The Trifecta pericardial bioprosthesis maximized effective orifice area and exploited >80% of the nominal luminal area, compared to <75% for Crown and <70% for Magna in an in vitro model.
Does the design of pericardial bioprostheses affect downstream flow field patterns and fluid dynamic performance in an in vitro aortic root phantom?
The design of pericardial bioprostheses directly impacts downstream flow field patterns, with the Trifecta valve demonstrating superior fluid dynamic performance in vitro compared to Crown and Magna valves.
We investigated the effect of the design of bioprosthetic pericardial valves on the downstream fluid flow pattern through four-dimensional flow magnetic resonance imaging (4D Flow). A dedicated in vitro test bench, including a paradigmatic aortic root phantom, was used to compare, under steady flow conditions, three commercially used pericardial bioprostheses (TrifectaTM, Carpentier-Edwards PERIMOUNT Magna, Crown PRT®), selecting the two smallest and comparable valve sizes. In-house 4D Flow post-processing provided the downstream flow pattern of velocity, the velocity profile at vena contracta, its effective orifice area (EOA) and the corresponding hydraulic diameter (DH). Trifecta reported the lowest peak of velocity for both the tested sizes, with vena contracta position being the most proximal to the free margin of leaflets. Conversely, in both Crown and Magna, jet flow continued to increase its downstream velocity, resulting in a farther position of vena contracta. EOA shape was trilobal for Magna, triangular for Crown and circular for Trifecta, the last one maximising EOA. The percentage of nominal luminal area effectively exploited by the flow was largely above 80% in Trifecta, below 75% in Crown and below 70% in Magna. Hence, the design of pericardial bioprostheses directly impacts on the downstream flow field pattern and its fluid dynamic performance.
Tasca et al. (Fri,) conducted a other in Bioprosthetic pericardial valves. Trifecta bioprosthesis vs. Carpentier-Edwards PERIMOUNT Magna and Crown PRT was evaluated on Downstream flow pattern of velocity, velocity profile at vena contracta, effective orifice area, and hydraulic diameter. The Trifecta pericardial bioprosthesis maximized effective orifice area and exploited >80% of the nominal luminal area, compared to <75% for Crown and <70% for Magna in an in vitro model.