Aix Marseille Univ, CNRS, Centrale Med, M2P2, Marseille, France.
Department of Cardiac Surgery, La Timone Hospital, APHM, Aix Marseille Univ, Marseille, France.
Ann Biomed Eng. 2024 Nov;52(11):3021-3036. doi: 10.1007/s10439-024-03566-1. Epub 2024 Sep 3.
The Ozaki procedure is a surgical technique which avoids to implant foreign aortic valve prostheses in human heart, using the patient's own pericardium. Although this approach has well-identified benefits, it is still a topic of debate in the cardiac surgical community, which prevents its larger use to treat valve pathologies. This is linked to the actual lack of knowledge regarding the dynamics of tissue deformations and surrounding blood flow for this autograft pericardial valve. So far, there is no numerical study examining the coupling between the blood flow characteristics and the Ozaki leaflets dynamics. To fill this gap, we propose here a comprehensive comparison of various performance criteria between a healthy native valve, its pericardium-based counterpart, and a bioprosthetic solution, this is done using a three-dimensional fluid-structure interaction solver. Our findings reveal similar physiological dynamics between the valves but with the emergence of fluttering for the Ozaki leaflets and higher velocity and wall shear stress for the bioprosthetic heart valve.
大崎手术是一种避免将人工主动脉瓣膜植入人体心脏的外科技术,而是使用患者自身的心包膜。尽管这种方法具有明显的优势,但它仍然是心脏外科学术界争论的话题,这阻碍了其更大规模地用于治疗瓣膜病变。这与目前对这种自体心包瓣组织变形和周围血流动力学的实际知识缺乏有关。到目前为止,还没有关于血流特征与大崎瓣叶动力学之间耦合的数值研究。为了填补这一空白,我们在这里使用三维流固耦合求解器对健康的原生瓣膜、基于心包的对应瓣膜和生物假体瓣膜之间的各种性能标准进行了全面比较。我们的研究结果表明,瓣膜之间存在相似的生理动力学,但大崎瓣叶出现了飘动,生物假体心脏瓣膜的速度和壁面剪切应力更高。