0
Journal of Biomechanical Engineering | Volume 128 | Issue 5 | TECHNICAL PAPERS
TECHNICAL PAPERS: Fluids/Heat/Transport

Dynamic Simulation Pericardial Bioprosthetic Heart Valve Function

[+] Author and Article Information
Hyunggun Kim

Department of Biomedical Engineering, University of Iowa, Iowa City, IA 52242

Jia Lu

Department of Mechanical and Industrial Engineering, University of Iowa, Iowa City, IA 52242

Michael S. Sacks

Engineered Tissue Mechanics Laboratory, Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA

Krishnan B. Chandran

Departments of Biomedical and Mechanical and Industrial Engineering, University of Iowa, Iowa City, IA IIHR-Hydroscience and Engineering, Iowa City, IA 52242chandran@engineering.uiowa.edu

J Biomech Eng 128(5), 717-724 (Apr 20, 2006) (8 pages) doi:10.1115/1.2244578 History: Received October 06, 2005; Revised April 20, 2006
Article
References
Figures
Tables
Citing Articles

While providing nearly trouble-free function for 10–12 years, current bioprosthetic heart valves (BHV) continue to suffer from limited long-term durability. This is usually a result of leaflet calcification and/or structural degeneration, which may be related to regions of stress concentration associated with complex leaflet deformations. In the current work, a dynamic three-dimensional finite element analysis of a pericardial BHV was performed with a recently developed FE implementation of the generalized nonlinear anisotropic Fung-type elastic constitutive model for pericardial BHV tissues (W. Sun and M.S. Sacks, 2005, [Biomech. Model. Mechanobiol., 4(2-3), pp. 190–199]). The pericardial BHV was subjected to time-varying physiological pressure loading to compute the deformation and stress distribution during the opening phase of the valve function. A dynamic sequence of the displacements revealed that the free edge of the leaflet reached the fully open position earlier and the belly region followed. Asymmetry was observed in the resulting displacement and stress distribution due to the fiber direction and the anisotropic characteristics of the Fung-type elastic constitutive material model. The computed stress distribution indicated relatively high magnitudes near the free edge of the leaflet with local bending deformation and subsequently at the leaflet attachment boundary. The maximum computed von Mises stress during the opening phase was 33.8kPa. The dynamic analysis indicated that the free edge regions of the leaflets were subjected to significant flexural deformation that may potentially lead to structural degeneration after millions of cycles of valve function. The regions subjected to time varying flexural deformation and high stresses of the present study also correspond to regions of tissue valve calcification and structural failure reported from explanted valves. In addition, the present simulation also demonstrated the importance of including the bending component together with the in-plane material behavior of the leaflets towards physiologically realistic deformation of the leaflets. Dynamic simulations with experimentally determined leaflet material specification can be potentially used to modify the valve towards an optimal design to minimize regions of stress concentration and structural failure.
FIGURES IN THIS ARTICLE
<>
Copyright © 2006 by American Society of Mechanical Engineers
Your Session has timed out. Please sign back in to continue.

