Experimental and numerical modeling of heart valve dynamics

Previousin vitro testing mainly in aortic position and clinical experience often based on Doppler echocardiographic observations demonstrated an excellent haemodynamic behavior of the On-X valve. However, integrative studies including simultaneous haemodynamic pressure and flow measurements and Doppler echocardiography are lacking. Using our computer controlled mock loop system, two samples of the Mitral 27/29 and one sample of the Conform-X Mitral 25/33 are tested in mitral position. Data include transvalvular pressure gradient and flow as well as transthoracic Doppler echocardiography. The valves were tested in 3 pressure conditions (ventricular systolic pressure of 100, 130, and 160 mmHg) at three different heart rates (60, 100, and 140 beats/min). In addition, ventricular pressure conditions simulating fibrillation were imposed. Both valve types show similar hydrodynamic characteristics and have an effective orifice area of 2.1 cm 2 and a performance index of 0.56 for a cardiac output of 3.5 l/min. Regurgitant volumes remain below 6 ml.

[1]  K. Matthys Assessment of vascular haemodynamics : investigation of non-invasive and minimally invasive methods for assessment of vascular function at rest and during cardiovascular challenge , 2004 .

[2]  Z. Turi Cardiology patient page. Mitral valve disease. , 2004, Circulation.

[3]  Elazer R Edelman,et al.  Tissue Engineering Therapy for Cardiovascular Disease , 2003, Circulation research.

[4]  Frederic Blom,et al.  A monolithical fluid-structure interaction algorithm applied to the piston problem , 1998 .

[5]  Barbara M. Johnston,et al.  Non-Newtonian blood flow in human right coronary arteries: steady state simulations. , 2004, Journal of biomechanics.

[6]  F P T Baaijens,et al.  A computational fluid-structure interaction analysis of a fiber-reinforced stentless aortic valve. , 2003, Journal of biomechanics.

[7]  R. Hetzer,et al.  Endothelialization of PTFE vascular grafts under flow induces significant cell changes * , 2001, The International journal of artificial organs.

[8]  N. Westerhof,et al.  An artificial arterial system for pumping hearts. , 1971, Journal of applied physiology.

[9]  F. N. van de Vosse,et al.  Mathematical modelling of the cardiovascular system , 2003 .

[10]  P. Duray,et al.  Tissue culture in microgravity. , 1997, Science & medicine.

[11]  L. Morbidelli,et al.  Endothelial cells in culture: a model for studying vascular functions. , 2000, Pharmacological research.

[12]  A Haverich,et al.  Tissue engineering of heart valves--human endothelial cell seeding of detergent acellularized porcine valves. , 1998, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[13]  B. Kuban,et al.  Validated computation of physiologic flow in a realistic coronary artery branch. , 1997, Journal of biomechanics.

[14]  R M Nerem,et al.  Vascular tissue engineering. , 2001, Annual review of biomedical engineering.

[15]  Paulo Diaz Villegas Experiences with New Types of Aortic Valvular Prostheses , 1958, Annals of surgery.

[16]  M Umezu,et al.  In vitro hydrodynamic characteristics among three bileaflet valves in the mitral position. , 2000, Artificial organs.

[17]  P J Dionne,et al.  Three‐Dimensional Coupled Fluid‐Structure Simulation of Pericardial Bioprosthetic Aortic Valve Function , 1997, ASAIO journal.

[18]  F. N. van de Vosse,et al.  Finite-element-based computational methods for cardiovascular fluid-structure interaction , 2003 .

[19]  R. Hibbs,et al.  The atrioventricular valves of the guinea-pig. II. An ultrastructural study. , 1973, The American journal of anatomy.

[20]  F J Schoen,et al.  Functional Living Trileaflet Heart Valves Grown In Vitro , 2000, Circulation.

[21]  J. Brock,et al.  Effect of Stent Mounting on Tissue Valves for Aortic Valve Replacement , 1991, Journal of cardiac surgery.

[22]  M. Carrier,et al.  Clinical and hemodynamic assessment of the Omniscience prosthetic heart valve. , 1987, The Journal of thoracic and cardiovascular surgery.

