Compared to the Perimount biological valve, the TRIFLO and On-X mechanical valves reduced peak mean velocity by up to 33% and 32%, and decreased peak turbulent kinetic energy by up to 66% and 60%, respectively.
How do the hemodynamic performance and turbulence levels compare among a tri-leaflet mechanical, bi-leaflet mechanical, and biological heart valve under varying cardiac output conditions?
In an in vitro model, mechanical valves (TRIFLO and On-X) demonstrated lower peak mean velocities and turbulent kinetic energy compared to the Perimount biological valve across varying cardiac outputs.
Abstract The hemodynamic performance of different prosthetic heart valves is difficult to compare among studies due to a variety of test conditions and experimental techniques. Existing studies are typically limited to one family of valves (biological or mechanical) and testing conditions of 5l/min and often lack sufficient spatial resolution. To address these limitations, a pulse duplicator with a multi-view imaging system (Tomo-PIV) was employed to investigate the three-dimensional flow field in the aortic root of three different valves: a tri-leaflet mechanical heart valve (TRIFLO, Novostia), a bi-leaflet mechanical heart valve (On-X, Artivion), and a biological heart valve (Perimount, Edwards Lifesciences). The valves were tested at low (3 l/min), normal (5 l/min), and elevated (7 l/min) cardiac output (CO) (C O) under hypotensive (40/60mmHg), normotensive (80/120mmHg), and moderate hypertensive (105/170mmHg) pressure conditions, respectively. Compared to the Perimount, peak mean velocity was − 33%, − 24%, − 18% for the TRIFLO and − 32%, − 20%, − 11% for the On-X at low, moderate, and elevated CO CO, respectively. Corresponding peak TKE TKE values decreased by − 66%, − 57%, − 44% (TRIFLO) and − 60%, − 50%, − 36% (On-X). At low CO CO, EOA EOA was lower for Perimount (1. 07cm 2) than for TRIFLO (1. 47cm 2) and On-X (1. 52cm 2), while it increased for elevated CO CO to 2. 75cm 2 (TRIFLO) and 2. 16cm 2 (Perimount and On-X). For all valves, increasing CO CO led to increased flow velocities, higher EOA, E O A, and higher levels of turbulence, and the spatial influence of the valve on the flow field in the ascending aorta was extended. TKE TKE peaked closer to the STJ than for TRIFLO and Perimount.
Ferrari et al. (2024) studied Aortic valve replacement (in vitro model). Prosthetic heart valves (TRIFLO, On-X, Perimount) vs. Comparison among the three valves was evaluated on Hemodynamic performance (peak mean velocity and turbulent kinetic energy). Compared to the Perimount biological valve, the TRIFLO and On-X mechanical valves reduced peak mean velocity by up to 33% and 32%, and decreased peak turbulent kinetic energy by up to 66% and 60%, respectively.