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Effect of Aortic Wall Deformation with Healthy and Calcified Annulus on Hemodynamic Performance of Implanted On-X Valve.
Cardiovascular Engineering and Technology ( IF 1.8 ) Pub Date : 2020-01-07 , DOI: 10.1007/s13239-019-00453-y
Masod Sadipour 1 , Pedram Hanafizadeh 1 , Keyvan Sadeghy 1 , Amirmohammad Sattari 1
Affiliation  

Introduction

In this research, the hemodynamic performance of a 23-mm On-X bileaflet mechanical heart valve (BMHV) was investigated with the realistic geometry model of the valve and the deformable aorta in accelerating systole. In addition, the effect of ascending aorta flexibility and aortic annulus calcification on the complex blood flow characteristics were investigated.

Methods

The geometry of the aorta is derived from the medical images, and the Ogden model has been utilized for the mechanical behavior of the ascending aorta. The 3D numerical simulation by a two-way Fluid-Structure Interaction (FSI) analysis using the Arbitrary Lagrangian–Eulerian (ALE) method was performed throughout the accelerating systolic phase.

Results

The dynamics of the leaflets are investigated, and blood flow characteristics such as velocities, vorticities as well as viscous and turbulent shear stress were precisely captured in the flow domain specifically in the hinge region. Streamline results are in accordance with the previously reported data, which show that the flared On-X valves inlet yields a more uniform flow in accelerating systole. Simulations show that aorta flexibility or valve annulus calcification causes variations up to 7% in maximum fluid velocity and 20% in Turbulence Kinetic Energy (TKE).

Conclusions

In this study, the complex flow field characteristics in the new generation of BMHVs considering aorta flexibility with healthy and calcified annulus were investigated. It was found that the blood flow around the hinges region is in the danger of hemolysis and platelet activation and subsequently thromboembolism. Furthermore, the results show that similar to vessel wall deformation, considering the probable annulus calcification after valve replacement is also essential.


中文翻译:

健康且钙化环带对主动脉壁的变形对植入式On-X瓣膜血流动力学性能的影响。

介绍

在这项研究中,采用阀的实际几何模型和可变形主动脉加速收缩期,研究了23毫米On-X双叶机械心脏瓣膜(BMHV)的血液动力学性能。此外,研究了升主动脉弹性和主动脉瓣环钙化对复杂血流特征的影响。

方法

主动脉的几何形状是从医学图像中得出的,Ogden模型已被用于升主动脉的力学行为。在整个加速收缩期,通过使用任意拉格朗日-欧拉(ALE)方法的双向流体-结构相互作用(FSI)分析进行了3D数值模拟。

结果

研究了小叶的动力学,并精确地在流域中特别是在铰链区域捕获了血流特征,例如速度,涡度以及粘性和湍流剪切应力。流线化结果与先前报道的数据一致,后者表明喇叭形的On-X阀门入口在加速收缩过程中产生了更均匀的流量。模拟表明,主动脉的柔韧性或瓣膜环钙化会导致最大流体速度变化高达7%,湍流动能(TKE)高达20%。

结论

在这项研究中,研究了考虑健康和钙化环的主动脉挠性的新一代BMHV的复杂流场特性。发现在铰链区域周围的血流处于溶血和血小板活化以及随后的血栓栓塞的危险中。此外,结果表明,与血管壁变形相似,考虑到瓣膜置换后可能的环形钙化也是必不可少的。
更新日期:2020-01-07
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