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Influence of Configuration on Stress Distribution of Pulmonary Monocusp Leaflet

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Abstract

Purpose

For the relief of right ventricular outflow tract obstruction in operative treatment of tetralogy of Fallot and other complex congenital heart diseases, transannular monocusp patch operations are often necessary to prevent right ventricular pressure overload and reduce pulmonary regurgitation. However, long-term durability of a monocusp leaflet is unsatisfactory, its failure is believed to be related to mechanical stress, whose distribution is primarily affected by geometric configurations. Therefore, the influence of several geometrical parameters on stress distribution of leaflet is investigated.

Methods

Five parameters affecting leaflet configuration were established: angle between free edge of the leaflet and vessel wall, angle formed by the two end points of free edge, length of the free edge of the leaflet, height of the leaflet, and shape of elliptic conical surface constituting the leaflet surface. The first four parameters were fixed, and two factors were defined to describe the last parameter. Seven models with different values of these factors were analyzed using finite element method at the pressure of the pulmonary artery loaded on the leaflet.

Results

The peak stresses of all models occurred at end points of the free edge of the leaflet (tear high-risk regions). The middle of leaflet had the greatest stress gradient and produced tissue wrinkling; this area could be the risk region of calcification. Both factors were noted to influence the stress distribution, and one of the factors could also relieve the wrinkling.

Conclusions

The leaflet of model (1.2_min) had the most even stress distribution and lowest peak principal stress, which was the optimal choice among all the models.

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Acknowledgments

This work was supported by the National Key Research and Development Program of China (2017YFB0702500); Beijing Natural Science Foundation (7194287); Innovation Teams in Priority Areas Accredited by the Ministry of Science and Technology (11421201); Special-Funded Program on National Key Scientific Instruments and Equipment Development (11827803).

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Correspondence to Jie Yao or Yubo Fan.

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The authors (Wentao Feng, Yishan Teng, Jie Yao, Xianda Yang, Chenglong Feng and Yubo Fan) have no conflicts of interest to declare.

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Associate Editor Wei Sun oversaw the review of this article.

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Feng, W., Teng, Y., Yao, J. et al. Influence of Configuration on Stress Distribution of Pulmonary Monocusp Leaflet. Cardiovasc Eng Tech 11, 134–140 (2020). https://doi.org/10.1007/s13239-019-00449-8

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  • DOI: https://doi.org/10.1007/s13239-019-00449-8

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