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Cardiovascular Engineering

, Volume 5, Issue 1, pp 13–20 | Cite as

Mitral Prosthesis Opening and Flow Dynamics in a Model of Left Ventricle: An In Vitro Study on a Monoleaflet Mechanical Valve

  • Frederic Mouret
  • Lyes Kadem
  • Eric Bertrand
  • Jean G. Dumesnil
  • Philippe Pibarot
  • Regis Rieu
Article

Abstract

A complete understanding of the flow past a mitral valve prosthesis require a new generation of pulse duplicators and more realistic flow conditions. The objective of this study is to describe the opening kinetics of a monoleaflet Medtronic Hall 27-mm mechanical valve in mitral position and to determine the flow pattern within the left ventricle using particle image velocimetry (PIV) for different instants during the cardiac cycle. At the onset of diastolic phase, the flow goes through the major orifice and then through the minor orifice. The two jets generated induce two counterclockwise vortices within the ventricle, which can lead to a partial closure of the valve during mitral E wave deceleration. During diastasis and mitral A wave, only one vortex persists in the ventricle and pushes the valve disk backward at the end of the diastolic phase. The valve disc never reached its maximum opening (65 vs.75). This study underscores that the flow past a monoleaflet valve in mitral position is highly dependent on the complex interaction between the inflow, the vortices development within the left ventricle, and the gravity. Such a complex interaction can only be highlighted using new generation of pulse duplicators.

Key words

cardiovascular simulator mitral valve prostheses particle image velocimetry valve implantation 

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References

  1. Bellhouse BJ. Fluid mechanics of a model mitral valve and left ventricle. Cardiovasc Res 6: 199–210, 1972.CrossRefGoogle Scholar
  2. Björk VO, Book K, and Holmgren A. Significance of position and opening angle of the Björk-Shiley tilting disk valve in mitral surgery. Scand J Thorac Cardiovasc Surg 7: 187–201, 1973.Google Scholar
  3. Cassot F, Morvan D, Issartier P, and Pelissier R. New versatile physical model fitting the systemic circulation accurately. Med Biol Eng Comput 23: 511–516, 1985.Google Scholar
  4. Chandran KB, Schoephoester R, and Dellsperger KC. Effect of prosthetic mitral valve geometry and orientation flow dynamics in a model of human left ventricle. J Biomech 1: 51–65, 1991.Google Scholar
  5. Funes-Gallanzi M. High accuracy measurement of unsteady flows using digital particle image velocimetry. Opt Laser Technol 30: 349–359, 1998.Google Scholar
  6. Garitey V, Gandelheid T, Fuseri J, Pelissier R, and Rieu R. Ventricular flow dynamics past bileaflet prosthetic heart valves. Int J Artif Organs 18: 380–391, 1995.Google Scholar
  7. Haggag YA. The central axis prosthetic cardiac valve: An in vitro study of pressure drop assessment under steady-state flow conditions. J Biomed Eng 12(1): 63–68, 1990.MathSciNetGoogle Scholar
  8. Kilner PJ, Yang GZ, Wilkes AJ, Mohiaddin RH, Firmin DN, and Yacoub MH. Asymetric redirection of flow through the heart. Nature 404: 759–761, 2000.Google Scholar
  9. Kim WY, Walker PG, Pedersen EM, Poulsen JK, Oyre S, Houlind K, and Yoganathan AP. Left ventricular blood flow patterns in normal subjects: A quantitative analysis by three dimensional magnetic resonance velocity mapping. J Am Coll Cardiol 26: 224–238, 1995.Google Scholar
  10. Mouret F, Garitey V, Gandelheid T, Fuseri R, and Rieu R. A new dual activation simulator of the left heart that reproduces physiological and pathological conditions. Med Biol Eng Comput 38: 558–561, 2000.Google Scholar
  11. Naemura K, Sonderegger M, Umezu M, et al. Study of effect of atrial contraction in mitral prosthetic valve by high speed video camera. Artif Organs 21: 300–305, 1997.CrossRefGoogle Scholar
  12. Pop G, Sutherland GR, Roedland J, Vletter W, and Bos E. What is the ideal orientation of a mitral disc prosthesis. An in vivo haemodynamic study based on colour flow imaging and continuous wave Doppler. Eur Heart J 10: 346–353, 1989.Google Scholar
  13. Rashtian MY, Stevenson DM, Allen DT, et al. Flow characteristics of four commonly used mechanical heart valves. Am J Cardiol 58(9): 743–752, 1986.Google Scholar
  14. Rodevand O, Bjornerheim R, Edvardsen T, Smiseth OA, and Ihlen H. Diastolic flow pattern in the normal left ventricle. J Am Soc Echocardiogr 12: 500–507, 1999.Google Scholar
  15. Senthilnathan V, Treasure T, Grunkemeier G, and Starr A. Heart valves: Which is the best choice? Cardiovasc Surg 7: 393–397, 1999.Google Scholar
  16. Van Rijk-Zwikker GL, Delemarre BJ, and Huysmans HA. The orientation of the bi-leaflet Carbomedics valve in the mitral position determines left ventricular spatial flow patterns. Eur J Cardiothorac Surg 10: 513–520, 1996.Google Scholar
  17. Verdonck P, Kleven A, Verhoeven R, Angelsen B, and Vandenbogaerde J. Computer-controlled in vitro model of the human left heart. Med Biol Eng Comput 30: 656–659, 1992.Google Scholar

Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  • Frederic Mouret
    • 1
    • 3
  • Lyes Kadem
    • 1
  • Eric Bertrand
    • 1
  • Jean G. Dumesnil
    • 2
  • Philippe Pibarot
    • 2
  • Regis Rieu
    • 1
    • 4
  1. 1.Cardiovascular Biomechanics Laboratory, IRPHE – CNRS UMR 6594Université de la MéditerranéeMarseillesFrance
  2. 2.Quebec Heart Institute, Laval HospitalLaval UniversitySainte-Foy, QuebecCanada
  3. 3.PROTOMEDMarseillesFrance
  4. 4.École Généraliste d’Ingénieurs de MarseilleEquipe de Biomécanique Cardio-vasculaire IRPHE, IMT – Technopôle de Château GombertMarseille cedex 13France

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