[23]  P. R. Verdonck,et al.  Pulse Duplicator Hydrodynamics of Four Different Bileaflet Valves in the Mitral Position , 1997 .

[24]  C A Heath,et al.  Cells for tissue engineering. , 2000, Trends in biotechnology.

[25]  Chang Nyung Kim,et al.  Characteristics of transient blood flow in MHVs with different maximum opening angles using fluid-structure interaction method , 2001, Korean Journal of Chemical Engineering.

[26]  S. Alper,et al.  Hemodynamic shear stress and its role in atherosclerosis. , 1999, JAMA.

[27]  K. Yasuda,et al.  Shear flow properties of concentrated solutions of linear and star branched polystyrenes , 1981 .

[28]  I Vesely,et al.  Aortic valve cusp microstructure: the role of elastin. , 1995, The Annals of thoracic surgery.

[29]  Gordana Vunjak-Novakovic,et al.  Perfusion improves tissue architecture of engineered cardiac muscle. , 2002, Tissue engineering.

[30]  L Gross,et al.  Topographic Anatomy and Histology of the Valves in the Human Heart. , 1931, The American journal of pathology.

[31]  G. Vunjak‐Novakovic,et al.  Microgravity cultivation of cells and tissues. , 1999, Gravitational and space biology bulletin : publication of the American Society for Gravitational and Space Biology.

[32]  J. Moake,et al.  Platelets and shear stress. , 1996, Blood.

[33]  Komarakshi R Balakrishnan,et al.  Dynamic analysis of the aortic valve using a finite element model. , 2002, The Annals of thoracic surgery.

[34]  Patrick Segers,et al.  Mock loop testing of On-x prosthetic mitral valve with Doppler echocardiography. , 2002, Artificial organs.

[35]  Frederick J Schoen,et al.  Cardiovascular tissue engineering. , 2002, Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology.

[36]  Han Y. Chu Arbitrary Lagrangian-Eulerian Method for Transient Fluid-Structure Interactions , 1980 .

[37]  F N van de Vosse,et al.  Wall shear stress in backward-facing step flow of a red blood cell suspension. , 1998, Biorheology.

[38]  Hermann G. Matthies,et al.  How to make weak couplings strong , 2001 .

[39]  P. Verdonck,et al.  Computer-controlledin vitro model of the human left heart , 1992, Medical and Biological Engineering and Computing.

[40]  R. Gibbons,et al.  ACC/AHA Guidelines for the Management of Patients With Valvular Heart Disease. Executive Summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Valvular Heart Disease). , 1998, The Journal of heart valve disease.

[41]  T David,et al.  The integrated design of mechanical bi-leaflet prosthetic heart valves. , 1996, Medical engineering & physics.

[42]  I Vesely,et al.  The role of elastin in aortic valve mechanics. , 1997, Journal of biomechanics.

[43]  I. C. Howard,et al.  A three-dimensional analysis of a bioprosthetic heart valve. , 1991, Journal of biomechanics.

[44]  J. Halleux,et al.  An arbitrary lagrangian-eulerian finite element method for transient dynamic fluid-structure interactions , 1982 .

[45]  Karen Mudry,et al.  The Biomedical Engineering Handbook: Second Edition. , 1999 .

[46]  T C Flanagan,et al.  Living artificial heart valve alternatives: a review. , 2003, European cells & materials.

[47]  K. B. Chandran,et al.  Numerical simulation of instantaneous backflow through central clearance of bileaflet mechanical heart valves at closure: shear stress and pressure fields within clearance , 1995, Medical and Biological Engineering and Computing.

[48]  M A Moses,et al.  Tissue engineering of autologous aorta using a new biodegradable polymer. , 1999, The Annals of thoracic surgery.

[49]  Y. Cho,et al.  Effects of the non-Newtonian viscosity of blood on flows in a diseased arterial vessel. Part 1: Steady flows. , 1991, Biorheology.

[50]  J. Chambers,et al.  Early postoperative echocardiographic hemodynamic performance of the On-X prosthetic heart valve: a multicenter study. , 1998, The Journal of heart valve disease.

[51]  A M Malek,et al.  Mechanism of endothelial cell shape change and cytoskeletal remodeling in response to fluid shear stress. , 1996, Journal of cell science.

