0
research-article

Fluid-structure interaction and in vitro analysis of a real bileaflet mitral prosthetic valve to gain insight into Doppler-silent thrombosis

[+] Author and Article Information
Annalisa Dimasi

Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milan, Italy
annalisa.dimasi@gmail.com

Daniela Piloni

Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milan, Italy
daniela.piloni@mail.polimi.it

Laura Spreafico

Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milan, Italy
laura.spreafico@mail.polimi.it

Emiliano Votta

Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milan, Italy
emiliano.votta@polimi.it

Riccardo Vismara

Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milan, Italy
riccardo.vismara@polimi.it

Gianfranco/B Fiore

Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milan, Italy
gianfranco.fiore@polimi.it

Masoud Meskin

Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milan, Italy
masoud.meskin@mail.polimi.it

laura Fusini

Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138 Milan, Italy
laura.fusini@gmail.com

Manuela Muratori

Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138 Milan, Italy
manuela.muratori@ccfm.it

Piero Montorsi

Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138 Milan, Italy
piero.montorsi@ccfm.it

Mauro Pepi

Centro Cardiologico Monzino IRCCS, Via Carlo Parea 4, 20138 Milan, Italy
mauro.pepi@cardiologicomonzino.it

Alberto Redaelli

Department of Electronics, Information and Bioengineering, Politecnico di Milano, Via Golgi 39, 20133 Milan, Italy
alberto.redaelli@polimi.it

1Corresponding author.

ASME doi:10.1115/1.4043664 History: Received January 31, 2018; Revised April 24, 2019

Abstract

Prosthetic valve thrombosis (PVT) is a serious complication affecting prosthetic heart valves. The transvalvular mean pressure gradient (MPG) derived by Doppler echocardiography is a crucial index to diagnose PVT, but may result in false negatives mainly in case of bileaflet mechanical valves (BMVs) in mitral position. This may happen because MPG estimation relies on simplifying assumptions on the transvalvular fluid dynamics or because Doppler examination is manual and operator-dependent. A deeper understanding of these issues may allow for improving PVT diagnosis and management. To this aim, we used in vitro and fluid-structure interaction (FSI) modeling to simulate the function of a real mitral BMV in different configurations: normally functioning and stenotic with symmetric and completely asymmetric leaflet opening, respectively. In each condition, the MPG was measured in vitro, computed directly from FSI simulations and derived from the corresponding velocity field through a Doppler-like post-processing approach. Following verification vs. in vitro data, MPG computational data were analyzed to test their dependency on the severity of fluid-dynamic derangements and on the measurement site. Computed MPG clearly discriminated between normally functioning and stenotic configurations. They did not depend markedly on the site of measurement, yet differences below 3 mmHg were found between MPG values at the central and lateral orifices of the BMV. This evidence suggests a mild uncertainty of the Doppler-based evaluation of the MPG due to probe positioning, which yet may lead to false negatives when analyzing subjects with almost normal MPG.

Copyright (c) 2019 by ASME
Your Session has timed out. Please sign back in to continue.

References

Figures

Tables

Errata

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
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