CFD Simulation of a Novel Bileaflet Mechanical Heart Valve Prosthesis - An Estimation of the Venturi Passage Formed by the Leaflets

The aim of this study was to validate the flow characteristics of the novel Helmholtz-Institute Aachen Bileaflet (HIA-BL) heart valve prosthesis. The curved leaflets of the HIA-BL valve form a Venturi passage between the leaflets at peak systole. By narrowing the cross section the flow accelerates and the static pressure at the central passage decreases according to the Venturi effect. The low-pressure zone between the leaflets is expected to stabilize the leaflets in fully open position at peak systole.

To investigate the Venturi passage, the flow fields of two valve geometries were investigated by CFD (Computational Fluid Dynamics): one geometry exhibits curved leaflets resulting in a Venturi passage; the other geometry features straight leaflets. The flow profiles, pressure distribution and resulting torque of both passages were compared and investigated.

Although flow profiles downstream of both valves were similar, the flow passages between the leaflets were different for the investigated leaflet geometries. The straight leaflet passage showed a large boundary layer separation zone near the leaflets and the lowest pressure at the leading edge of the leaflet. The Venturi passage showed a reduction of the boundary layer separation zones and the lowest pressure between the leaflets could be found in the narrowest flow cross section of the Venturi passage. Additionally, the resulting torque showed that the Venturi passage produced an opening momentum. The results demonstrate that the Venturi passage stabilizes the leaflets in open position at peak systole.

An Initial Parametric Study on Fluid Flow Through Bileaflet Mechanical Heart Valves Using Computational Fluid Dynamics

The effect of leaflet opening angle on flow through a bileaflet mechanical heart valve has been investigated using computational fluid dynamics (CFD). Steady state, laminar flow for a Newtonian fluid at a Reynolds number of 1500 was used in the two-dimensional model of the valve, ventricle, sinus and aorta. This computational model was verified using one-dimensional laser Doppler velocimetry (LDV). Although marked differences in the flow fields and energy dissipation of the jets downstream of the valve were found between the CFD predictions and the three-dimensional experimental model, both methods showed similar trends in the changes of the flow fields as the leaflet opening angle was altered. As the opening angle increased the area of recirculating fluid downstream of the leaflets, the pressure drop across the valve and the volumetric flow rate through the outer orifice decreased. For opening angles greater than 80° the jet through the outer orifice recombined with the central jet downstream of the leaflet; for an opening angle of 78° the jet through the outer orifice impinged on the aortic wall before recombining with the central jet. This study suggests that the opening angle has a marked effect on the flow downstream of the bileaflet mechanical heart valve and that valves with opening angles greater than 80° are preferable.

NUMERICAL STUDY AND DYNAMIC BEHAVIOR ANALYSIS OF MECHANICAL HEART VALVE

This paper develops an analysis tool, for the mechanical heart valve designs, which contains a quick flow analysis model and a pseudo steady-state dynamic model. The flow model utilizes an irrotational, inviscid algorithm of source/doublet elements simulating the closed leaflet geometry and the aortic root coupled with a boundary layer model to simulate the viscous components. The numerical study provides quick simulation and vital design data of the shear stress distributed over the valve leaflet, the separation point prediction behind the leaflet and the sewing ring, and the aerodynamic loads acting on the leaflet. Those aerodynamic loads have been sent to a dynamic model, which simulates the leaflet motion as a 2nd order rotating system, to simulate the opening/closing characteristics of the leaflet. The analysis of the presented new heart valve design leads to a conclusion that the regurgitant volumes depends very much on the orientation of the gravity force. The maximum difference of the ratio of the valve closing regurgitation to the main flow can be as high as 12%. Hence the leaflet ought to be designed with a light material to avoid the unstable influence on the heart work due to the human's physical actions.

Four-year experience with the CarboMedics valve: the North American experience. North American team of clinical investigators for the CarboMedics prosthetic heart valve

A multicenter prospective trial of the CarboMedics valve was initiated in July 1988. Twelve North American centers were included for the purpose of establishing the safety and efficacy of this new rotatable, bileaflet, pyrolytic-Carbon prosthesis. The study included 786 patients (using 891 valves) enrolled between July 1988 and August 1992. There were 447 male and 339 female patients from ages 2 to 83 years. Of the 618 primary replacement operations (including double valves), 393 were aortic and 292 were mitral valve replacements. Mean follow-up time was 16.1 months; 94.7% of patients had completed documentation up to and including one year. New York Heart Association functional class was III or IV for 84.4% of patients preoperatively, and I and II in over 96% of patients for the first three postoperative years. Survival for the entire group was 93% (622) at 1 month, 89% (504) at 1 year, 87% (213) at 2 years, and 85% (41) at 3 years. There were no significant survival differences between primary and repeat replacements or between aortic, mitral, and double-valve replacements. Primary replacement patients with concomitant procedures (n = 241) had slightly decreased survival rates compared with those who underwent isolated procedures (isolated survival rate, 92% [98]; concomitant procedure survival rate, 81% [59] at 2 years; p = 0.002). There was no valve failure. Linearized rates (events per 100 patient-years) in primary replacement patients after 30 days included the following: thrombosis, 0.39; thromboembolism, 0.92; hemolysis, 0.53; anticoagulant-related hemorrhage, 2.36; paravalvular leak, 0.92; endocarditis, 0.53; reoperation, 0.92; and explantation, 0.66.(ABSTRACT TRUNCATED AT 250 WORDS)

Mechanical and other problems of artificial valves

This chapter has discussed the design, development, laboratory testing and clinical performance of artificial heart valve replacements. The published material on this subject is extensive and clearly this present chapter represents only a limited selection of the many topics and researchers associated with the production of clinically implantable valves. Any omissions should not be regarded as a criticism, but simply the result of economy of space. The field is still developing and the situation regarding the advantages and disadvantages of the various types of valves as illustrated in Table 3 still obtains notwithstanding the many improvements which have been made with current designs. Valve development is, and will continue to be, closely allied to advances in our understanding of the behaviour of the materials of construction. Ultimately, improved haemodynamic performances of the various valve configurations will result from designs based on data from computerised fluid dynamic analysis combined with finite element stress analysis according to recognised engineering design principles.