Why the study?
Mechanical heart valve obstruction is a life-threatening complication, but the relationship between thrombus, pannus, and mechanical heart valve hemodynamics has not been thoroughly studied.
How do varying degrees of thrombus, pannus, and subaortic stenosis affect the hemodynamics of mechanical heart valves in computational models?
How do varying degrees of thrombus, pannus, and subaortic stenosis affect the hemodynamics of mechanical heart valves in computational models?
Computational simulations demonstrate that mechanical heart valve obstruction >20% by pannus, thrombus, or subaortic stenosis significantly worsens hemodynamic parameters, highlighting the need for early detection.
May inform early detection of mechanical valve obstruction; leaves open human validation before clinical thresholds.
Patients after mechanical heart valve implantation are prone to complications. Mechanical heart valve obstruction is a rare but life-threatening complication. Obstruction may include thrombosis, pannus formation around the valve, or both. However, the relationship between thrombus and pannus and mechanical heart valve hemodynamics has not been thoroughly studied. We studied the fluid dynamics of thrombus and pannus formation through numerical simulations and provided detailed information about the interaction between complications and related prosthetic valves so that complications can be detected early. Studies have shown that the formation of thrombus and pannus leads to significant changes in the peak transvalvular velocity of the artificial valve, the transvalvular pressure gradient, and the corresponding hemodynamic indicators. As the height of the thrombus and pannus increases, the jet velocity and transvalvular pressure gradient will increase accordingly. When obstruction exceeds 20%, the impact increases significantly under the same percentage of obstacles. When the obstruction percentage is over 30%, the rest at least doubled. The results also indicate that SAS obstruction has the most significant impact on the blood flow of MHV. At the same time, it should be noted that when SAS and pannus are combined, the ring form vortex in front of the pannus has a potential risk of accelerating the deterioration of the pannus.
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Chen et al. (2022) studied this question.
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