Device Thrombogenicity Emulator (DTE) − Design optimization methodology for cardiovascular devices: A study in two bileaflet MHV designs

Autor: Yared Alemu, Shmuel Einav, Danny Bluestein, Jolyon Jesty, Michalis Xenos, Marvin J. Slepian, Gaurav Girdhar
Rok vydání: 2010
Předmět:
Materials science
Biomedical Engineering
Biophysics
fluid-structure interaction
Thrombogenicity
computational fluid dynamics
Regurgitation (circulation)
In Vitro Techniques
Prosthesis Design
free emboli formation
Article
Mechanical heart
thrombogenic performance
experimental validation
platelet assays
platelet activation
medicine
Humans
prosthetic heart valves (phv)
Prosthesis design
Orthopedics and Sports Medicine
Platelet activation
Heart valve
mechanical heart-valves
Prosthetic heart
blood damage
Prosthetic valve
mechanical circulation support (mcs)
Models
Statistical
Rehabilitation
Models
Cardiovascular
Anticoagulants
Thrombosis
shear-stress
Platelet Activation
Biomechanical Phenomena
numerical-simulation
mechanical heart valves (mhv)
medicine.anatomical_structure
Heart Valve Prosthesis
induced platelet activation
Hemorheology
flow-through
Stress
Mechanical
mathematical-model
Biomedical engineering
Zdroj: Journal of Biomechanics. 43:2400-2409
ISSN: 0021-9290
Popis: Patients who receive prosthetic heart valve (PHV) implants require mandatory anticoagulation medication after implantation due to the thrombogenic potential of the valve. Optimization of PHV designs may facilitate reduction of flow-induced thrombogenicity and reduce or eliminate the need for post-implant anticoagulants. We present a methodology entitled Device Thrombogenicty Emulator (DTE) for optimizing the thrombo-resistance performance of PHV by combining numerical and experimental approaches. Two bileaflet mechanical heart valves (MHV) designs, St. Jude Medical (SJM) and ATS, were investigated by studying the effect of distinct flow phases on platelet activation. Transient turbulent and direct numerical simulations (DNS) were conducted, and stress loading histories experienced by the platelets were calculated along flow trajectories. The numerical simulations indicated distinct design dependent differences between the two valves. The stress loading waveforms extracted from the numerical simulations were programmed into a hemodynamic shearing device (HSD), emulating the flow conditions past the valves in distinct 'hot-spot' flow regions that are implicated in MHV thrombogenicity. The resultant platelet activity was measured with a modified prothrombinase assay, and was found to be significantly higher in the SJM valve, mostly during the regurgitation phase. The experimental results were in excellent agreement with the calculated platelet activation potential. This establishes the utility of the DTE methodology for serving as a test bed for evaluating design modifications for achieving better thrombogenic performance for such devices. (C) 2010 Elsevier Ltd. All rights reserved. J Biomech
Databáze: OpenAIRE
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