° the jet through the outer orifice recombined with the central jet downstream of the leaflet; for an opening angle of 78° the jet through the outer orifice impinged on the aortic wall before recombining with the central jet. This study suggests that the opening angle has a marked effect on the flow downstream of the bileaflet mechanical heart valve and that valves with opening angles greater than 80° are preferable.


2012 ◽  
Vol 61 (5) ◽  
pp. 10-24
Author(s):  
Aleksandr Davidovich Makatsariya ◽  
Viktoriya Omarovna Bitsadze ◽  
Dzhamilya Khizriyevna Khizroyeva ◽  
Vyacheslav Borisovich Nemirovskiy ◽  
Svetlana Vladimirovna Akinshina

In patients with prosthetic heart valves pregnancy and labor are associated with high risk. There are no established anticoagulation guidelines in pregnant women with mechanical heart valve prostheses. More often physiological hypercoagulable state during pregnancy can reveal acquired and/or inherited hemostasis abnormalities which were asymptotic before pregnancy. The presence in the history of patients the foetal loss syndrome, severe obstetric complications (severe preeclampsia, abruptio placenta, antenatal fetal death, feto-placental insufficiency), thrombosis events is an indication for the screening for genetic thrombophilia and antiphospholipid syndrome. The diagnosis of thrombophilia in patients with mechanical heart valve prostheses can explain the inefficiency of anticoagulation therapy, warfarin resistance, «floating» hemostasis markers and difficulties in adequate dose selection


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