References

1
Schoen, F. J., 2001, "Pathology of Heart Valve Substitution with Mechanical and Tissue Prostheses", Churchill Livingstone, New York.
2
Schoen, F. J., and Levy, R. J., 1994, “Pathology of Substitute Heart Valves: New Concepts and Developments,” J. Card. Surg., 9 (2, Suppl.), pp. 222–227.
3
Ferrans, V. J., Hilbert, S. L., Fujita, S., Jones, M., and Roberts, W. C., 1991, "Morphologic Abnormalities in Explanted Bioprosthetic Heart Valves", Saunders, Philadelphia.
4
Harasaki, H., Baker, M., and Zona, D., 1990, “Cross-Linking Agents, Degree of Crosslinkage and Calcifiability in Bioprosthetic Heart Valves,” (Abstract) Trans. Soc. Biomater., 13 , p. 25.
5
Pereira, C. A., Lee, J. M., and Haberer, S. A., 1990, “Effect of Alternative Crosslinking Methods on the Low Strain Rate Viscoelastic Properties of Bovine Pericardial Bioprosthetic Material,” J. Biomed. Mater. Res., 24 (3), pp. 345–361.
6
Petite, H., Rault, I., Huc, A., Menasche, P., and Herbage, D., 1990, “Use of the Acyl Azide Method for Cross-Linking Collagen-Rich Tissues such as Pericardium,” J. Biomed. Mater. Res., 24 (2), pp. 179–187.
7
Vasudev, S. C., and Chandy, T., 1997, “Effect of Alternative Crosslinking Techniques on the Enzymatic Degradation of Bovine Pericardia and their Calcification,” J. Biomed. Mater. Res.  [CrossRef], 35 (3), pp. 357–369.
8
Bengtsson, L. A., Phillips, R., and Haegerstrand, A. N., 1995, “In vitro Endothelialization of Photooxidatively Stabilized Xenogeneic Pericardium,” Ann. Thorac. Surg., 60 (2, Suppl.), pp. S365–S368.
9
Moore, M. A., Bohachevsky, I. K., Cheung, D. T., Boyan, B. D., Chen, W. M., Bickers, R. R., and McIlroy, B. K., 1994, “Stabilization of Pericardial Tissue by Dye-Mediated Photooxidation,” J. Biomed. Mater. Res.  [CrossRef], 28 (5), pp. 611–618.
10
Moore, M. A., Chen, W. M., Phillips, R. E., Bohachevsky, I. K., and McIlroy, B. K., 1996, “Shrinkage Temperature Versus Protein Extraction as a Measure of Stabilization of Photooxidized Tissue,” J. Biomed. Mater. Res.  [CrossRef], 32 (2), pp. 209–214.
11
Moore, M. A., McIlroy, B. K., and Phillips, R. E., 1997, “Nonaldehyde Sterilization of Biologic Tissue for Use in Implantable Medical Devices,” ASAIO J., 43 (1), pp. 23–30.
12
Schoen, F. J., 1998, “Pathologic Findings in Explanted Clinical Bioprosthetic Valves Fabricated From Photooxidized Bovine Pericardium,” J. Heart Valve Dis., 7 (2), pp. 174–179.
13
Sacks, M. S., and Schoen, F. J., 2002, “Collagen Fiber Disruption Occurs Independent of Calcification in Clinically Explanted Bioprosthetic Heart Valves,” J. Biomed. Mater. Res.  [CrossRef], 62 (3), pp. 359–371.
14
Cataloglu, A., Clark, R. E., and Gould, P. L., 1977, “Stress Analysis of Aortic Valve Leaflets With Smoothed Geometrical Data,” J. Biomech.  [CrossRef], 10 (3), pp. 153–158.
15
Chandran, K. B., Kim, S. H., and Han, G., 1991, “Stress Distribution on the Cusps of a Polyurethane Trileaflet Heart Valve Prosthesis in the Closed Position,” J. Biomech.  [CrossRef], 24 (6), pp. 385–395.