[52]  J Fisher,et al.  Three-dimensional study of the effect of two leaflet opening angles on the time-dependent flow through a bileaflet mechanical heart valve. , 1997, Medical engineering & physics.

[53]  Y. Moriyama,et al.  Clinical experience of 473 patients with the omnicarbon prosthetic heart valve. , 1999, The Journal of heart valve disease.

[54]  W. S. Ring,et al.  Differential collagen distribution in the mitral valve and its influence on biomechanical behaviour. , 1993, The Journal of heart valve disease.

[55]  Joseph Palladino The Biomedical Engineering Handbook: Second Edition. , 1999 .

[56]  A. Starr,et al.  Mitral replacement: the shielded ball valve prosthesis. , 1961, Journal of Thoracic and Cardiovascular Surgery.

[57]  G. G. Peters,et al.  A two-dimensional fluid–structure interaction model of the aortic value , 2000 .

[58]  R. Nishimura Cardiology patient pages. Aortic valve disease. , 2002, Circulation.

[59]  J. Chambers,et al.  A comparison of the classical and modified forms of the continuity equation in the On-X prosthetic heart valve in the aortic position. , 2000, The Journal of heart valve disease.

[60]  D. J. Hart Fluid-structure interaction in the aortic heart valve : a three-dimensional computational analysis , 2002 .

[61]  Robin Fåhræus,et al.  THE VISCOSITY OF THE BLOOD IN NARROW CAPILLARY TUBES , 1931 .

[62]  F. Baaijens A fictitious domain/mortar element method for fluid-structure interaction , 2001 .

[63]  M. Karck,et al.  ON-X Bileaflet Valve in Aortic Position - Early Experience Shows an Improved Hemodynamic Profile , 1998, The Thoracic and cardiovascular surgeon.

[64]  S. Vandenberghe,et al.  Omnicarbon™ 21 mm Aortic Valve Prosthesis: In Vitro Hydrodynamic and Echo-Doppler Study , 2002 .

[65]  Lawrence W. Solomon,et al.  Yale University School of Medicine Heart Book , 1992, The Yale Journal of Biology and Medicine.

[66]  F J Schoen,et al.  Tissue engineering of heart valves: in vitro experiences. , 2000, The Annals of thoracic surgery.

[67]  Vladimir Kasyanov,et al.  Comparison of biomechanical and structural properties between human aortic and pulmonary valve. , 2004, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[68]  P. Carreau Rheological Equations from Molecular Network Theories , 1972 .

[69]  Philippe A. Tanguy,et al.  A three-dimensional fictitious domain method for incompressible fluid flow problems , 1997 .

[70]  R. Dewall,et al.  The Omni design: evolution of a valve. , 1989, The Journal of thoracic and cardiovascular surgery.

[71]  K S Kunzelman,et al.  Mechanisms of aortic valve incompetence: finite-element modeling of Marfan syndrome. , 2001, The Journal of thoracic and cardiovascular surgery.

[72]  Fotis Sotiropoulos,et al.  Numerical simulation of flow in mechanical heart valves: grid resolution and the assumption of flow symmetry. , 2003, Journal of biomechanical engineering.

[73]  Y. Fung,et al.  Mechanics of the Circulation , 2011, Developments in Cardiovascular Medicine.

[74]  N. Hwang Mitral regurgitation of the On-X size 23 valve is comparable to or less than the size 27 SJM, which has the same geometric orifice area. , 1998, ASAIO journal.

[75]  U A Stock,et al.  Cardiovascular physiology during fetal development and implications for tissue engineering. , 2001, Tissue engineering.

[76]  H. Matthies,et al.  Partitioned Strong Coupling Algorithms for Fluid-Structure-Interaction , 2003 .

[77]  J. J. Horsten On the analysis of moving heart valves : a numerical fluid-structure interaction model , 1990 .

[78]  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.

[79]  Frederick J Schoen,et al.  Evolution of cell phenotype and extracellular matrix in tissue-engineered heart valves during in-vitro maturation and in-vivo remodeling. , 2002, The Journal of heart valve disease.

