Impact of bileaflet mechanical heart valve leaflet dysfunction on left ventricular blood flow: An experimental study

Abstract

Artificial heart valve replacement is recognized as the most effective method for treating valvular heart disease. Presently, the bileaflet mechanical heart valve is the predominant type utilized. Nonetheless, complications are known to arise following valve replacement surgery, mostly attributable to deviations in the left ventricular blood flow pattern instigated by the dysfunction of the bileaflet mechanical valve. However, the impact of mitral valve leaflet dysfunction on left ventricular hemodynamics has not been studied in depth. Hence, to approximate the physiological conditions of the left ventricular flow and pressure, a left heart circulation pulsatile flow system was devised. The time-resolved particle image velocimetry method was employed to evaluate the left ventricular blood flow under standard working conditions of the bileaflet mechanical valve and in the case where one of the valve leaflets is determined to be functionally impaired. The experimental results reveal that the normally functioning bileaflet valve manifests a tri-jet flow pattern, with intense jets on both sides generating two expansive vortices. Conversely, when one of the valve leaflets is impaired, the tri-jet flow metamorphoses into a bi-jet flow, coupled with augmented velocity. In both instances, the jets traverse along the ventricular model wall and alter their direction subsequent to passing the apex. Consequently, the employment of bileaflet valves culminates in a multifaceted left ventricular blood flow pattern. Furthermore, the valve leaflet dysfunction escalates shear stress, a condition that could potentially instigate damage to blood cells. The insights gained from this study can potentially guide the improved design of the mechanical bivalve.