16
Ghista, D. N., and Reul, H., 1977, “Optimal Prosthetic Aortic Leaflet Valve: Design Parametric and Longevity Analyses: Development of the Avcothane-51 Leaflet Valve Based on the Optimum Design Analysis,” J. Biomech.  [CrossRef], 10 (5-6), pp. 313–324.
17
Hamid, M. S., Sabbah, H. N., and Stein, P. D., 1986, “Influence of Stent Height Upon Stresses on the Cusps of Closed Bioprosthetic Valves,” J. Biomech.  [CrossRef], 19 (9), pp. 759–769.
18
Rousseau, E. P., van Steenhoven, A. A., and Janssen, J. D., 1988, “A Mechanical Analysis of the Closed Hancock Heart Valve Prosthesis,” J. Biomech.  [CrossRef], 21 (7), pp. 545–562.
19
Black, M. M., Howard, I. C., Huang, X., and Patterson, E. A., 1991, “A Three-Dimensional Analysis of a Bioprosthetic Heart Valve,” J. Biomech.  [CrossRef], 24 (9), pp. 793–801.
20
Howard, I. C., Patterson, E. A., and Yoxall, A., 2003, “On the Opening Mechanism of the Aortic Valve: Some Observations From Simulations,” J. Med. Eng. Technol., 27 (6), pp. 259–266.
21
Huang, X., Black, M. M., Howard, I. C., and Patterson, E. A., 1990, “A Two-Dimensional Finite Element Analysis of a Bioprosthetic Heart Valve,” J. Biomech.  [CrossRef], 23 (8), pp. 753–762.
22
Patterson, E. A., Howard, I. C., and Thornton, M. A., 1996, “A Comparative Study of Linear and Nonlinear Simulations of the Leaflets in a Bioprosthetic Heart Valve During the Cardiac Cycle,” J. Med. Eng. Technol., 20 (3), pp. 95–108.
23
Grande, K. J., Cochran, R. P., Reinhall, P. G., and Kunzelman, K. S., 1998, “Stress Variations in the Human Aortic Root and Valve: the Role of Anatomic Asymmetry,” Ann. Biomed. Eng.  [CrossRef], 26 (4), pp. 534–545.
24
Grande, K. J., Cochran, R. P., Reinhall, P. G., and Kunzelman, K. S., 1999, “Mechanisms of Aortic Valve Incompetence in Aging: A Finite Element Model,” J. Heart Valve Dis., 8 (2), pp. 149–156.
25
Grande, K. J., Cochran, R. P., Reinhall, P. G., and Kunzelman, K. S., 2000, “Mechanisms of Aortic Valve Incompetence: Finite Element Modeling of Aortic Root Dilatation,” Ann. Thorac. Surg., 69 (6), pp. 1851–1857.
26
Sun, W., Abad, A., and Sacks, M. S., 2005, “Simulated Bioprosthetic Heart Valve Deformation Under Quasi-static Loading,” ASME J. Biomech. Eng.  [CrossRef], 127 (6), pp. 905–914.
27
Burriesci, G., Howard, I. C., and Patterson, E. A., 1999, “Influence of Anisotropy on the Mechanical Behaviour of Bioprosthetic Heart Valves,” J. Med. Eng. Technol.  [CrossRef], 23 (6), pp. 203–215.
28
Sun, W., and Sacks, M. S., 2005, “Finite Element Implementation of a Generalized Fung-Elastic Constitutive Model for Planar Soft Tissues,” Biomech. Model Mechanobiol., 4 (2-3), pp. 190–199.
29
Sacks, M. S., and Sun, W., 2003, “Multiaxial Mechanical Behavior of Biological Materials,” Annu. Rev. Biomed. Eng.  [CrossRef], 5 , pp. 251–284.
30
