Principal stress analysis in LDA measurement of the flow field downstream of 19-mm Sorin Bicarbon heart valve.

Heart valve replacement has become, since many years, a common surgical practice. Along with the improvement that the patients' health has derived from it, however, a certain amount of risk could not be avoided, bound to the inevitable hemodynamic disturbances that an artificial device generates. A major shortcoming, often reported, is the formation of thrombus on the edge of the prosthetic valve, with a possible obstruction of the orifices through which blood should normally flow undisturbed. Hemolysis is another possible consequence of the implantation of a mechanical heart valve, generally correlated to turbulence downstream of prosthetic heart valves (PHV). As it is agreed upon by many researchers, the risk of thrombogenicity or hemolysis is higher in those valves that are more subject to promote turbulence and flow separation in the flow through them. In the following paper, we present a study of the turbulence-related shear stress downstream of a bileaflet valve of minimum size (19 mm external diameter) Sorin Bicarbon. This size was chosen, accordingly to the Food & Drug Administration (FDA) draft guidance suggestion to investigate the worst case in turbulence promoted by PHVs, in order to have the highest velocity gradients and shear stresses for the FDA-stated cardiac output (6 1/min), related to maximum Reynolds number conditions. Velocity data were collected with the two-dimensional laser Doppler anemometry (LDA) technique; whereas this approach does not investigate directly all three components of the flow field, in the present case (bileaflet valves) it is not a limitation to the assessment of the maximum turbulence shear stress (TSS), thanks to the two-dimensional flow nature downstream of bileaflet models. Data taken in coincident mode were elaborated in order to determine the maximum shear stress in the measured points in the flow field, using the 2D Principal Stress Analysis (PSA). The consequences of a variable principal normal stress direction all along the measured profile will be illustrated in terms of differences between measured and maximum shear stresses. Results show the need to estimate the maximum values for the TSS and the direction along which it is obtained to correctly define the turbulent flow field downstream of PHVs.

[1]  N H Hwang,et al.  Human red blood cell hemolysis in a turbulent shear flow: contribution of Reynolds shear stresses. , 1984, Biorheology.

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

[3]  M Grigioni,et al.  19 mm Sized Bileaflet Valve Prostheses’ flow Field Investigated by Bidimensional Laser Doppler Anemometry (part II: Maximum Turbulent Shear Stresses) , 1997, The International journal of artificial organs.

[4]  D B Geselowitz,et al.  LDA measurements of mean velocity and Reynolds stress fields within an artificial heart ventricle. , 1994, Journal of biomechanical engineering.

[5]  H Reul,et al.  Velocity and Shear Stress Distribution Downstream of Mechanical Heart Valves in Pulsatile Flow , 1989, The International journal of artificial organs.

[6]  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.

[7]  A P Yoganathan,et al.  In vitro pulsatile flow velocity and shear stress measurements in the vicinity of mechanical mitral heart valve prostheses. , 1986, Journal of biomechanics.

[8]  L. E. Malvern Introduction to the mechanics of a continuous medium , 1969 .

[9]  H L Petrie,et al.  Determination of principal reynolds stresses in pulsatile flows after elliptical filtering of discrete velocity measurements. , 1993, Journal of biomechanical engineering.

[10]  D. Middleton,et al.  Statistical Errors in Measurements on Random Time Functions , 1952 .

[11]  H Nygaard,et al.  Turbulent stress measurements downstream of six mechanical aortic valves in a pulsatile flow model. , 1988, Journal of biomechanics.

[12]  H Reul,et al.  In vitro comparison of aortic heart valve prostheses. Part 1: Mechanical valves. , 1988, The Journal of thoracic and cardiovascular surgery.

[13]  A. Fontaine,et al.  Identification of Peak Stresses in Cardiac Prostheses: A Comparison of Two‐Dimensional Versus Three‐Dimensional Principal Stress Analyses , 1996, ASAIO journal.

[14]  U. Steinseifer,et al.  In vitro comparison of bileaflet aortic heart valve prostheses. St. Jude Medical, CarboMedics, modified Edwards-Duromedics, and Sorin-Bicarbon valves. , 1993, The Journal of thoracic and cardiovascular surgery.

[15]  M Grigioni,et al.  19 mm Sized Bileaflet Valve Prostheses’ flow Field Investigated by Bidimensional Laser Doppler Anemometry (part I: Velocity Profiles) , 1997, The International journal of artificial organs.

[16]  J. Lumley,et al.  A First Course in Turbulence , 1972 .

[17]  H N Sabbah,et al.  Measured Turbulence and Its Effect on Thrombus Formation , 1974, Circulation research.

[18]  A P Yoganathan,et al.  In vitro flow dynamics of four prosthetic aortic valves: a comparative analysis. , 1989, Journal of biomechanics.

[19]  Woo Yr,et al.  In vitro pulsatile flow velocity and turbulent shear stress measurements in the vicinity of mechanical aortic heart valve prostheses. , 1985 .

[20]  E. Leonard,et al.  Separated flows in artificial organs. A cause of early thrombogenesis? , 1996, ASAIO journal.

[21]  P K Paulsen,et al.  Estimation of turbulent shear stresses in pulsatile flow immediately downstream of two artificial aortic valves in vitro. , 1990, Journal of biomechanics.

[22]  J. D. Hellums,et al.  Physical effects in red blood cell trauma , 1969 .