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新型设计的无支架双叶瓣人工主动脉瓣置换术聚四氟乙烯瓣的数值和体外实验评估。

Numerical and in-vitro experimental assessment of the performance of a novel designed expanded-polytetrafluoroethylene stentless bi-leaflet valve for aortic valve replacement.

机构信息

School of Energy and Power Engineering, Xi'an Jiaotong University, Xian, Shaanxi, China.

School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore, Singapore.

出版信息

PLoS One. 2019 Jan 30;14(1):e0210780. doi: 10.1371/journal.pone.0210780. eCollection 2019.

Abstract

The expanded polytetrafluoroethylene (ePTFE) heart valve can serve as a viable option for prosthetic aortic valve. In this study, an ePTFE bi-leaflet valve design for aortic valve replacement (AVR) is presented, and the performance of the proposed valve was assessed numerically and experimentally. The valve was designed using CAE software. The dynamic behavior of the newly designed bi-leaflet valve under time-varying physiological pressure loading was first investigated by using commercial finite element code. Then, in-vitro tests were performed to validate the simulation and to assess the hemodynamic performance of the proposed design. A tri-leaflet ePTFE valve was tested in-vitro under the same conditions as a reference. The maximum leaflet coaptation area of the bi-leaflet valve during diastole was 216.3 mm2. When fully closed, no leakage gap was observed and the free edges of the molded valve formed S-shaped lines. The maximum Von Mises stress during a full cardiac cycle was 4.20 MPa. The dynamic performance of the bi-leaflet valve was validated by the in-vitro test under physiological aortic pressure pulse. The effective orifice area (EOA), mean pressure gradient, regurgitant volume, leakage volume and energy loss of the proposed valve were 3.14 cm2, 8.74 mmHg, 5.93 ml/beat, 1.55 ml/beat and 98.99 mJ, respectively. This study reports a novel bi-leaflet valve design for AVR. The performance of the proposed valve was numerically and experimentally assessed. Compared with the reference valve, the proposed design exhibited better structural and hemodynamic performances, which improved valve competency. Moreover, the performance of the bi-leaflet design is comparable to commercialized valves available on the market. The results of the present study provide a viable option for the future clinical applications.

摘要

膨体聚四氟乙烯(ePTFE)心脏瓣膜可用作人工主动脉瓣的可行选择。在这项研究中,提出了一种用于主动脉瓣置换术(AVR)的 ePTFE 双叶瓣设计,并通过数值和实验评估了所提出的瓣膜的性能。使用 CAE 软件设计了该瓣膜。首先使用商业有限元代码研究了在时变生理压力载荷下新设计的双叶瓣的动态行为。然后,进行了体外测试以验证模拟并评估所提出设计的血液动力学性能。在相同条件下,以三叶瓣 ePTFE 阀作为参考进行了体外测试。舒张期双叶瓣的最大瓣叶贴合面积为 216.3mm2。当完全关闭时,未观察到泄漏间隙,并且模制阀的自由边缘形成 S 形线。整个心动周期的最大 Von Mises 应力为 4.20MPa。通过生理主动脉压脉冲下的体外测试验证了双叶瓣的动态性能。提出的瓣膜的有效瓣口面积(EOA)、平均压力梯度、反流量、泄漏量和能量损失分别为 3.14cm2、8.74mmHg、5.93ml/beat、1.55ml/beat 和 98.99mJ。本研究报告了一种用于 AVR 的新型双叶瓣设计。对提出的瓣膜的性能进行了数值和实验评估。与参考瓣膜相比,提出的设计表现出更好的结构和血液动力学性能,从而提高了瓣膜的性能。此外,双叶设计的性能可与市场上商业化的瓣膜相媲美。本研究的结果为未来的临床应用提供了可行的选择。

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