[80]  L. Brush,et al.  McDonaldʼs Blood Flow in Arteries , 1991 .

[81]  M. M. Adamczyk,et al.  Biaxial strain properties of elastase-digested porcine aortic valves. , 2000, The Journal of heart valve disease.

[82]  H Kawano,et al.  Cineradiographic evaluation of ATS open pivot bileaflet valves. , 1997, The Journal of heart valve disease.

[83]  J E Mayer,et al.  Tissue engineering of a trileaflet heart valve-early in vitro experiences with a combined polymer. , 1999, Tissue engineering.

[84]  I Vesely,et al.  The effect of elastin damage on the mechanics of the aortic valve. , 2001, Journal of biomechanics.

[85]  M. Ozkan,et al.  Early clinical experience with the On-X prosthetic heart valve. , 2005, Interactive cardiovascular and thoracic surgery.

[86]  Komarakshi R Balakrishnan,et al.  Further insights into normal aortic valve function: role of a compliant aortic root on leaflet opening and valve orifice area. , 2004, The Annals of thoracic surgery.

[87]  Simon P Hoerstrup,et al.  Heart valve tissue engineering. , 2004, Transplant immunology.

[88]  Klaus Affeld,et al.  Numerical estimation of blood damage in artificial organs. , 2004, Artificial organs.

[89]  Z. Ruggeri,et al.  Mechanisms of Shear-induced Platelet Adhesion and Aggregation , 1993, Thrombosis and Haemostasis.

[90]  L. Hillis,et al.  Diagnostic Cardiac Catheterization , 2003, Circulation.

[91]  Alfrey Cp,et al.  Erythrocyte damage and destruction induced by shearing stress. , 1968 .

[92]  F J Schoen,et al.  Cardiac tissue engineering: cell seeding, cultivation parameters, and tissue construct characterization. , 1999, Biotechnology and bioengineering.

[93]  Bart Meuris,et al.  Design of a new pulsatile bioreactor for tissue engineered aortic heart valve formation. , 2002, Artificial organs.

[94]  J E Mayer,et al.  New pulsatile bioreactor for in vitro formation of tissue engineered heart valves. , 2000, Tissue engineering.

[95]  Fjh Frank Gijsen Modeling of wall shear stress in large arteries , 1998 .

[96]  J. Pepper,et al.  Do stentless valves make a difference? , 2002, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[97]  Charles S. Peskin,et al.  Modeling prosthetic heart valves for numerical analysis of blood flow in the heart , 1980 .

[98]  E L Yellin,et al.  Mechanisms of mitral valve motion during diastole. , 1981, The American journal of physiology.

[99]  P. Vandervoort,et al.  Pressure recovery in bileaflet heart valve prostheses. Localized high velocities and gradients in central and side orifices with implications for Doppler-catheter gradient relation in aortic and mitral position. , 1995, Circulation.

[100]  B. Griffin,et al.  Caring for patients with prosthetic heart valves. , 2002, Cleveland Clinic journal of medicine.

[101]  R. E. Collingham,et al.  Shear, wall interaction and hemolysis. , 1966, Transactions - American Society for Artificial Internal Organs.

[102]  S Chien,et al.  Shear-dependent deformation of erythrocytes in rheology of human blood. , 1970, The American journal of physiology.

[103]  Hou Zhang,et al.  Direct and iterative computing of fluid flows fully coupled with structures , 2001 .

[104]  M. M. Cross Rheology of non-Newtonian fluids: A new flow equation for pseudoplastic systems , 1965 .

[105]  S. Price,et al.  Pathophysiology: Clinical Concepts of Disease Processes , 1978 .

[106]  I. Krukenkamp,et al.  Free emboli formation in the wake of bi-leaflet mechanical heart valves and the effects of implantation techniques. , 2002, Journal of biomechanics.

[107]  M S Chapekar,et al.  Tissue engineering: challenges and opportunities. , 2000, Journal of biomedical materials research.

[108]  Gordana Vunjak-Novakovic,et al.  Microgravity Studies of Cells and Tissues , 2002, Annals of the New York Academy of Sciences.

[109]  van de Fn Frans Vosse,et al.  A fictitious domain method combined with adaptive meshing for enhanced modelling of blood-heart valve interaction , 2004 .

