Kim Yongwoo, Pyo Won Kyung, Kim Wan Kee, Suh Ga-Young, Kang Keonwook, Lee Seung Hyun
Department of Mechanical Engineering, Yonsei University, Seoul, Republic of Korea.
Department of Thoracic Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Heliyon. 2024 Mar 6;10(6):e27310. doi: 10.1016/j.heliyon.2024.e27310. eCollection 2024 Mar 30.
Since the introduction of transcatheter aortic valve (AV) implantation as a viable option, surgical bioprosthetic AVs have recently started incorporating shorter struts considering future valve-in-valve procedures. However, the effect of leaflet coaptation geometry on the longevity of these valves remains unexplored. To address this gap, we performed a finite element analysis on bioprosthetic AVs with varying strut heights using a two-way fluid-structure interaction method. To establish a baseline, we used a standard height based on a rendered platform image of the CE PERIMOUNT Magna Ease valve from Edward Lifesciences in Irvine, CA. Bovine pericardium properties were assigned to the leaflets, while normal saline properties were used as the recirculating fluid in hemodynamic simulations. The physiological pressure profile of the cardiac cycle was applied between the aorta and left ventricle. We calculated blood flow velocity, effective orifice area (EOA), and mechanical stress on the leaflets. The results reveal that as the strut height increases, the stroke volume increases, leakage volume decreases, and EOA improves. Additionally, the maximum mechanical stress experienced by the leaflet decreases by 62% as the strut height increases to 1.2 times the standard height. This research highlights that a low-strut design in bioprosthetic AVs may negatively affect their durability, which can be useful in design of next-generation bioprosthetic AVs.
自从经导管主动脉瓣植入术成为一种可行的选择以来，考虑到未来的瓣中瓣手术，外科生物人工主动脉瓣最近开始采用更短的支柱。然而，瓣叶贴合几何形状对这些瓣膜使用寿命的影响仍未得到探索。为了填补这一空白，我们使用双向流固耦合方法对具有不同支柱高度的生物人工主动脉瓣进行了有限元分析。为了建立一个基线，我们根据加利福尼亚州欧文市爱德华生命科学公司的CE PERIMOUNT Magna Ease瓣膜的渲染平台图像使用了一个标准高度。将牛心包的属性赋予瓣叶，而在血流动力学模拟中使用生理盐水的属性作为循环流体。在主动脉和左心室之间应用心动周期的生理压力曲线。我们计算了血流速度、有效瓣口面积（EOA）以及瓣叶上的机械应力。结果显示，随着支柱高度增加，每搏输出量增加，漏血量减少，EOA改善。此外，当支柱高度增加到标准高度的1.2倍时，瓣叶所承受的最大机械应力降低了62%。这项研究强调，生物人工主动脉瓣的低支柱设计可能会对其耐久性产生负面影响，这对于下一代生物人工主动脉瓣的设计可能会有所帮助。
