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Experimental investigation of the flow downstream of a dysfunctional bileaflet mechanical aortic valve

机译：软障碍机械主动脉瓣下游流动的实验研究

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Abstract Mechanical heart valve replacement is the preferred alternative in younger patients with severe symptomatic aortic valve disease. However, thrombus and pannus formations are common complications associated with bileaflet mechanical heart valves. This leads to risks of valve leaflet dysfunction, a life‐threatening event. In this experimental study, we investigate, using time‐resolved planar particle image velocimetry, the flow characteristics in the ascending aorta in the presence of a dysfunctional bileaflet mechanical heart valve. Several configurations of leaflet dysfunction are investigated and the induced flow disturbances in terms of velocity fields, viscous energy dissipation, wall shear stress, and accumulation of viscous shear stresses are evaluated. We also explore the ability of a new set of parameters, solely based on the analysis of the normalized axial velocity profiles in the ascending aorta, to detect bileaflet mechanical heart valve dysfunction and differentiate between the different configurations tested in this study. Our results show that a bileaflet mechanical heart valve dysfunction leads to a complex spectrum of flow disturbances with each flow characteristic evaluated having its own worst case scenario in terms of dysfunction configuration. We also show that the suggested approach based on the analysis of the normalized axial velocity profiles in the ascending aorta has the potential to clearly discriminate not only between normal and dysfunctional bilealfet heart valves but also between the different leaflet dysfunction configurations. This approach could be easily implemented using phase‐contrast MRI to follow up patients with bileaflet mechanical heart valves.
机译：摘要机械心脏瓣膜置换是患者严重症状主动脉瓣病的患者的首选替代品。然而，血栓和肺部形成是与双方机械心阀相关的常见并发症。这导致阀门传单功能障碍的风险，威胁危及生命的事件。在该实验研究中，我们使用时间分辨的平面粒子图像测速方法来调查，在存在功能官能失调的BILAFLET机械心脏瓣膜存在下升高的主动脉中的流动特性。研究了宣传叶功能障碍的几种配置，并且评估了速度场的诱导流动扰动，粘性能量耗散，壁剪切应力和粘性剪切应力的积累。我们还探讨了一组新的参数的能力，仅基于升序主动脉中的归一化轴向速度分布的分析，以检测双方机械心脏瓣膜功能障碍并区分本研究中测试的不同配置。我们的结果表明，双方机械心脏瓣膜功能障碍导致复杂的流动紊乱频谱，每个流动特性评估在功能障碍配置方面具有其自己的最坏情况。我们还表明，基于升高主动脉中归一化轴向速度分析的建议方法具有明显不仅在正常和功能失调的BileAlfet心阀之间清晰地区分，而且可以在不同的宣传单功能障碍配置之间清晰地区分。可以使用相位对比MRI轻松实现这种方法，以跟踪双方机械心脏瓣膜的患者。

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