Key result
In an in vitro left heart simulator, physiological left ventricular vortical flow depended on jet-wall interaction driven by the orifice's distance from the posterior wall, rather than orifice shape alone.
Why the study?
Artificial mitral valve replacement can disrupt physiological LV vortex formation and flow stability, and the native D-shaped mitral annulus may play a crucial role in these flow patterns.
How do orifice geometry and position affect left ventricular vortex formation and turbulence intensity in an in vitro model?
How do orifice geometry and position affect left ventricular vortex formation and turbulence intensity in an in vitro model?
In vitro modeling demonstrates that the distance of the mitral orifice from the posterior ventricular wall, rather than just its shape, is crucial for generating physiological left ventricular vortical flow.
May stabilize LV flow after mitral replacement; leaves open whether D-shaped prostheses improve outcomes.
In a healthy human cardiac system, a large asymmetric clockwise vortex present in the left ventricle (LV) efficiently diverts the filling jet from the mitral annulus to the left ventricular outflow track. However, prior clinical studies have shown that artificial mitral valve replacement can affect the formation of physiological vortex, resulting in overall flow instability in the LV. Lately, the findings from several recent hemodynamic studies seem to suggest that the native D-shaped mitral annulus might be a crucial factor in the development of this physiological flow pattern, with its inherent flow stability and formation of coherent structures within the LV. This study aims to investigate the effect of orifice shape and its position with respect to the posterior wall of the ventricle on vortical formation and turbulence intensity in the LV, by utilizing four separate orifice configurations within an in vitro left heart simulator. Stereo particle image velocimetry experiments were then carried out to characterize the downstream flow field of each configuration. Our findings demonstrate that the generation of the physiological left ventricular vortical flow was not solely dependent upon the orifice shape but rather the subsequent jet-wall interaction. The distance of the orifice geometric center from the left ventricular posterior wall plays a significant role in this jet-wall interaction, and thus, vortical flow dynamics.
No takes yet. Share an insight, caveat, or question.
Tan et al. (2020) studied this question. Orifice shape and position was evaluated on Vortical formation and turbulence intensity in the left ventricle. In an in vitro left heart simulator, physiological left ventricular vortical flow depended on jet-wall interaction driven by the orifice's distance from the posterior wall, rather than orifice shape alone.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: