Hydrodynamic performance of mechanical and biological prosthetic heart valves
Creators: name: Bishop, Winona F.
Publisher: name: University of British Columbia
Year: 2010

description: One of the major achievements in cardiac surgery over the past 30 years has been the ability to replace severely diseased heart valves with prosthetic ones. The option of using prosthetic heart valves for the treatment of valvular diseases has improved and prolonged many lives. This is reflected in around 120,000 heart valve replacement operations carried out every year in North America alone to correct the cardiovascular problems of stenosis, insufficiency, regurgitation, etc. The development of artificial heart valves depends on reliable knowledge of the hemodynamic performance and physiology of the cardiovascular system in addition to a sound understanding, at the fundamental level, of the associated fluid mechanics. It is evident from the literature review that noninvasive measurements in a confined area of complex transient geometry, providing critical information relating to valve performance, are indeed scarce. This thesis presents results of an extensive test program aimed at measuring turbulence stresses, steady and transient velocity profiles and their decay downstream of the mitral valve. Three mechanical tilting disc-type heart valves (Björk-Shiley convexo- concave, Björk-Shiley monostrut, and Bicer-Val) and two biological tissue valves (Hancock II and Carpentier-Edwards supraannular) are studied. The investigation was carried out using a sophisticated and versatile cardiac simulator in conjunction with a highly sensitive, noninvasive, two-component three-beam laser doppler anemometer system. The study covers both the steady (valve fully open) and pulsatile (resting heart rate) flow conditions. The continuous monitoring of the parametric time histories revealed useful details of the complex flow as well as helped establish location and timing of the peak parameter values. In addition, orientation experiments are conducted on the mechanical valves in an attempt to reduce stresses by altering the position of the major orifice. The experiments suggest correlation between high stresses and orientation. Based on the the data, the following general conclusions can be made: (i) Hemodynamic test results should be presented in nondimensional form to render them independent of test facilities, flow velocities, size of models, etc. This would facilitate comparison of results by different investigators, using different facilities and test conditions. (ii) The valves tested showed very disturbed flow fields which generated high turbulent stresses presenting a possibility of thromboembolism and, perhaps, haemolysis. (iii) Implantation orientation of the valve significantly affect the mechanical prostheses flow field. The single vortex formation in the posterior orientation results in a reduction in stresses compared to the anterior configuration. (iv) The present results together with the earlier information on pressure drop and regurgitation provide a comprehensive and organized picture of the valve performance. (v) The information is fundamental to the improvement in valve design, and development of guidelines for test methodology and acceptable performance criteria for marketing of the valves.