Comparative In Vitro Study of Bileaflet and Tilting Disk Valve Behavior in the Pulmonary Position

[+] Author and Article Information
Jeffrey Gohean, Tiffany Camp

Departments of Mechanical Engineering and Bioengineering,  Clemson University, Clemson, SC 29634-0921

Richard Figliola1

Departments of Mechanical Engineering and Bioengineering,  Clemson University, Clemson, SC 29634-0921fgliola@clemson.edu

Tim McQuinn

Pediatric Cardiology,  Medical University of South Carolina, Charleston, SC 29425


Author to whom correspondence should be addressed.

J Biomech Eng 128(4), 631-635 (Feb 09, 2006) (5 pages) doi:10.1115/1.2206204 History: Received July 12, 2005; Revised February 09, 2006

A study of mechanical heart valve behavior in the pulmonary position as a function of pulmonary vascular resistance is reported for the St. Jude Medical bileaflet (SJMB) valve and the MedicalCV Omnicarbon (OTD) tilting disk valve. Tests were conducted in a pulmonic mock circulatory system and impedance was varied in terms of system pulmonary vascular resistance (PVR). An impedance spectrum was found using instantaneous pulmonary artery pressure and flow rate curves. Both valves fully opened and closed at and above a nominal PVR of 3.0mmHgLmin. The SJMB valve was prone to leaflet bounce at closure, but otherwise completely closed, at settings above and below this nominal setting. At PVR values at and below 2.0mmHgLmin, the SJMB valve exhibited two types of leaflet aberrant behavior: single leaflet only closure while the other leaflet fluttered, and incomplete closure where both leaflets flutter but neither remain fully closed. The OTD valve fully opened and closed to a PVR value of 1.6mmHgLmin. At lower values, the valve did not close. Valves designed for the left heart can show aberrant behavior under normal conditions as pulmonary valves.

Copyright © 2006 by American Society of Mechanical Engineers
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Figure 1

Schematic of the mock circulatory system. Arrows indicate flow direction. 1. Atrial head tank with tricuspid valve; 2. Right ventricular chamber; 3. Flow meter; 4. Test chamber; 5. Mechanical heart valve; 6. Resistance elements; 7. Compliance chambers; 8. Reservoir; 9. Pump; 10. Pressurizing flow valve; 11. Venting flow valve; 12. Head tank.

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Figure 2

Plan view of pulmonary artery test section (dimensions in mm)

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Figure 3

Valve orientation. (left – right) SJMB; OTD orientation one; OTD orientation 2.

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Figure 4

Instantaneous pressure and flow curves for SJMB valve (CO=6.0L∕min@75beats∕min; SR=42%; PVR=3.0mmHg∕L∕min)

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Figure 5

Impedance spectrum for base line behavior of SJMB and OTD valves and for aberrant behavior for the SJMB valve and two orientations of the OTD valve

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Figure 6

Images of aberrant behavior through one cycle of SJMB valve and OTD valve. (A) SJMB valve incomplete closure; (B) SJMB valve with one leaflet closure, other remains open; (C) OTD valve incomplete closure in orientation two. Time t=0s corresponds to onset of systole and pulse interval is 0.80s.

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Figure 7

Sample pulmonary artery pressure wave forms through one cycle



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