Numerical and experimental investigations of pulsatile blood flow pattern through a dysfunctional mechanical heart valve

O. Smadi, Ibrahim Hassan, P. Pibarot, L. Kadem

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Around 250,000 heart valve replacements are performed every year around the world. Due their higher durability, approximately 2/3 of these replacements use mechanical prosthetic heart valves (mainly bileaflet valves). Although very efficient, these valves can be subject to valve leaflet malfunctions. These malfunctions are usually the consequence of pannus ingrowth and/or thrombus formation and represent serious and potentially fatal complications. Hence, it is important to investigate the flow field downstream of a dysfunctional mechanical heart valve to better understand its impact on blood components (red blood cells, platelets and coagulation factors) and to improve the current diagnosis techniques. Therefore, the objective of this study will be to numerically and experimentally investigate the pulsatile turbulent flow downstream of a dysfunctional bileaflet mechanical heart valve in terms of velocity field, vortex formation and potential negative effect on blood components. The results show that the flow downstream of a dysfunctional valve was characterized by abnormally elevated velocities and shear stresses as well as large scale vortices. These characteristics can predispose to blood components damage. Furthermore, valve malfunction led to an underestimation of maximal transvalvular pressure gradient, using Doppler echocardiography, when compared to numerical results. This could be explained by the shifting of the maximal velocity towards the normally functioning leaflet. As a consequence, clinicians should try, when possible, to check the maximal velocity position not only at the central orifice but also through the lateral orifices. Finding the maximal velocity in the lateral orifice could be an indication of valve dysfunction.

Original languageEnglish
Pages (from-to)1565-1572
Number of pages8
JournalJournal of Biomechanics
Volume43
Issue number8
DOIs
Publication statusPublished - May 2010
Externally publishedYes

Fingerprint

Pulsatile Flow
Heart Valves
Flow patterns
Blood
Orifices
Vortex flow
Blood Coagulation Factors
Heart valve prostheses
Doppler Echocardiography
Blood Coagulation
Echocardiography
Platelets
Coagulation
Pressure gradient
Thrombosis
Blood Platelets
Erythrocytes
Turbulent flow
Shear stress
Flow fields

Keywords

  • CFD
  • Doppler-echocardiography
  • Dysfunctional mechanical heart valve
  • In vitro model
  • Platelet activation

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Rehabilitation
  • Biophysics
  • Biomedical Engineering

Cite this

Numerical and experimental investigations of pulsatile blood flow pattern through a dysfunctional mechanical heart valve. / Smadi, O.; Hassan, Ibrahim; Pibarot, P.; Kadem, L.

In: Journal of Biomechanics, Vol. 43, No. 8, 05.2010, p. 1565-1572.

Research output: Contribution to journalArticle

@article{4aeab187db254ce4966e063430759a7d,
title = "Numerical and experimental investigations of pulsatile blood flow pattern through a dysfunctional mechanical heart valve",
abstract = "Around 250,000 heart valve replacements are performed every year around the world. Due their higher durability, approximately 2/3 of these replacements use mechanical prosthetic heart valves (mainly bileaflet valves). Although very efficient, these valves can be subject to valve leaflet malfunctions. These malfunctions are usually the consequence of pannus ingrowth and/or thrombus formation and represent serious and potentially fatal complications. Hence, it is important to investigate the flow field downstream of a dysfunctional mechanical heart valve to better understand its impact on blood components (red blood cells, platelets and coagulation factors) and to improve the current diagnosis techniques. Therefore, the objective of this study will be to numerically and experimentally investigate the pulsatile turbulent flow downstream of a dysfunctional bileaflet mechanical heart valve in terms of velocity field, vortex formation and potential negative effect on blood components. The results show that the flow downstream of a dysfunctional valve was characterized by abnormally elevated velocities and shear stresses as well as large scale vortices. These characteristics can predispose to blood components damage. Furthermore, valve malfunction led to an underestimation of maximal transvalvular pressure gradient, using Doppler echocardiography, when compared to numerical results. This could be explained by the shifting of the maximal velocity towards the normally functioning leaflet. As a consequence, clinicians should try, when possible, to check the maximal velocity position not only at the central orifice but also through the lateral orifices. Finding the maximal velocity in the lateral orifice could be an indication of valve dysfunction.",
keywords = "CFD, Doppler-echocardiography, Dysfunctional mechanical heart valve, In vitro model, Platelet activation",
author = "O. Smadi and Ibrahim Hassan and P. Pibarot and L. Kadem",
year = "2010",
month = "5",
doi = "10.1016/j.jbiomech.2010.01.029",
language = "English",
volume = "43",
pages = "1565--1572",
journal = "Journal of Biomechanics",
issn = "0021-9290",
publisher = "Elsevier Limited",
number = "8",

