Numerical investigation on the effect of bileaflet mechanical heart valve's implantation tilting angle and aortic root geometry on intermittent regurgitation and platelet activation

Abbas, S.S. and Nasif, M.S. and Al-Waked, R. and Meor Said, M.A. (2020) Numerical investigation on the effect of bileaflet mechanical heart valve's implantation tilting angle and aortic root geometry on intermittent regurgitation and platelet activation. Artificial Organs, 44 (2). E20-E39.

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Abstract

Platelet activation induced by shear stresses and non-physiological flow field generated by bileaflet mechanical heart valves (BMHVs) leads to thromboembolism, which can cause fatal consequences. One of the causes of platelet activation could be intermittent regurgitation, which arises due to asynchronous movement and rebound of BMHV leaflets during the valve closing phase. In this numerical study, the effect of intermittent regurgitation on the platelet activation potential of BMHVs was quantified by modeling a BMHV in the straight and anatomic aorta at implantation tilt angles 0°, 5°, 10°, and 20°. A fully implicit Arbitrary Lagrangian�Eulerian-based Fluid�Structure Interaction formulation was adopted with blood modeled as a multiphase, non-Newtonian fluid. Results showed that the intermittent regurgitation and consequently the platelet activation level increases with the increasing implantation tilt of BMHV. For the straight aorta, the leaflet of the 20° tilted BMHV underwent a rebound of approximately 20° after initially closing, whereas the leaflet of the 10°, 5°, and 0° tilted BMHVs underwent a rebound of 8.5°, 3°, and 0°, respectively. For the anatomic aorta, the leaflet of the 20° tilted BMHV underwent a rebound of approximately 24° after initially closing, whereas the leaflet of the 10°, 5°, and 0° tilted BMHVs underwent a rebound of 14°, 10°, and 7°, respectively. For all the implantation orientations of BMHVs, intermittent regurgitation and platelet activation were always higher in the anatomic aorta than in the straight aorta. The study concludes that the pivot axis of BMHV must be implanted parallel to the aortic root's curvature to minimize intermittent regurgitation and platelet activation. © 2019 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Item Type: Article
Impact Factor: cited By 4
Uncontrolled Keywords: aortic flow; aortic root; Article; computer simulation; equipment design; heart hemodynamics; kinematics; mathematical computing; mathematical model; mitral valve regurgitation; priority journal; shear stress; thrombocyte activation; transcatheter aortic valve implantation; adverse event; aortic regurgitation; aortic valve; biological model; biomechanics; blood; computer simulation; devices; heart valve prosthesis; heart valve replacement; hemodynamics; human; pathophysiology; prosthesis design; surgery; thromboembolism, Aortic Valve; Aortic Valve Insufficiency; Biomechanical Phenomena; Computer Simulation; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Hemodynamics; Humans; Models, Cardiovascular; Numerical Analysis, Computer-Assisted; Platelet Activation; Prosthesis Design; Thromboembolism
Depositing User: Ms Sharifah Fahimah Saiyed Yeop
Date Deposited: 19 Aug 2021 07:27
Last Modified: 19 Aug 2021 07:27
URI: http://scholars.utp.edu.my/id/eprint/23240

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