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

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.

Author(s):  
C. Hutchison ◽  
P. E. Sullivan ◽  
C. R. Ethier

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.


CFD letters ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 69-79
Author(s):  
Nursyaira Mohd Salleh ◽  
Mohamad Shukri Zakaria ◽  
Mohd Juzaila Abd Latif ◽  
Adi Azriff Basri

Artificial heart valves for replacing diseased indigenous heart valves were widely used. The treatment of certain types of heart disease requires mechanical valves to be implanted operatively. Healthy cardiac valves are essential to proper cardiac function. The current study presents an investigation of the pulsatile blood flow through a bileaflet mechanical heart valve (BMHV) with a vortex generator (VG) in fully open position. A St. Jude Medical Regent valve with a diameter of 23 mm was used to mount triangular VGs as a means of improving pressure gradients and reducing turbulence. The anatomic aorta and axisymmetric aorta was computed by large eddy simulation (LES) approached. The implications for both models with VGs were observed in terms of velocity magnitude, vortices and wall shear stress. The results suggested that the anatomic aorta is prone to develop more blood clotting at the leading edge of the leaflets with 2.03 m/s. Furthermore, the anatomic aorta produces higher wall shear stress with 69Pa, which possibly contributes to a high risk of thrombosis.


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.


2012 ◽  
Vol 569 ◽  
pp. 487-490
Author(s):  
Liang Liang Wu ◽  
Guo Jiang Wan ◽  
Feng Zhou ◽  
Jie Yang ◽  
Nan Huang

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.


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


2021 ◽  
Vol 54 (3) ◽  
pp. 277-284
Author(s):  
Natasha Mukhtiar ◽  
Murtaza Najabat Ali ◽  
Hafsa Inam

Heart valve problems affect more than 100 million people worldwide. According to statistics, around 55% of valvular diseases are treated by a mechanical prosthesis. The first heart valve replaced model was the caged-ball valve, more than 50 models of heart valves designed by different companies. Each design has different aspects such as valve geometry, leaflets design, materials used for model manufacturing, coating techniques, and coating materials. Depending on the patient's need and condition, the native heart valve either replaced by a biological or mechanical heart valve. Biological valves are made of living tissues whereas mechanical valves manufactured by the biomaterials, which are biocompatible and do not causes any reaction inside the body. The prototype discussed in this paper provides good hemocompatibility, because of the biomaterial used in this prototype manufacturing. It will reduce tissue ingrowth, due to the enhanced leaflet ear of the orifice ring. Moreover, it will cause less thrombotic effects into the host due to greater contact angel of graphite and smooth surface of graphite after pyrolytic coating. The significant evolution of mechanical valve designs consists of valve geometry, coating technique, and materials. In this research, the 3D-CAD model of Bileaflet Mechanical Mitral Heart Valve was designed using SOLID WORKS 2016 and fabricated by 5-axis Computer Numeric Control (CNC) machine. Graphite was used for the fabrication of prototype and Pyrolytic Carbon (PyC) coating was performed with Chemical Vapor deposition (CVD) technique. Scanning electron microscopy (SEM), Fourier Transform Infrared Spectroscopy (FTIR), and X-ray Diffraction (XRD) were used to determine the effects of CVD on surface topography and chemical structure of graphite model before and after coating. Furthermore, hemocompatibility of graphite and PyC analyzed through in-vitro hemolytic activity. The Characterization results showed that the Bileaflet Mechanical Mitral Heart valve prototype after PyC coating provides a smooth surface with improved hemocompatibility and less adhesion. Besides, the Mechanical Heart valves showed no hemolysis during the hemolytic activity. By virtue of its smooth and nonporous surface, it is antithrombotic and provides good hemodynamics. The advance long leaflet ear design reduces the tissue ingrowth around the orifice which will further limit the leaflets movement.


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