Sun, W., Sacks, M. S., Sellaro, T. L., Slaughter, W. S., and Scott, M. J., 2003, “Biaxial Mechanical Response of Bioprosthetic Heart Valve Biomaterials to High In-plane Shear,” ASME J. Biomech. Eng.  [CrossRef], 125 (3), pp. 372–380.
31
Fung, Y. C., 1993, "Biomechanics: Mechanical Properties of Living Tissues", Springer-Verlag, New York.
32
Sacks, M. S., 1999, “A Method for Planar Biaxial Mechanical Testing That Includes In-plane Shear,” ASME J. Biomech. Eng., 121 (5), pp. 551–555.
33
Sacks, M. S., 2000, “Biaxial Mechanical Evaluation of Planar Biological Materials,” J. Elast.  [CrossRef], 61 (1-3), pp. 199–246.
34
Hildebrand, F., 1980, "Advanced Calculus for Applications", Prentice Hall, Englewood Cliffs, NJ.
35
Sun, W., Abad, A., and Sacks, M. S., 2005, “Simulated Bioprosthetic Heart Valve Deformation Under Quasi-Static Loading,” ASME J. Biomech. Eng.  [CrossRef], 127 (6), pp. 905–914.
36
Smith, D. B., Sacks, M. S., Pattany, P. M., and Schroeder, R., 1999, “Fatigue-Induced Changes in Bioprosthetic Heart Valve Three-Dimensional Geometry and the Relation to Tissue Damage,” J. Heart Valve Dis., 8 (1), pp. 25–33.
37
Sacks, M. S., 2001, “The Biomechanical Effects of Fatigue on the Porcine Bioprosthetic Heart Valve,” J. Long Term Eff. Med. Implants, 11 (3-4), pp. 231–247.
38
Naghdi, P. M., 1972, "The Theory of Plates and Shells", Springer-Verlag, New York.
39
Simo, J. C., and Fox, D. D., 1989, “On a Stress Resultant Geometrically Exact Shell-Model. 1. Formulation and Optimal Parametrization,” Comput. Methods Appl. Mech. Eng.  [CrossRef], 72 (3), pp. 267–304.
40
Simo, J. C., Fox, D. D., and Rifai, M. S., 1989, “On a Stress Resultant Geometrically Exact Shell-Model. 2. The Linear-Theory - Computational Aspects,” Comput. Methods Appl. Mech. Eng.  [CrossRef], 73 (1), pp. 53–92.
41
Simo, J. C., Fox, D. D., and Rifai, M. S., 1990, “On a Stress Resultant Geometrically Exact Shell-Model. 3. Computational Aspects of the Nonlinear-Theory,” Comput. Methods Appl. Mech. Eng.  [CrossRef], 79 (1), pp. 21–70.
42
Brossollet, L. J., and Vito, R. P., 1996, “A New Approach to Mechanical Testing and Modeling of Biological Tissues, with Application to Blood Vessels,” ASME J. Biomech. Eng., 118 (4), pp. 433–439.
43
Rousseeuw, P. J., and Leroy, A. M., 1987, "Robust Regression and Outlier Detection—Wiley Series in Probability and Mathematical Statistics. Applied Probability and Statistics", Wiley, New York.
44
Weiss, J. A., Maker, B. N., and Govindjee, S., 1996, “Finite Element Implementation of Incompressible, Transversely Isotropic Hyperelasticity,” Comput. Methods Appl. Mech. Eng.  [CrossRef], 135 (1-2), pp. 107–128.
45
Gnyaneshwar, R., Kumar, R. K., and Balakrishnan, K. R., 2002, “Dynamic Analysis of the Aortic Valve Using a Finite Element Model,” Ann. Thorac. Surg., 73 (4), pp. 1122–1129.
46
Zienkiewicz, O. C., and Taylor, R. L., 2000, "The Finite Element Method", Butterworth-Heinemann, Oxford.
47
Taylor, R. L., 2003, FEAP User Manual: v7.5., Department of Civil and Environmental Engineering, University of California, Berkeley, Berkeley, CA.
