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.
Issue Section:
Fluids/Heat/Transport
Keywords:
prosthetics,
cardiology,
velocity measurement,
vortices,
turbulence,
electromagnetism,
haemodynamics,
biomedical measurement,
Doppler measurement,
Mechanical Heart Valves,
Bioprosthetic Heart Valves,
Time-Resolved DPIV,
Vortex Dynamics,
Mechanical Heart Valves,
MHV Orientation,
Left Ventricle Filling
1.
Bronzino, Joseph D., 1999, The Biomedical Engineering Handbook, 2nd ed., CRC Press, Boca Raton, Vol. I, Chap. 29, pp. 1–15.
2.
Edmunds
, Henry I.
, 2001
, “Evolution of Prosthetic Heart Valves
,” Am. Heart J.
, 141
, pp. 849
–855
.3.
Hammermeister
, K.
, Sethi
, G. K.
, Henderson
, W. G.
, Grover
, F. L.
, Oprian
, C.
, and Rahimtoola
, S. H.
, 2000
, “Outcome 15 Years After Valve Replacement With a Mechanical Versus a Bioprosthetic Valve: Final Report of the Veterans Affairs Randomized Trial
,” J. Am. Coll. Cardiol.
, 36
(4
), pp. 1152
–1158
.4.
Chandran
, K. B.
, Cabell
, G. N.
, Khalighi
, B.
, and Chen
, C. J.
, 1983
, “Laser Anemometry Measurements of Pulsatile Flow Past Aortic Valve Prostheses
,” J. Biomech.
, 16
(10
), pp. 865
–873
.5.
Chandran
, K. B.
, Khaloghi
, B.
, and Chen
, C. J.
, 1985
, “Experimental Study of Physiological Pulsatile Flow Past Valve Prostheses in a Model of Human Aorta. I. Caged Ball Valves
,” J. Biomech.
, 18
(10
), pp. 763
–772
.6.
Reul
, H.
, Giersiepen
, M.
, Schindehutte
, H.
, Effert
, S.
, and Rau
, G.
, 1986
, “Comparative in Vitro Evaluation of Porcine and Pericardial Bioprostheses
,” Z. Kardiol.
, 75
(Suppl. 2), pp. 223
–231
.7.
Bruss
, K. H.
, Reul
, H.
, Van Gilse
, J.
, and Knott
, E.
, 1983
, “Pressure Drop and Velocity Fields at Four Mechanical Heart Valve Prostheses: Bjork-Shiley Standard, Bjork-Shiley Concave-Convex, Hall-Kaster and St-Jude Medical
,” Life Support Syst.
, 1
, pp. 3
–22
.8.
Giersiepen
, M.
, Reul
, H.
, Knoch
, M.
, and Rau
, G.
, 1986
, “Pressure Drop and Velocity Fields at Mechanical Heart Valves
,” Life Support Syst.
, 4
(Suppl. 2), pp. 166
–168
.9.
Yoganathan
, A. P.
, Woo
, Y.
, and Sung
, H.
, 1986
, “Turbulent Shear Stress Measurements in the Vicinity of Aortic Heart Valve Prostheses
,” J. Biomech.
, 19
(6
), pp. 433
–442
.10.
Hasenkam
, J. M.
, Westphal
, D.
, Wygaard
, H.
, Reul
, H.
, Giersiepen
, M.
, and Stodkilde-Jorgensen
, H.
, 1988
, “In Vitro Stress Measurements in the Vicinity of Six Mechanical Aortic Valves Using Hot-Film Anemometry in Steady Flow
,” J. Biomech.
, 21
, pp. 235
–247
.11.
Hanle
, D. D.
, Harrison
, E. C.
, Yoganathan
, A. P.
, Alens
, D. T.
, and Corocran
, W. H.
, 1989
, “In Vitro Flow Dynamics of Four Prosthetic Aortic Valves: A Comparative Analysis
,” J. Biomech.
, 22
, pp. 597
–607
.12.
Giersiepen
, M.
, Krause
, U.
, Knott
, E.
, Reul
, H.
, and Rau
, G.
, 1989
, “Velocity and Shear Stress Distribution Downstream of Mechanical Heart Valves in Pulsatile Flow
,” Int. J. Artif. Organs
, 12
(4
), pp. 261
–269
.13.
Tonietto, G, 1990, “Etude experimentale et numerique des ecoulements post-valvulaires.” These de Doctorat, Universite. Aix-Marseille II, Institut de Mecanique des Fluides de Marseille.
