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设计参数对双叶机械心脏瓣膜血流动力学的影响。

Impact of design parameters on bileaflet mechanical heart valve flow dynamics.

作者信息

Govindarajan Vijay, Udaykumar Holavanahalli S, Herbertson Luke H, Deutsch Steven, Manning Keefe B, Chandran Krishnan B

机构信息

Department of Biomedical Engineering, College of Engineering, University of Iowa, Iowa City, Iowa 52242, USA.

出版信息

J Heart Valve Dis. 2009 Sep;18(5):535-45.

Abstract

BACKGROUND AND AIM OF THE STUDY

One significant problem encountered during surgery to implant mechanical heart valve prostheses is the propensity for thrombus formation near the valve leaflet and housing. This may be caused by the high shear stresses present in the leakage jet flows through small gaps between leaflets and the valve housing during the valve closure phase.

METHODS

A two-dimensional (2D) study was undertaken to demonstrate that design changes in bileaflet mechanical valves result in notable changes in the flow-induced stresses and prediction of platelet activation. A Cartesian grid technique was used for the 2D simulation of blood flow through two models of bileaflet mechanical valves, and their flow patterns, closure characteristics and platelet activation potential were compared. A local mesh refinement algorithm allowed efficient and fast flow computations with mesh adaptation based on the gradients of the flow field in the gap between the leaflet and housing at the instant of valve closure. Leaflet motion was calculated dynamically, based on the fluid forces acting on it. Platelets were modeled and tracked as point particles by a Lagrangian particle tracking method which incorporated the hemodynamic forces on the particles.

RESULTS

A comparison of results showed that the velocity, wall shear stress and simulated platelet activation parameter were lower in the valve model, with a smaller angle of leaflet traverse between the fully open to the fully closed position. The parameters were also affected to a lesser extent by local changes in the leaflet and housing geometry.

CONCLUSION

Computational simulations can be used to examine local design changes to help minimize the fluid-induced stresses that may play a key role in thrombus initiation with the implanted mechanical valves.

摘要

研究背景与目的

在植入机械心脏瓣膜假体的手术过程中遇到的一个重大问题是瓣膜小叶和瓣座附近形成血栓的倾向。这可能是由于在瓣膜关闭阶段,通过小叶与瓣膜座之间小间隙的泄漏射流中存在高剪切应力所致。

方法

进行了一项二维研究,以证明双叶机械瓣膜的设计变化会导致流动诱导应力和血小板活化预测的显著变化。采用笛卡尔网格技术对通过两种双叶机械瓣膜模型的血流进行二维模拟,并比较它们的流动模式、关闭特性和血小板活化潜力。一种局部网格细化算法允许基于瓣膜关闭瞬间小叶与瓣座之间间隙中的流场梯度进行网格自适应,从而高效快速地进行流动计算。小叶运动基于作用在其上的流体力进行动态计算。血小板通过拉格朗日粒子跟踪方法建模并作为点粒子进行跟踪,该方法考虑了作用在粒子上的血液动力学力。

结果

结果比较表明,在小叶从完全打开到完全关闭位置的横向角度较小的瓣膜模型中,速度、壁面剪应力和模拟的血小板活化参数较低。这些参数受小叶和瓣座几何形状局部变化的影响也较小。

结论

计算模拟可用于研究局部设计变化,以帮助最小化可能在植入机械瓣膜引发血栓中起关键作用的流体诱导应力。

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本文引用的文献

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Ann Biomed Eng. 2006 Oct;34(10):1519-34. doi: 10.1007/s10439-006-9194-5. Epub 2006 Sep 30.
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Flow in prosthetic heart valves: state-of-the-art and future directions.
Ann Biomed Eng. 2005 Dec;33(12):1689-94. doi: 10.1007/s10439-005-8759-z.
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Ann Biomed Eng. 2004 Nov;32(11):1471-83. doi: 10.1114/b:abme.0000049032.51742.10.
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Flow-induced platelet activation in mechanical heart valves.
J Heart Valve Dis. 2004 May;13(3):501-8.
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Dynamics of blood flow and platelet transport in pathological vessels.
Ann N Y Acad Sci. 2004 May;1015:351-66. doi: 10.1196/annals.1302.031.

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