[110]  van Aa Anton Steenhoven,et al.  Model studies of the closing behaviour of the aortic valve , 1979, Journal of Fluid Mechanics.

[111]  Deck Jd,et al.  Tissue and cell renewal in the natural aortic valve of rats: an autoradiographic study , 1981 .

[112]  Rui Cheng,et al.  Two-dimensional fluid-structure interaction simulation of bileaflet mechanical heart valve flow dynamics. , 2003, The Journal of heart valve disease.

[113]  D. Hoffman,et al.  Endothelial covering of biological artificial heart valves. , 1992, The Annals of thoracic surgery.

[114]  P. Lelkes,et al.  Growing tissues in microgravity , 1998, Nature Medicine.

[115]  G. Vunjak‐Novakovic,et al.  Tissue engineering of cartilage in space. , 1997, Proceedings of the National Academy of Sciences of the United States of America.

[116]  H. Schima,et al.  Numerical study of wall mechanics and fluid dynamics in end-to-side anastomoses and correlation to intimal hyperplasia. , 1996, Journal of biomechanics.

[117]  Antonios G Mikos,et al.  Formation of three-dimensional cell/polymer constructs for bone tissue engineering in a spinner flask and a rotating wall vessel bioreactor. , 2002, Journal of biomedical materials research.

[118]  Culav Em,et al.  Connective Tissues: Matrix Composition and Its Relevance to Physical Therapy , 1999 .

[119]  Damien Garcia,et al.  Discrepancies between catheter and Doppler estimates of valve effective orifice area can be predicted from the pressure recovery phenomenon: practical implications with regard to quantification of aortic stenosis severity. , 2003, Journal of the American College of Cardiology.

[120]  I. Vesely,et al.  Aortic root dilation prior to valve opening explained by passive hemodynamics. , 2000, The Journal of heart valve disease.

[121]  F. Baaijens,et al.  Collagen fibers reduce stresses and stabilize motion of aortic valve leaflets during systole. , 2004, Journal of biomechanics.

[122]  Jack Lemmon,et al.  A numerical simulation of mechanical heart valve closure fluid dynamics. , 2002, Journal of biomechanics.

[123]  P J Kilner,et al.  The aortic outflow and root: a tale of dynamism and crosstalk. , 1999, The Annals of thoracic surgery.

[124]  A Haverich,et al.  Tissue Engineering of Pulmonary Heart Valves on Allogenic Acellular Matrix Conduits: In Vivo Restoration of Valve Tissue , 2000, Circulation.

[125]  Eric J. Topol,et al.  Pan Vascular Medicine : integrated clinical management , 2002 .

[126]  A. Pries,et al.  Blood viscosity in tube flow: dependence on diameter and hematocrit. , 1992, The American journal of physiology.

[127]  Stuart G D Kelly Computational fluid dynamics insights in the design of mechanical heart valves. , 2002, Artificial organs.

[128]  T Cooper,et al.  Structural basis of cardiac valvar function. , 1966, Archives of surgery.

[129]  Robert Langer,et al.  Tissue engineering: the design and fabrication of living replacement devices for surgical reconstruction and transplantation , 1999, The Lancet.

[130]  Miguel Angel Fernández,et al.  A Newton method using exact jacobians for solving fluid-structure coupling , 2005 .

[131]  van de Fn Frans Vosse,et al.  The influence of the non-Newtonian properties of blood on the flow in large arteries: unsteady flow in a 90° curved tube , 1999 .

[132]  K S Kunzelman,et al.  Mechanisms of aortic valve incompetence in aging: a finite element model. , 1999, The Journal of heart valve disease.

[133]  K Caidahl,et al.  Assessment of effective orifice area of prosthetic aortic valves with Doppler echocardiography: an in vivo and in vitro study. , 2001, The Journal of thoracic and cardiovascular surgery.

[134]  H Nygaard,et al.  Tilting disc versus bileaflet aortic valve substitutes: intraoperative and postoperative hemodynamic performance in humans. , 2000, The Journal of heart valve disease.

