Effects of Tilting Disk Heart Valve Gap Width on Regurgitant Flow Through an Artificial Heart Mitral Valve

• Published in: Artificial organs Vol. 21; no. 9; pp. 1014 - 1025
• Main Authors: Maymir, Juan-Carlos, Deutsch, Steven, Meyer, Richard S., Geselowitz, David B., Tarbell, John M.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.09.1997
• Subjects: Artificial heart; Blood Flow Velocity; Erythrocytes; Heart valve; Heart, Artificial - standards; Hemolysis; Laser-Doppler Flowmetry; Mitral Valve; Models, Theoretical; Regurgitation; Rheology; Temperature; Turbulence
• ISSN: 0160-564X; 1525-1594
• DOI: 10.1111/j.1525-1594.1997.tb00517.x

: While many investigators have measured the turbulent stresses associated with forward flow through tilting disk heart valves, only recently has attention been given to the regurgitant jets formed as fluid is squeezed through the gap between the occluder and housing of a closed valve. The objective of this investigation was to determine the effect of gap width on the turbulent stresses of the regurgitant jets through a Bjork‐Shiley monostrut tilting disk heart valve seated in the mitral position of a Penn State artificial heart. A 2 component laser‐Doppler velocimetry system with a temporal resolution of 1 ms was used to measure the instantaneous velocities in the regurgitant jets in the major and minor orifices around the mitral valve. The gap width was controlled through temperature variation by taking advantage of the large difference between the thermal expansion coefficients of the Delrin occluder and the Stellite housing of Bjork‐Shiley monostrut valves. The turbulent shear stress and mean (ensemble averaged) velocity were incorporated into a model of red blood cell damage to assess the potential for hemo‐lytic damage at each gap width investigated. The results revealed that the minor orifice tends to form stronger jets during regurgitant flow than the major orifice, indicating that the gap width is not uniform around the circumference of the valve. Based on the results of a red blood cell damage model, the hemolytic potential of the mitral valve decreases as the gap width increases. This investigation also established that the hemolytic potential of the regurgitant phase of valve operation is comparable to, if not greater than, the hemolytic potential of forward flow, consistent with experimental data on hemolysis.