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Bioengineering 2018, 5(3), 74; https://doi.org/10.3390/bioengineering5030074

Adverse Hemodynamic Conditions Associated with Mechanical Heart Valve Leaflet Immobility

1
Biomedical Acoustics Research Laboratory, University of Central Florida, 4000 Central Florida Blvd, Orlando, FL 32816, USA
2
Department of Mechanical Engineering, Embry-Riddle Aeronautical University, 600 South Clyde Morris Blvd., Daytona Beach, FL 32114-3900, USA
3
College of Medicine, University of Central Florida, 6850 Lake Nona Blvd, Orlando, FL 32827, USA
*
Author to whom correspondence should be addressed.
Received: 24 July 2018 / Revised: 8 September 2018 / Accepted: 10 September 2018 / Published: 16 September 2018
(This article belongs to the Special Issue Advances in Biological Tissue Biomechanics)
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Abstract

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. View Full-Text
Keywords: computational fluid dynamics; bileaflet mechanical heart valve; adverse hemodynamics; transvalvular pressure gradients; turbulent shear stresses; blood damage; platelet activation computational fluid dynamics; bileaflet mechanical heart valve; adverse hemodynamics; transvalvular pressure gradients; turbulent shear stresses; blood damage; platelet activation
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Khalili, F.; Gamage, P.P.T.; Sandler, R.H.; Mansy, H.A. Adverse Hemodynamic Conditions Associated with Mechanical Heart Valve Leaflet Immobility. Bioengineering 2018, 5, 74.

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