Hemodynamic Performance of Dysfunctional Prosthetic Heart Valve with the Concomitant Presence of Subaortic Stenosis: In Silico Study

Figures

• 

  Figure 1. Model geometry with dimensions (m) for 15 different cases: 0% dysfunction (LVOT diameter: 27, 25, 23, 21 and 19 mm); 50% dysfunction (LVOT diameter: 27, 25, 23, 21 and 19 mm) and 100% dysfunction (LVOT diameter: 27, 25, 23, 21 and 19 mm). Mesh quality and velocity file for the healthy model at normal cardiac output (5 L/min) are also shown.

• 

  Figure 2. Comparison between normalized velocity of the current study and the study of Bluestein and co-authors around the peak systole. Velocity profile was measured downstream of the BMHV and near the trailing edges of the leaflets. (R/Rmax) is the normalized radius.

• 

  Figure 3. Velocity contours at three LVOT diameters (27, 23 and 19 m) at three different time instants (45 (acceleration phase), 90 (peak) and 210 ms (deceleration phase)) during the systole for normal BMHV at normal cardiac output (5 L/min).

• 

  Figure 4. Velocity contours for three LVOT diameters (27, 23 and 19 m) at three different time instants (45 (acceleration phase), 90 ms (peak) and 210 ms (deceleration phase)) during the systole for 100% dysfunctional BMHV at the normal cardiac output (5 L/min).

• 

  Figure 5. Velocity contours at peak systole (90 ms) for different percentages of BMHV dysfunction at three different cardiac outputs (3, 5 and 7 L/min) for 27 mm LVOT.

• 

  Figure 6. Velocity contours at peak systole (90 ms) for different percentages of BMHV dysfunction at three different cardiac outputs (3, 5 and 7 L/min) for 19 mm LVOT.

• 

  Figure 7. Vorticity distributions downstream of a healthy and dysfunction heart valve for both 27 mm and 19 mm inlet diameter at Q = 7 L/min and two time instances: peak time (90 ms) and during deceleration time (150 ms).

• 

  Figure 8. Shear stress magnitude contours of a healthy and dysfunction heart valve for both 27 mm and 19 mm inlet diameter at Q = 7 L/min and two time instances: peak time (90 ms) and during deceleration time (150 ms).

• 

  Figure 9. The Doppler echocardiographic parameters calculated for the (0, 50, 100%) of valve dysfunction with the presence of different sub valvar stenosis at three flow rates. (A) Peak velocity; (B) mean transvalvular pressure gradient; (C) Doppler velocity index (DVI); and (D) effective orifice area (EOA). The dashed and dotted lines represent the lower and upper proposed cut-off values in the ASE guidelines, respectively.