A parametric study on pulse duplicator design and valve hemodynamics.

Autor: Smid CC; Laboratory of Composite Materials and Adaptive Structures, ETH Zurich, Zürich, Switzerland., Pappas GA; Laboratory of Composite Materials and Adaptive Structures, ETH Zurich, Zürich, Switzerland., Falk V; Translational Cardiovascular Technologies, ETH Zurich, Zürich, Switzerland.; Department for Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité, Charité Universitätsmedizin Berlin, Berlin, Germany.; German Center for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany., Ermanni P; Laboratory of Composite Materials and Adaptive Structures, ETH Zurich, Zürich, Switzerland., Cesarovic N; Translational Cardiovascular Technologies, ETH Zurich, Zürich, Switzerland.; Department for Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charité, Charité Universitätsmedizin Berlin, Berlin, Germany.
Jazyk: angličtina
Zdroj: Artificial organs [Artif Organs] 2024 Sep; Vol. 48 (9), pp. 977-987. Date of Electronic Publication: 2024 Apr 23.
DOI: 10.1111/aor.14757
Abstrakt: Background: In vitro assessment is mandatory for artificial heart valve development. This study aims to investigate the effects of pulse duplicator features on valve responsiveness, conduct a sensitivity analysis across valve prosthesis types, and contribute on the development of versatile pulse duplicator systems able to perform reliable prosthetic aortic valve assessment under physiologic hemodynamic conditions.
Methods: A reference pulse duplicator was established based on literature. Further optimization process led to new designs that underwent a parametric study, also involving different aortic valve prostheses. These designs were evaluated on criteria such as mean pressure differential and pulse pressure (assessed from high-fidelity pressure measurements), valve opening and closing behavior, flow, and regurgitation. Finally, the resulting optimized setup was tested under five different hemodynamic settings simulating a range of physiologic and pathologic conditions.
Results: The results show that both, pulse duplicator design and valve type significantly influence aortic and ventricular pressure, flow, and valve kinematic response. The optimal design comprised key features such as a compliance chamber and restrictor for diastolic pressure maintenance and narrow pulse pressure. Additionally, an atrial reservoir was included to prevent atrial-aortic interference, and a bioprosthetic valve was used in mitral position to avoid delayed valve closing effects.
Conclusion: This study showed that individual pulse duplicator features can have a significant effect on valve's responsiveness. The optimized versatile pulse duplicator replicated physiologic and pathologic aortic valve hemodynamic conditions, serving as a reliable characterization tool for assessing and optimizing aortic valve performance.
(© 2024 The Authors. Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.)
Databáze: MEDLINE
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