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TECHNICAL PAPERS

A Computational Study of the Hemodynamics After “Edge-to-Edge” Mitral Valve Repair

[+] Author and Article Information
A. Redaelli, G. Guadagni, R. Fumero

Department of Bioengineering, Politecnico di Milano and CeBITeC, IRCCS San Raffaele and Politecnico di Milano, Milan, Italy

F. Maisano, O. Alfieri

Cardiothoracic Unit, IRCCS San Raffaele, Milan, Italy

J Biomech Eng 123(6), 565-570 (May 16, 2001) (6 pages) doi:10.1115/1.1408938 History: Received May 18, 2000; Revised May 16, 2001
Copyright © 2001 by ASME
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References

Figures

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Sketches of the post-operative mitral valve configurations attainable after the edge-to-edge repair: (a) double orifice configuration; (b) paracommissural configuration
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Fluid dynamic model: (a) the left heart model is composed of the lower region of the left atrium, the valve plane and the left ventricle; on the right, the valve configurations taken into account in the present study are reported: with two equal orifices (b), two orifices of different areas (c), i.e., one twice as much as the other one, and a single orifice (d)
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Boundary conditions: (a) typical mitral transvalvular velocity waveform recorded with the Doppler instrumentation; (b) sketch of the enveloping curve; in the present study the fluid, initially quiescent, has been accelerated to 16 L/min (E peak) in 0.1 s by means of a polynomial time function that provides an almost constant acceleration until about 0.09 s and abruptly decelerates the fluid in the last 0.01 s
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Steamlines (a) within the ventricle, and gray-mapped plots of the velocity (b) and pressure (c) at the plane of symmetry of the ventricle model for the case with two orifices of different size, a flow rate of 16 L/min and a total area equal to 1.5 cm2
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Fluid velocity (left panels) and pressure (right panels) at the axes passing at the orifice centers, normal to the atrial inlet. Three total cross-sectional areas of the mitral valve (1.50, 2.25, and 3.00 cm2 ) and three mitral valve configurations have been considered: (a) single orifice; (b) two equal orifices, (c) two orifices of different areas. In the case of two orifices the second line is gray plotted. z-axis refers to the longitudinal coordinate being z=−0.02 m the coordinate of the atrium upper surface, z=0.00 cm the valve base coordinate and z=0.0695 the ventricular apex coordinate.
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Comparison between the pressure drop calculated with the Bernoulli formula (4Vmax2) and a) the calculated maximum pressure drop (Δpmax), and (b) the calculated pressure drop accounting for recovery (Δpnet)
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Influence of the valve height. Pressure (a) and velocity (b) values sampled at the axes passing at the orifice centers, normal to the atrial inlet for two different valve heights: 1.65 cm and 0.8 cm, respectively. The total area is equal to 1.5 cm2 .
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Influence of the ventricular volume. Pressure (a) and velocity (b) values sampled at the axes passing at the orifice centers, normal to the atrial inlet for two ventricle with different inner volumes: 75 cm3 and 25 cm3 . The total area is equal to 1.5 cm2 .
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Influence of the subvalvular apparatus. Steamlines (a) within the ventricle, and gray-mapped plots of the velocity (b) and pressure (c) at the plane of symmetry of the ventricle model with the subvalvular apparatus. The simulation was performed for the case with two orifices of different size and a total area equal to 2.25 cm2 as in the case of Fig. 4.

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