Key result
Different orientations of the St. Jude Medical bileaflet valve and the SJM Biocor porcine valve produced three distinct flow patterns and vortical structures in an in vitro left ventricular model.
Why the study?
Does the orientation and type of mitral valve prosthesis affect vortex dynamics and flow patterns in a left ventricular model?
Does the orientation and type of mitral valve prosthesis affect vortex dynamics and flow patterns in a left ventricular model?
The design and orientation of mitral valve prostheses significantly alter intraventricular vortex dynamics and flow patterns, potentially impacting left ventricular efficiency.
Valve orientation may alter LV flow; hypothesis-generating and leaves clinical relevance open.
The performance of the heart after a mitral valve replacement operation greatly depends on the flow character downstream of the valve. The design and implanting orientation of valves may considerably affect the flow development. A study of the hemodynamics of two orientations, anatomical and anti-anatomical, of the St. Jude Medical (SJM) bileaflet valve are presented and compared with those of the SJM Biocor porcine valve, which served also to represent the natural valve. We document the velocity field in a flexible, transparent (LV) using time-resolved digital particle image velocimetry (TRDPIV). Vortex formation and vortex interaction are two important physical phenomena that dominate the filling and emptying of the ventricle. For the three configurations, the following effects were examined: mitral valve inlet jet asymmetry, survival of vortical structures upstream of the aortic valve, vortex-induced velocities and redirection of theflow in abidance of the Biot-Savart law, domain segmentation, resonant times of vortical structures, and regions of stagnantflow. The presence of three distinct flow patterns, for the three configurations, was identified by the location of vortical structures and level of coherence corresponding to a significant variation in the turbulence level distribution inside the LV. The adverse effect of these observations could potentially compromise the efficiency of the LV and result in flow patterns that deviate from those in the natural heart.
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Pierrakos et al. (2004) studied Mitral valve replacement hemodynamics. St. Jude Medical bileaflet valve (anatomical and anti-anatomical orientations) vs. SJM Biocor porcine valve was evaluated on Velocity field, vortex formation, and vortex interaction. Different orientations of the St. Jude Medical bileaflet valve and the SJM Biocor porcine valve produced three distinct flow patterns and vortical structures in an in vitro left ventricular model.
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