The influence of hematocrit on the hemodynamics of artificial heart valve using fluid-structure interaction analysis.

Patients with severe aortic stenosis could regain the proper hemodynamic performance and cardiovascular output by restoring the diseased aortic valve with an artificial heart valve replacement. However, given the uniqueness of each patient, the hemodynamic improvements after an aortic valve replacement could vary. The biomechanical and hemodynamical parameters can be influenced by some major factors including the patient's blood pressure and hematocrit. Therefore, the objective of this study is to analyze the hemodynamics and valve mechanics of a bileaflet mechanical heart valve and investigate the hemorheological characteristics under the change of hematocrit. The fully coupled fluid-structure interaction (FSI) approach was used to model the hemodynamics and valve dynamics. Particle image velocimetry (PIV) experiments were conducted with in vitro benchtop model using ViVitro Pulse Duplicator to verify and validate the FSI models. The current numerical analysis revealed the hematocrit influenced the shear stress distributions over a cardiac cycle. The structural stresses in the mechanical valve were also affected by the distributions of the shear stress in the blood flow. Parameter dependencies found in the current study indicate that the hematocrit is influential when conducting patient-specific modelling of prosthetic heart valves.

A correlation between long-term in vitro dynamic calcification and abnormal flow patterns past bioprosthetic heart valves.

In this paper, a long-term in vitro dynamic calcification of three porcine aortic heart valves was investigated using a combined approach that involved accelerated wear testing of the valves in the rapid calcification solution, hydrodynamic assessment of the progressive change of effective orifice area (EOA) along with the transaortic pressure gradient, and quantitative visualization of the flow. The motivation for this study was developing a standardized, economical, and feasible in vitro testing methodology for bioprosthetic heart valve calcification, which would address both the hydrodynamic performance of the valves as well as the subsequent changes in the flow field. The results revealed the failure of the test valves at 40 million cycles mark, associated with the critical decrease in the EOA, followed by the increase in the maximum value of viscous shear stress of up to 52%, compared to the values measured at the beginning of the study. The decrease in the EOA was subsequently followed by the rapid increase in the maximum streamwise velocity of the central orifice jet up to the value of about 2.8 m/s, compared to the initial value of 2 m/s, and to the value of 2.2 m/s in the case of a control valve along with progressive narrowing of the velocity profile for two test valves. The significance of the current work is in demonstrating a correlation between calcification of the aortic valve and spatial as well as the temporal development of abnormal flow features.

The influence of the aortic root geometry on flow characteristics of a prosthetic heart valve.

In this paper, performance of aortic heart valve prosthesis in different geometries of the aortic root is investigated experimentally. The objective of this investigation is to establish a set of parameters, which are associated with abnormal flow patterns due to the flow through a prosthetic heart valve implanted in the patients that had certain types of valve diseases prior to the valve replacement. Specific valve diseases were classified into two clinical categories and were correlated with the corresponding changes in aortic root geometry while keeping the aortic base diameter fixed. These categories correspond to aortic valve stenosis and aortic valve insufficiency. The control case that corresponds to the aortic root of a patient without valve disease was used as a reference. Experiments were performed at test conditions corresponding to 70 beats/min, 5.5 L/min target cardiac output, and a mean aortic pressure of 100 mmHg. By varying the aortic root geometry, while keeping the diameter of the orifice constant, it was possible to investigate corresponding changes in the levels of Reynolds shear stress and establish the possibility of platelet activation and, as a result of that, the formation of blood clots.