48
Thubrikar, M. J., 1990, "The Aortic Valve", CRC, Boca Raton, FL.
49
Kunzelman, K. S., Cochran, R. P., Chuong, C., Ring, W. S., Verrier, E. D., and Eberhart, R. D., 1993, “Finite Element Analysis of the Mitral Valve,” J. Heart Valve Dis., 2 (3), pp. 326–340.
50
Sripathi, V. C., Kumar, R. K., and Balakrishnan, K. R., 2004, “Further Insights into Normal Aortic Valve Function: Role of a Compliant Aortic Root on Leaflet Opening and Valve Orifice Area,” Ann. Thorac. Surg., 77 (3), pp. 844–851.
51
Lim, K. H., Yeo, J. H., and Duran, C. M., 2005, “Three-Dimensional Asymmetrical Modeling of the Mitral Valve: A Finite Element Study with Dynamic Boundaries,” J. Heart Valve Dis., 14 (3), pp. 386–392.
52
Thubrikar, M. J., Deck, J. D., Aouad, J., and Nolan, S. P., 1983, “Role of Mechanical Stress in Calcification of Aortic Bioprosthetic Valves,” J. Thorac. Cardiovasc. Surg., 86 (1), pp. 115–125.
53
Schoen, F. J., Levy, R. J., and Piehler, H. R., 1992, “Pathological Considerations in Replacement Cardiac Valves,” Cardiovasc. Pathol.  [CrossRef], 1 (1), pp. 29–52.
54
Deiwick, M., Glasmacher, B., Baba, H. A., Roeder, N., Reul, H., von Bally, G., and Scheld, H. H., 1998, “In vitro Testing of Bioprostheses: Influence of Mechanical Stresses and Lipids on Calcification,” Ann. Thorac. Surg., 66 (6, Suppl.), pp. S206–S211.
55
Driessen, N. J., Boerboom, R. A., Huyghe, J. M., Bouten, C. V., and Baaijens, F. P., 2003, “Computational Analyses of Mechanically Induced Collagen Fiber Remodeling in the Aortic Heart Valve,” ASME J. Biomech. Eng.  [CrossRef], 125 (4), pp. 549–557.
56
Kunzelman, K. S., Quick, D. W., and Cochran, R. P., 1998, “Altered Collagen Concentration in Mitral Valve Leaflets: Biochemical and Finite Element Analysis,” Ann. Thorac. Surg., 66 (6, Suppl.), pp. S198–S205.
57
Thornton, M. A., Howard, I. C., and Patterson, E. A., 1997, “Three-Dimensional Stress Analysis of Polypropylene Leaflets for Prosthetic Heart Valves,” Med. Eng. Phys.  [CrossRef], 19 (6), pp. 588–597.
58
De Hart, J., Baaijens, F. P., Peters, G. W., and Schreurs, P. J., 2003, “A Computational Fluid-Structure Interaction Analysis of a Fiber-Reinforced Stentless Aortic Valve,” J. Biomech.  [CrossRef], 36 (5), pp. 699–712.
59
De Hart, J., Peters, G. W., Schreurs, P. J., and Baaijens, F. P., 2003, “A Three-Dimensional Computational Analysis of Fluid-Structure Interaction in the Aortic Valve,” J. Biomech.  [CrossRef], 36 (1), pp. 103–112.
60
Sacks, M. S., 2003, “Incorporation of Experimentally-Derived Fiber Orientation into a Structural Constitutive Model for Planar Collagenous Tissues,” ASME J. Biomech. Eng.  [CrossRef], 125 (2), pp. 280–287.
61
Sacks, M. S., Smith, D. B., and Hiester, E. D., 1997, “A Small Angle Light Scattering Device for Planar Connective Tissue Microstructural Analysis,” Ann. Biomed. Eng., 25 (4), pp. 678–689.
62
Hole, J. W., 1996, "Hole’s Human Anatomy and Physiology", Brown, Dubuque, IA.