}

TY - JOUR

T1 - Numerical and experimental investigations of pulsatile blood flow pattern through a dysfunctional mechanical heart valve

AU - Smadi, O.

AU - Hassan, Ibrahim

AU - Pibarot, P.

AU - Kadem, L.

PY - 2010/5

Y1 - 2010/5

N2 - Around 250,000 heart valve replacements are performed every year around the world. Due their higher durability, approximately 2/3 of these replacements use mechanical prosthetic heart valves (mainly bileaflet valves). Although very efficient, these valves can be subject to valve leaflet malfunctions. These malfunctions are usually the consequence of pannus ingrowth and/or thrombus formation and represent serious and potentially fatal complications. Hence, it is important to investigate the flow field downstream of a dysfunctional mechanical heart valve to better understand its impact on blood components (red blood cells, platelets and coagulation factors) and to improve the current diagnosis techniques. Therefore, the objective of this study will be to numerically and experimentally investigate the pulsatile turbulent flow downstream of a dysfunctional bileaflet mechanical heart valve in terms of velocity field, vortex formation and potential negative effect on blood components. The results show that the flow downstream of a dysfunctional valve was characterized by abnormally elevated velocities and shear stresses as well as large scale vortices. These characteristics can predispose to blood components damage. Furthermore, valve malfunction led to an underestimation of maximal transvalvular pressure gradient, using Doppler echocardiography, when compared to numerical results. This could be explained by the shifting of the maximal velocity towards the normally functioning leaflet. As a consequence, clinicians should try, when possible, to check the maximal velocity position not only at the central orifice but also through the lateral orifices. Finding the maximal velocity in the lateral orifice could be an indication of valve dysfunction.

AB - Around 250,000 heart valve replacements are performed every year around the world. Due their higher durability, approximately 2/3 of these replacements use mechanical prosthetic heart valves (mainly bileaflet valves). Although very efficient, these valves can be subject to valve leaflet malfunctions. These malfunctions are usually the consequence of pannus ingrowth and/or thrombus formation and represent serious and potentially fatal complications. Hence, it is important to investigate the flow field downstream of a dysfunctional mechanical heart valve to better understand its impact on blood components (red blood cells, platelets and coagulation factors) and to improve the current diagnosis techniques. Therefore, the objective of this study will be to numerically and experimentally investigate the pulsatile turbulent flow downstream of a dysfunctional bileaflet mechanical heart valve in terms of velocity field, vortex formation and potential negative effect on blood components. The results show that the flow downstream of a dysfunctional valve was characterized by abnormally elevated velocities and shear stresses as well as large scale vortices. These characteristics can predispose to blood components damage. Furthermore, valve malfunction led to an underestimation of maximal transvalvular pressure gradient, using Doppler echocardiography, when compared to numerical results. This could be explained by the shifting of the maximal velocity towards the normally functioning leaflet. As a consequence, clinicians should try, when possible, to check the maximal velocity position not only at the central orifice but also through the lateral orifices. Finding the maximal velocity in the lateral orifice could be an indication of valve dysfunction.

KW - CFD

KW - Doppler-echocardiography

KW - Dysfunctional mechanical heart valve

KW - In vitro model

KW - Platelet activation

UR - http://www.scopus.com/inward/record.url?scp=77952581806&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77952581806&partnerID=8YFLogxK

U2 - 10.1016/j.jbiomech.2010.01.029

DO - 10.1016/j.jbiomech.2010.01.029

M3 - Article

C2 - 20188372

AN - SCOPUS:77952581806

VL - 43

SP - 1565

EP - 1572

JO - Journal of Biomechanics

JF - Journal of Biomechanics

SN - 0021-9290

IS - 8

ER -