Numerical Investigation of the Performance of Three Hinge Designs of Bileaflet Mechanical Heart Valves

Thromboembolic complications (TECs) of bileaflet mechanical heart valves (BMHVs) are believed to be due to the nonphysiologic mechanical stresses imposed on blood elements by the hinge flows. Relating hinge flow features to design features is, therefore, essential to ultimately design BMHVs with lower TEC rates. This study aims at simulating the pulsatile three-dimensional hinge flows of three BMHVs and estimating the TEC potential associated with each hinge design. Hinge geometries are constructed from micro-computed tomography scans of BMHVs. Simulations are conducted using a Cartesian sharp-interface immersed-boundary methodology combined with a second-order accurate fractional-step method. Leaflet motion and flow boundary conditions are extracted from fluid–structure-interaction simulations of BMHV bulk flow. The numerical results are analyzed using a particle-tracking approach coupled with existing blood damage models. The gap width and, more importantly, the shape of the recess and leaflet are found to impact the flow distribution and TEC potential. Smooth, streamlined surfaces appear to be more favorable than sharp corners or sudden shape transitions. The developed framework will enable pragmatic and cost-efficient preclinical evaluation of BMHV prototypes prior to valve manufacturing. Application to a wide range of hinges with varying design parameters will eventually help in determining the optimal hinge design.

[1]  A P Yoganathan,et al.  A microstructural flow analysis within a bileaflet mechanical heart valve hinge. , 1996, The Journal of heart valve disease.

[2]  Fotis Sotiropoulos,et al.  A numerical method for solving the 3D unsteady incompressible Navier-Stokes equations in curvilinear domains with complex immersed boundaries , 2007, J. Comput. Phys..

[3]  Massimiliano Lucchesi,et al.  The Numerical Method , 2008 .

[4]  Hwa Liang Leo,et al.  Bileaflet Aortic Valve Prosthesis Pivot Geometry Influences Platelet Secretion and Anionic Phospholipid Exposure , 2001, Annals of Biomedical Engineering.

[5]  Ajit P Yoganathan,et al.  Microflow fields in the hinge region of the CarboMedics bileaflet mechanical heart valve design. , 2002, The Journal of thoracic and cardiovascular surgery.

[6]  L P Chua,et al.  Numerical investigation of the effect of blade geometry on blood trauma in a centrifugal blood pump. , 2002, Artificial organs.

[7]  H Schmid-Schönbein,et al.  Platelet and Coagulation Parameters Following Millisecond Exposure to Laminar Shear Stress , 1985, Thrombosis and Haemostasis.

[8]  Ajit P Yoganathan,et al.  Effect of hinge gap width on the microflow structures in 27-mm bileaflet mechanical heart valves. , 2006, The Journal of heart valve disease.

[9]  L. J. Wurzinger,et al.  Mechanical bloodtrauma. An overview , 1986 .

[10]  Helene A. Simon Influence of the Implant Location on the Hinge and Leakage Flow Fields Through Bileaflet Mechanical Heart Valves , 2004 .

[11]  A P Yoganathan,et al.  A comparison of the hinge and near-hinge flow fields of the St Jude medical hemodynamic plus and regent bileaflet mechanical heart valves. , 2000, The Journal of thoracic and cardiovascular surgery.

[12]  M. Shu,et al.  Flow characterization of the ADVANTAGE and St. Jude Medical bileaflet mechanical heart valves. , 2004, The Journal of heart valve disease.

[13]  Brandon R. Travis,et al.  An In Vitro Study of the Hinge and Near-Field Forward Flow Dynamics of the St. Jude Medical® Regent™ Bileaflet Mechanical Heart Valve , 2000, Annals of Biomedical Engineering.

[14]  F. Sotiropoulos,et al.  A hybrid Cartesian/immersed boundary method for simulating flows with 3D, geometrically complex, moving bodies , 2005 .

[15]  Ajit Yoganathan,et al.  An in vitro assessment by means of laser Doppler velocimetry of the medtronic advantage bileaflet mechanical heart valve hinge flow. , 2003, The Journal of thoracic and cardiovascular surgery.

[16]  H. Reul,et al.  Estimation of Shear Stress-related Blood Damage in Heart Valve Prostheses - in Vitro Comparison of 25 Aortic Valves , 1990, The International journal of artificial organs.

[17]  A P Yoganathan,et al.  Velocity measurements and flow patterns within the hinge region of a Medtronic Parallel bileaflet mechanical valve with clear housing. , 1996, The Journal of heart valve disease.

[18]  Ajit P. Yoganathan,et al.  Comparison of the Hinge Flow Fields of Two Bileaflet Mechanical Heart Valves under Aortic and Mitral Conditions , 2004, Annals of Biomedical Engineering.

[19]  Steven Deutsch,et al.  Impact of design parameters on bileaflet mechanical heart valve flow dynamics. , 2009, The Journal of heart valve disease.

[20]  K. Riemslagh,et al.  A Three-dimensional Analysis of Flow in the Pivot Regions of an ATS Bileaflet Valve , 1999, The International journal of artificial organs.

[21]  Fotis Sotiropoulos,et al.  Curvilinear immersed boundary method for simulating fluid structure interaction with complex 3D rigid bodies , 2008, J. Comput. Phys..

[22]  C Bludszuweit,et al.  Model for a general mechanical blood damage prediction. , 1995, Artificial organs.

[23]  Fotis Sotiropoulos,et al.  Erratum to: Simulation of the Three-Dimensional Hinge Flow Fields of a Bileaflet Mechanical Heart Valve Under Aortic Conditions , 2010, Annals of Biomedical Engineering.

[24]  N H Hwang,et al.  Pressure and flow fields in the hinge region of bileaflet mechanical heart valves. , 1999, The Journal of heart valve disease.

[25]  K B Chandran,et al.  Two-dimensional simulation of flow and platelet dynamics in the hinge region of a mechanical heart valve. , 2009, Journal of biomechanical engineering.

[26]  Hélène A. Simon,et al.  Vorticity dynamics of a bileaflet mechanical heart valve in an axisymmetric aorta , 2007 .

[27]  N H Hwang,et al.  Computational fluid dynamics study of a protruded-hinge bileaflet mechanical heart valve. , 2001, The Journal of heart valve disease.

[28]  Fotis Sotiropoulos,et al.  Characterization of Hemodynamic Forces Induced by Mechanical Heart Valves: Reynolds vs. Viscous Stresses , 2008, Annals of Biomedical Engineering.

[29]  D Horstkotte,et al.  Results with mechanical cardiac valvular prostheses. , 1996, The Annals of thoracic surgery.