Figures

Grahic Jump Location
+(a) FE model of the pericardial BHV. (b) Subdivision of the leaflet geometry into three regions of interest. (c) Representative data (61) showing a uniform 45deg preferred fiber orientation throughout the pericardial BHV leaflet.
View Large  |  Save Figure  |  Download Slide (.ppt)
(a) FE model of the pericardial BHV. (b) Subdivision of the leaflet geometry into three regions of interest. (c) Representative data (61) showing a uniform 45deg preferred fiber orientation throughout the pericardial BHV leaflet.
Figure 1

(a) FE model of the pericardial BHV. (b) Subdivision of the leaflet geometry into three regions of interest. (c) Representative data (61) showing a uniform 45deg preferred fiber orientation throughout the pericardial BHV leaflet.

Grahic Jump Location
+Time-varying pressures for the complete human cardiac cycle: (a) Left ventricular and aortic pressure pulses. (b) Pressure difference between left ventricle and aorta, adapted from Hole’s human anatomy and physiology (62).
View Large  |  Save Figure  |  Download Slide (.ppt)
Time-varying pressures for the complete human cardiac cycle: (a) Left ventricular and aortic pressure pulses. (b) Pressure difference between left ventricle and aorta, adapted from Hole’s human anatomy and physiology (62).
Figure 2

Time-varying pressures for the complete human cardiac cycle: (a) Left ventricular and aortic pressure pulses. (b) Pressure difference between left ventricle and aorta, adapted from Hole’s human anatomy and physiology (62).

Grahic Jump Location
+Comparison between the FE simulation and experimental data for the equi-biaxial protocol: (a) normal components and (b) shear component
View Large  |  Save Figure  |  Download Slide (.ppt)
Comparison between the FE simulation and experimental data for the equi-biaxial protocol: (a) normal components and (b) shear component
Figure 3

Comparison between the FE simulation and experimental data for the equi-biaxial protocol: (a) normal components and (b) shear component

Grahic Jump Location
+Sequence of the displacements of the BHV model during the opening phase shown from an oblique and top view of the valve
View Large  |  Save Figure  |  Download Slide (.ppt)
Sequence of the displacements of the BHV model during the opening phase shown from an oblique and top view of the valve
Figure 4

Sequence of the displacements of the BHV model during the opening phase shown from an oblique and top view of the valve

Grahic Jump Location
+Time-varying von Mises stress distribution of the BHV model with the same color scale for all the plots
View Large  |  Save Figure  |  Download Slide (.ppt)
Time-varying von Mises stress distribution of the BHV model with the same color scale for all the plots
Figure 5

Time-varying von Mises stress distribution of the BHV model with the same color scale for all the plots

Grahic Jump Location
+Regional stress distribution of the normal and shear components of the BHV model at t=0.13s
View Large  |  Save Figure  |  Download Slide (.ppt)
Regional stress distribution of the normal and shear components of the BHV model at t=0.13s
Figure 6

Regional stress distribution of the normal and shear components of the BHV model at t=0.13s

Grahic Jump Location
+Comparison of the displacement of the BHV leaflet with and without the inclusion of the bending stiffness in the dynamic FE analysis
View Large  |  Save Figure  |  Download Slide (.ppt)
Comparison of the displacement of the BHV leaflet with and without the inclusion of the bending stiffness in the dynamic FE analysis
Figure 7

Comparison of the displacement of the BHV leaflet with and without the inclusion of the bending stiffness in the dynamic FE analysis

Grahic Jump Location
+Comparison of the von Mises stresses distribution between the Fung-type elastic (nonlinear anisotropic) model and Saint Venant (isotropic) model at the fully open position
View Large  |  Save Figure  |  Download Slide (.ppt)
Comparison of the von Mises stresses distribution between the Fung-type elastic (nonlinear anisotropic) model and Saint Venant (isotropic) model at the fully open position
Figure 8

Comparison of the von Mises stresses distribution between the Fung-type elastic (nonlinear anisotropic) model and Saint Venant (isotropic) model at the fully open position

Tables

Errata

Discussions

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging and repositioning the boxes below.

Related Journal Articles
Related eBook Content
Data Tabulations
Structural Shear Joints> Chapter 12
Understanding the Problem
Design and Application of the Worm Gear> Chapter 12
Dynamic Behavior of Pumping Systems
Pipeline Pumping and Compression Systems: A Practical Approach> Chapter 8
Outlook
Closed-Cycle Gas Turbines> Chapter 11
Analysis of Components in VIII-2
Guidebook for the Design of ASME Section VIII Pressure Vessels, Third Edition> Chapter 8
Topic Collections

Sorry! You do not have access to this content. For assistance or to subscribe, please contact us:

  • TELEPHONE: 1-800-843-2763 (Toll-free in the USA)
  • EMAIL: asmedigitalcollection@asme.org
Sign In