[135]  A. Leuprecht,et al.  Numerical study of hemodynamics and wall mechanics in distal end-to-side anastomoses of bypass grafts. , 2002, Journal of biomechanics.

[136]  M. Thubrikar,et al.  The mechanism of opening of the aortic valve. , 1979, The Journal of thoracic and cardiovascular surgery.

[137]  Robert E. Wilson,et al.  Fundamentals of momentum, heat, and mass transfer , 1969 .

[138]  H. Reul,et al.  In vitro evaluation of the long-body On-X bileaflet heart valve. , 1998, The Journal of heart valve disease.

[139]  H Nygaard,et al.  Orientation of tilting disc and bileaflet aortic valve substitutes for optimal hemodynamics. , 1999, The Annals of thoracic surgery.

[140]  F. Mohr,et al.  Comparison of On-X and SJM HP bileaflet aortic valves. , 2000, The Journal of heart valve disease.

[141]  B S Goldman,et al.  Inaccurate and misleading valve sizing: a proposed standard for valve size nomenclature. , 1998, The Annals of thoracic surgery.

[142]  A P Yoganathan,et al.  Turbulent shear stress measurements in the vicinity of aortic heart valve prostheses. , 1986, Journal of biomechanics.

[143]  H Reul,et al.  In-vitro wall shear measurements at aortic valve prostheses. , 1984, Journal of biomechanics.

[144]  H. Alexander,et al.  Development and characterization of tissue-engineered aortic valves. , 2001, Tissue engineering.

[145]  J Shaheen,et al.  Exercise hemodynamics of aortic prostheses: comparison between stentless bioprostheses and mechanical valves. , 2001, The Annals of thoracic surgery.

[146]  J Fisher,et al.  A three-dimensional, time-dependent analysis of flow through a bileaflet mechanical heart valve: comparison of experimental and numerical results. , 1996, Journal of biomechanics.

[147]  W. L. Wood Practical Time-Stepping Schemes , 1990 .

[148]  J L West,et al.  Tissue engineering in the cardiovascular system: Progress toward a tissue engineered heart , 2001, The Anatomical record.

[149]  R Langer,et al.  Functional arteries grown in vitro. , 1999, Science.

[150]  Oliver Ormerod,et al.  Ultrasound in cardiology. , 1972, Lancet.

[151]  Gordana Vunjak-Novakovic,et al.  Effects of oxygen on engineered cardiac muscle. , 2002, Biotechnology and bioengineering.

[152]  J. Gardin,et al.  Effect of left ventricular size on early diastolic left ventricular filling in neonates and in adults. , 1987, The American journal of cardiology.

[153]  M. Turina,et al.  Pressure gradients across bileaflet aortic valves by direct measurement and echocardiography. , 1996, The Annals of thoracic surgery.

[154]  Charbel Farhat,et al.  Partitioned procedures for the transient solution of coupled aeroelastic problems , 2001 .

[155]  P. Dubach,et al.  The Omnicarbon tilting-disc heart valve prosthesis. A clinical and Doppler echocardiographic follow-up. , 1993, The Journal of thoracic and cardiovascular surgery.

[156]  P. E. McHugh,et al.  Bioreactors for Cardiovascular Cell and Tissue Growth: A Review , 2003, Annals of Biomedical Engineering.

[157]  G. Grunkemeier,et al.  Survival advantage of stentless aortic bioprostheses. , 2000, The Annals of thoracic surgery.

[158]  Mitsuo Umezu,et al.  In vitro investigation of opening behavior and hydrodynamics of bileaflet valves in the mitral position. , 2002, Artificial organs.

[159]  Andrew L. Wit,et al.  Canine Mitral Complex: ULTRASTRUCTURE AND ELECTROMECHANICAL PROPERTIES , 1972, Circulation research.

[160]  X. Luo,et al.  A nonlinear anisotropic model for porcine aortic heart valves. , 2001, Journal of biomechanics.

[161]  Jan Vierendeels,et al.  STABILIZATION OF A FLUID-STRUCTURE COUPLING PROCEDURE FOR RIGID BODY MOTION , 2003 .

[162]  A. Henney,et al.  Collagen biosynthesis in normal and abnormal human heart valves. , 1982, Cardiovascular research.

