No abstract

Background phase distortion and random noise can adversely affect the quality of magnetic resonance (MR) phase velocity measurements. A semiautomated method has been developed that substantially reduces both effects. To remove the background phase distortion, the following steps were taken: The time standard deviations of the phase velocity images over a cardiac cycle were calculated. Static regions were identified as those in which the standard deviation was low. A flat surface representing an approximation to the background distortion was fitted to the static regions and subtracted from the phase velocity images to give corrected phase images. Random noise was removed by setting to zero those regions in which the standard deviation was high. The technique is demonstrated with a sample set of data in which the in-plane velocities have been measured in an imaging section showing the left ventricular outflow tract of a human left ventricle. The results are presented in vector and contour form, superimposed on the conventional MR angiographic images.

Valvular heart disease is a life-threatening disease that afflicts millions of people worldwide and leads to approximately 250,000 valve repairs and/or replacements each year. Malfunction of a native valve impairs its efficient fluid mechanic/hemodynamic performance. Artificial heart valves have been used since 1960 to replace diseased native valves and have saved millions of lives. Unfortunately, despite four decades of use, these devices are less than ideal and lead to many complications. Many of these complications/problems are directly related to the fluid mechanics associated with the various mechanical and bioprosthetic valve designs. This review focuses on the state-of-the-art experimental and computational fluid mechanics of native and prosthetic heart valves in current clinical use. The fluid dynamic performance characteristics of caged-ball, tilting-disc, bileaflet mechanical valves and porcine and pericardial stented and nonstented bioprostheic valves are reviewed. Other issues related to heart valve performance, such as biomaterials, solid mechanics, tissue mechanics, and durability, are not addressed in this review.

We present comprehensive particle image velocimetry measurements and direct numerical simulation (DNS) of physiological, pulsatile flow through a clinical quality bileaflet mechanical heart valve mounted in an idealized axisymmetric aorta geometry with a sudden expansion modeling the aortic sinus region. Instantaneous and ensemble-averaged velocity measurements as well as the associated statistics of leaflet kinematics are reported and analyzed in tandem to elucidate the structure of the velocity and vorticity fields of the ensuing flow-structure interaction. The measurements reveal that during the first half of the acceleration phase, the flow is laminar and repeatable from cycle to cycle. The valve housing shear layer rolls up into the sinus and begins to extract vorticity of opposite sign from the sinus wall. A start-up vortical structure is shed from the leaflets and is advected downstream as the leaflet shear layers become wavy and oscillatory. In the second half of flow acceleration the leaflet shear layers become unstable and break down into two von Karman-like vortex streets. The onset of vortex shedding from the valve leaflets is responsible for the growth of significant cycle-to-cycle vorticity oscillations. At peak flow, the housing and leaflet shear layers undergo secondary instabilities and break down rapidly into a chaotic, turbulent-like state with multiple small-scale vortical structures emerging in the flow. During the deceleration and closing phases all large-scale coherent flow features disappear and a chaotic small-scale vorticity field emerges, which persists even after the valve has closed. Probability density functions of the leaflet position during opening and closing phases show that the leaflet position fluctuates from cycle to cycle with larger fluctuations evident during valve closure. The DNS is carried out by prescribing the leaflet kinematics from the experimental data. The computed instantaneous vorticity fields are in very good agreement with the measurements, especially during the accelerating phase when the flow remains coherent and repeatable and instantaneous comparisons are meaningful. The computed results are analyzed to elucidate for the first time the intricate and highly three-dimensional structure of the pulsatile jet through the triple-opening orifice of the bileaflet valve and explain the rich flow phenomena documented in the two-dimensional vorticity measurements.