14.
Lim
, W. L.
, Chew
, Y. T.
, Chew
, T. C.
, and Low
, H. T.
, 1994
, “Particle Image Velocimetry in the Investigation of Flow Past Artificial Heart Valves
,” Ann. Biomed. Eng.
, 22
, pp. 307
–318
.15.
Bellhouse
, B. J.
, and Bellhouse
, F. H.
, 1969
, “Fluid Mechanics of the Mitral Valve
,” Nature (London)
, 224
, pp. 615
–616
.16.
Bellhouse
, B. J.
, 1972
, “Fluid Mechanics of a Model Mitral Valve and Left Ventricle
,” Cardiovasc. Res.
, 6
, pp. 199
–210
.17.
Woo
, Y.
, and Yoganathan
, A. P.
, 1986
, “In Vitro Pulsatile Flow Velocity and Shear Stress Measurements in the Vicinity of Mechanical Mitral Heart Valve Prostheses
,” J. Biomech.
, 19
(6
), pp. 39
–51
.18.
Chandran
, K. B.
, Schoephoerster
, R.
, and Dellesperger
, K. C.
, 1989
, “Effect of Prosthetic Mitral Valve Geometry and Orientation on Flow Dynamics in a Model of Human Left Ventricle
,” J. Biomech.
, 22
(1
), pp. 51
–65
.19.
Schoephoerster
, R. T.
, Oynes
, F.
, Numez
, H.
, Kapadvanjwala
, M.
, and Dewanjee
, M. K.
, 1993
, “Effects of Local Geometry and Fluid Dynamics on Regional Platelet Deposition on Artificial Surfaces
,” Arterioscler. Thromb.
, 12
, pp. 1806
–1813
.20.
Schoephoerster
, R. T.
, and Chandran
, K. B.
, 1991
, “Velocity and Turbulence Measurements Past Mitral Valve Prostheses in a Model Left Ventricle
,” J. Biomech.
, 24
(7
), pp. 549
–562
.21.
Lemmon
, D.
, and Yoganathan
, A. P.
, 2000
, “Three-Dimensional Computational Model of Left Heart Diastolic Function With Fluid-Structure Interaction
,” ASME J. Biomech. Eng.
, 122
, pp. 109
–117
.22.
Garitey
, V.
, Gandelheid
, T.
, Fusezi
, J.
, Pelissier
, R.
, and Rieu
, R.
, 1995
, “Ventricular Flow Dynamic Past Bileaflet Prosthetic Heart Valves
,” Int. J. Artif. Organs
, 18
(7
), pp. 380
–391
.23.
Bluestein
, D.
, Rambod
, E.
, and Gharib
, M.
, 2000
, “Vortex Shedding as a Mechanism for Free Emboli Formation in Mechanical Heart Valves
,” J. Biomech. Eng.
, 122
, pp. 125
–134
.24.
Kleine
, P.
, Perthel
, M.
, Hasenkam
, J. M.
, Nygaard
, H.
, Hansen
, S. B.
, and Laas
, J.
, 1999
, “High-Intensity Transient Signals (HITS) as a Parameter for Optimum Orientation of Mechanical Aortic Valves
,” Thorac. Cardiovasc. Surg.
, 48
, pp. 360
–363
.25.
Laas
, J.
, Kleine
, P.
, Hasenkam
, M. J.
, and Nygaard
, H.
, 1999
, “Orientation of Tilting Disc and Bileaflet Aortic Valve Substitutes for Optimal Hemodynamics
,” Ann. Thorac. Surg.
, 68
, pp. 1096
–1099
.26.
Fontaine
, A. A.
, Shengqiu
, H.
, Stadter
, R.
, Ellis
, J. T.
, Levine
, R. A.
, and Yoganathan
, A. P.
, 1996
, “In Vitro Assessment of Prosthetic Valve Function in Mitral Valve Replacement With Chordal Preservation Techniques
,” J. Heart Valve Dis.
, 5
(2
), pp. 186
–198
.27.
Panton, R. L., 1996, Incompressible Flow, 2nd ed., Wiley-Interscience, London, Chichester, Brisbane, p. 462.
28.
Reul
, H.
, Talukder
, N.
, and Mu¨ller
, E. W.
, 1981
, “Fluid Mechanics of the Natural Mitral Valve
,” J. Biomech.
, 14
(5
), pp. 361
–372
.29.
Gross
, J. M.
, Shermer
, C. D.
, and Hwang
, H. C.