[163]  L Kappenberger,et al.  Doppler echocardiographic assessment of the new ATS medical prosthetic valve in the aortic position. , 1996, American journal of cardiac imaging.

[164]  A. Yoganathan,et al.  Prosthesis-induced hemolysis: mechanisms and quantification of shear stress. , 1998, The Journal of heart valve disease.

[165]  C K Breuer,et al.  Tissue engineering heart valves: valve leaflet replacement study in a lamb model. , 1995, The Annals of thoracic surgery.

[166]  Robert W Emery,et al.  The initial experience with the ATS Medical mechanical cardiac valve prosthesis. , 2003, The Annals of thoracic surgery.

[167]  Umberto Morbiducci,et al.  The power-law mathematical model for blood damage prediction: analytical developments and physical inconsistencies. , 2004, Artificial organs.

[168]  J. Gardin,et al.  Relationship between age, body size, gender, and blood pressure and Doppler flow measurements in the aorta and pulmonary artery. , 1987, American heart journal.

[169]  N H Hwang,et al.  Bileaflet mechanical heart valves at low cardiac output. , 1996, ASAIO journal.

[170]  N. Broom,et al.  Fatigue-induced damage in glutaraldehyde-preserved heart valve tissue. , 1978, The Journal of thoracic and cardiovascular surgery.

[171]  F. N. van de Vosse,et al.  The influence of the non-Newtonian properties of blood on the flow in large arteries: steady flow in a carotid bifurcation model. , 1999, Journal of biomechanics.

[172]  J Vierendeels,et al.  Validation of a Fluid–Structure Interaction Model of a Heart Valve using the Dynamic Mesh Method in Fluent , 2004, Computer methods in biomechanics and biomedical engineering.

[173]  Gerhard Rappitsch,et al.  Numerical modelling of shear-dependent mass transfer in large arteries , 1997 .

[174]  T L Talbot,et al.  Errors in pressure gradient measurement by continuous wave Doppler ultrasound: type, size and age effects in bioprosthetic aortic valves. , 1991, Journal of the American College of Cardiology.

[175]  G. Darovic Hemodynamic Monitoring: Invasive and Noninvasive Clinical Application , 1987 .

[176]  P. Verdonck,et al.  Distortion of the stentless porcine valve induces accelerated leaflet fibrosis and calcification in juvenile sheep. , 1999, The Journal of heart valve disease.

[177]  A P Yoganathan,et al.  Three-dimensional computational model of left heart diastolic function with fluid-structure interaction. , 2000, Journal of biomechanical engineering.

[178]  S Jockenhoevel,et al.  Fibrin gel as a three dimensional matrix in cardiovascular tissue engineering. , 2000, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[179]  M. Simionescu,et al.  Interstitial Cells of the Heart Valves Possess Characteristics Similar to Smooth Muscle Cells , 1986, Circulation research.

[180]  J Fisher,et al.  Design of a function test apparatus for prosthetic heart valves. Initial results in the mitral position. , 1986, Clinical physics and physiological measurement : an official journal of the Hospital Physicists' Association, Deutsche Gesellschaft fur Medizinische Physik and the European Federation of Organisations for Medical Physics.

[181]  Wing Kam Liu,et al.  Lagrangian-Eulerian finite element formulation for incompressible viscous flows☆ , 1981 .

[182]  A. Tedgui,et al.  Differential effects of pressure and flow on DNA and protein synthesis and on fibronectin expression by arteries in a novel organ culture system. , 1995, Circulation research.

[183]  F P T Baaijens,et al.  A three-dimensional computational analysis of fluid-structure interaction in the aortic valve. , 2003, Journal of biomechanics.

[184]  S. Vandenberghe Modeling the interaction between cardiac assist devices and the left ventricle , 2004 .

[185]  F A Auger,et al.  A completely biological tissue‐engineered human blood vessel , 1998, FASEB journal : official publication of the Federation of American Societies for Experimental Biology.

[186]  S. Hoerstrup,et al.  Tissue engineering of a bioprosthetic heart valve: stimulation of extracellular matrix assessed by hydroxyproline assay. , 1999, ASAIO journal.