Comparison of hinge microflow fields of bileaflet mechanical heart valves implanted in different sinus shape and downstream geometry

Fluid-structure interaction modelling of a positive-displacement Total Artificial Heart

For those suffering from end-stage biventricular heart failure, and where a heart transplantation is not a viable option, a Total Artificial Heart (TAH) can be used as a bridge to transplant device. The Realheart TAH is a four-chamber artificial heart that uses a positive-displacement pumping technique mimicking the native heart to produce pulsatile flow governed by a pair of bileaflet mechanical heart valves. The aim of this work was to create a method for simulating haemodynamics in positive-displacement blood pumps, using computational fluid dynamics with fluid-structure interaction to eliminate the need for pre-existing in vitro valve motion data, and then use it to investigate the performance of the Realheart TAH across a range of operating conditions. The device was simulated in Ansys Fluent for five cycles at pumping rates of 60, 80, 100 and 120 bpm and at stroke lengths of 19, 21, 23 and 25 mm. The moving components of the device were discretised using an overset meshing approach, a novel blended weak-strong coupling algorithm was used between fluid and structural solvers, and a custom variable time stepping scheme was used to maximise computational efficiency and accuracy. A two-element Windkessel model approximated a physiological pressure response at the outlet. The transient outflow volume flow rate and pressure results were compared against in vitro experiments using a hybrid cardiovascular simulator and showed good agreement, with maximum root mean square errors of 15% and 5% for the flow rates and pressures respectively. Ventricular washout was simulated and showed an increase as cardiac output increased, with a maximum value of 89% after four cycles at 120 bpm 25 mm. Shear stress distribution over time was also measured, showing that no more than [Formula: see text]% of the total volume exceeded 150 Pa at a cardiac output of 7 L/min. This study showed this model to be both accurate and robust across a wide range of operating points, and will enable fast and effective future studies to be undertaken on current and future generations of the Realheart TAH.

Transient Study of Flow and Cavitation Inside a Bileaflet Mechanical Heart Valve

A mechanical heart valve (MHV) is an effective device to cure heart disease, which has the advantage of long life and high reliability. Due to the hemodynamic characteristics of blood, mechanical heart valves can lead to potential complications such as hemolysis, which have damage to the blood elements and thrombosis. In this paper, flowing features of the blood in the valve are analyzed and the cavitation mechanism in bileaflet mechanical heart valve (BMHV) is studied. Results show that the water hammer effect and the high-speed leakage flow effect are the primary causes of the cavitation in the valve. Compared with the high-speed leakage flow effect, the water hammer has a greater effect on the cavitation strength. The valve goes through four kinds of working condition within one heart beating period, including, fully opening stage, closing stage and fully closing stage. These four stages, respectively, make up 8.5%, 16.1%, 4.7% and 70.7% of the total period. The cavitation occurs on the fully closing stage. When the valve is in closing stage, the high pressure downstream of the valve lasts for about 20 ms and the high-speed leakage flow lasts for about 200 ms. This study systematically analyzes the causes of cavitation emerged in the process of periodic motion, which proposes the method for characterizing the intensity of the cavitation, and can be referred to for the cavitation suppression of the BHMV and similar valves.

Effect of Aortic Wall Deformation with Healthy and Calcified Annulus on Hemodynamic Performance of Implanted On-X Valve

INTRODUCTION

In this research, the hemodynamic performance of a 23-mm On-X bileaflet mechanical heart valve (BMHV) was investigated with the realistic geometry model of the valve and the deformable aorta in accelerating systole. In addition, the effect of ascending aorta flexibility and aortic annulus calcification on the complex blood flow characteristics were investigated.

METHODS

The geometry of the aorta is derived from the medical images, and the Ogden model has been utilized for the mechanical behavior of the ascending aorta. The 3D numerical simulation by a two-way Fluid-Structure Interaction (FSI) analysis using the Arbitrary Lagrangian-Eulerian (ALE) method was performed throughout the accelerating systolic phase.

RESULTS

The dynamics of the leaflets are investigated, and blood flow characteristics such as velocities, vorticities as well as viscous and turbulent shear stress were precisely captured in the flow domain specifically in the hinge region. Streamline results are in accordance with the previously reported data, which show that the flared On-X valves inlet yields a more uniform flow in accelerating systole. Simulations show that aorta flexibility or valve annulus calcification causes variations up to 7% in maximum fluid velocity and 20% in Turbulence Kinetic Energy (TKE).