, 1988
, “Vortex Shedding in Bileaflet Heart Valve Prosthesis
,” Trans. Am. Soc. Artif. Intern. Organs
, 34
, pp. 845
–850
.30.
Liu
, J. S.
, Lu
, P. C.
, and Chu
, S. H.
, 1996
, “Pulsatile Flow Past Bileaflet Aortic Valve Prostheses
,” J. Chin. Inst. Eng.
, 19
, pp. 333
–344
.31.
Mouret
, F.
, Garitey
, V.
, Gandelheid
, T.
, Fuseri
, R.
, and Rieu
, R.
, 2000
, “A New Dual Activation Simulator of the Left Heart Which Reproduces Physiological and Pathological Conditions
,” Med. Biol. Eng. Comput.
, 38
, pp. 558
–561
.32.
Bronzino, J. D., 1999, The Biomedical Engineering Handbook, 2nd ed., CRC Press, Boca Raton, Vol. I, Chap. 1.
33.
Reul
, H.
, van Son Jacques
, A. M.
, Steinseifer
, U.
, Schmitz
, B.
, Schmidt
, A.
, Schmitz
, C.
, and Rau
, G.
, 1993
, “In Vitro Comparison of Bileaflet Aortic Heart Valve Prostheses-St. Jude Medical, Carbomedics, Modified Edwards-Duromedics and Sorin-Bicarbon Valves
,” J. Thorac. Cardiovasc. Surg.
, 106
, pp. 412
–420
.34.
Willert
, C. E.
, and Gharib
, M.
, 1991
, “Digital Particle Image Velocimetry
,” Exp. Fluids
, 10
, pp. 181
–193
.35.
Westerweel, J., 1993, Digital Particle Image Velocimetry, Theory and Application. Delft University Press, Delft.
36.
Huang, H. T., and Gharib, M., 1993, “Processing Error in Digital Particle Image Velocimetry,” FEDSM97-3068.
37.
Vlachos, P. P., and Telionis, D. P., “Turbulence Characteristics In The Wake Of A Circular Cylinder Near The Free Surface,” FEDSM2000-11320, Boston, MA, 2000.
38.
Abiven, C., and Vlachos, P. P., 2002, “Comparative Study of Established DPIV Algorithms for Planar Velocity Measurements,” ASME IMECE-33170, New Orleans, LA.
39.
Abiven, C., and Vlachos, P. P., 2002, “Super Spatio-Temporal Resolution, Digital, PIV System for Multi-Phase Flows With Phase Differentiation and Simultaneous Shape and Size Quantification,” ASME IMECE-33115, New Orleans, LA.
40.
Lele, S. K., April 1990, “Compact Finite Difference Schemes With Spectral-Like Resolution,” CTR Manuscript 107, NASA Technical Reports.
41.
Laas, J., Perthel, M., Aiken, A., and Kivelitz, D., 2000, “Intraventricular Flow in the Normal Heart and After Mitral Valve Replacement,” (Video) Kurt Singel Mann, Videostudio MHH.
42.
Yuji
, O.
, Okamoto
, K.
, Sonderegger
, M.
, Dohi
, T.
, Matsumoto
, H.
, and Horiuchi
, T.
, 1997
, “Nonsymmetric Leaflet Motion of St. Jude Medical Mitral Valves Simulated With a Computer-Controlled Hydraulic Mock Circulator
,” Artif. Organs
, 21
(4
), pp. 335
–339
.43.
Kilner
, P. J.
, Yang
, G.-Z.
, Wilkes
, A. J.
, Mohladin
, R. H.
, Firmin
, D. N.
, and Yacoub
, M. H.
, 2000
, “Asymmetric Redirection of Flow Through the Heart
,” Nature (London)
, 404
, pp. 759
–761
.44.
Gharib
, M.
, Rambod
, E.
, and Shariff
, K.
, 1998
, “A Universal Time Scale for Vortex Ring Formation
,” J. Fluid Mech.
, 360
, pp. 121
–140
.45.
Tennekes, H., February 1972, A First Course in Turbulence, MIT Press, Cambridge, MA.
46.
Batchelor, G. K., 1982, Theory of Homogeneous Turbulence, Cambridge University Press, Cambridge.
47.
Kolmogorov, A. N., 1947, “Statistical Theory of Oscillations With Continuous Spectrum,” Anniversary Collection of Papers, Acad. Sci. U.S.S.R. Press, Moscow.
Copyright © 2004
by ASME
You do not currently have access to this content.