CONCLUSIONS

In this study, the complex flow field characteristics in the new generation of BMHVs considering aorta flexibility with healthy and calcified annulus were investigated. It was found that the blood flow around the hinges region is in the danger of hemolysis and platelet activation and subsequently thromboembolism. Furthermore, the results show that similar to vessel wall deformation, considering the probable annulus calcification after valve replacement is also essential.

A Numerical Analysis of Pressure Pulsation Characteristics Induced by Unsteady Blood Flow in a Bileaflet Mechanical Heart Valve

The leaflet vibration phenomenon in bileaflet mechanical heart valves (BMHVs) can cause complications such as hemolysis, leaflet damage, and valve fracture. One of the main reasons for leaflet vibration is the unsteady blood flow pressure pulsation induced by turbulent flow instabilities. In this study, we performed numerical simulations of unsteady flow through a BMHV and observed pressure pulsation characteristics under different flow rates and leaflet fully opening angle conditions. The pressure pulsation coefficient and the low-Reynolds k-ω model in CFD (Computational Fluid Dynamics) software were employed to solve these problems. Results showed that the level of pressure pulsation was highly influenced by velocity distribution, and that the higher coefficient of pressure pulsation was associated with the lower flow velocity along the main flow direction. The influence of pressure pulsation near the trailing edges was much larger than the data obtained near the leading edges of the leaflets. In addition, considering the level of pressure pulsation and the flow uniformity, the recommended setting of leaflet fully opening angle was about 80°.

Non-Newtonian Blood Flow Simulation of Diastolic Phase in Bileaflet Mechanical Heart Valve Implanted in a Realistic Aortic Root Containing Coronary Arteries

Coronary arteries, which are branched from the sinuses, have tangible effects on the hemodynamic performance of the bileaflet mechanical heart valve (BMHV), especially in the diastolic phase. To better understand this issue, a computer model of ascending aorta including realistic sinus shapes and coronary arteries has been generated in this study in order to investigate the BMHV performance during diastole. Three-dimensional transient numerical analysis is conducted to simulate the diastolic blood flow through the hinges and in coronary arteries under the assumption of non-Newtonian behavior. Results indicate that as blood flows to the coronary arteries mainly during diastole, leakage flow from the hinge and other gaps will change considering the influence of coronary arteries. In addition, BMHV in the case of aortic replacement will increase blood flow rate into the coronary arteries about 100% as the mechanical valve resistance is higher than a native heart valve. Also, it will change the wall shear stress (WSS) distribution and increase coronary artery disease (CAD) potential. It is found out that although less leakage flow reduces the velocity magnitudes through the gaps, the shear stress acting on blood elements with non-Newtonian assumption will be detrimental in the hinge corner at the ventricular side. High WSS of 1800 Pa is observed at beginning of diastole at this region.

On-X Heart Valve Prosthesis: Numerical Simulation of Hemodynamic Performance in Accelerating Systole

Numerical simulation of the bileaflet mechanical heart valves (BMHVs) has been of interest for many researchers due to its capability of predicting hemodynamic performance. A lot of studies have tried to simulate this three-dimensional complex flow in order to analyze the effect of different valve designs on the blood flow pattern. However, simplified models and prescribed motion for the leaflets were utilized. In this paper, transient complex blood flow in the location of ascending aorta has been investigated in a realistic model by fully coupled simulation. Geometry model for the aorta and the replaced valve is constructed based on the medical images and extracted point clouds. A 23-mm On-X Medical BMHV as the new generation design has been selected for the flow field analysis. The two-way coupling simulation is conducted throughout the accelerating phase in order to obtain valve dynamics in the opening process. The complex flow field in the hinge recess is captured precisely for all leaflet positions and recirculating zones and elevated shear stress areas have been observed. Results indicate that On-X valve yields relatively less transvalvular pressure gradient which would lower cardiac external work. Furthermore, converging inlet leads to a more uniform flow and consequently less turbulent eddies. However, the leaflets cannot open fully due to middle diffuser-shaped orifice. In addition, asymmetric butterfly-shaped hinge design and converging orifice leads to better hemodynamic performance. With the help of two-way fluid solid interaction simulation, leaflet angle follows the experimental trends more precisely rather than the prescribed motion in previous 3D simulations.