Fluid Dynamic Investigation of the ATS 3F Enable Sutureless Heart Valve

Abstract

<jats:sec><jats:title>Objective</jats:title><jats:p> Currently, sutureless heart valves (SHV) reveal good clinical results during aortic valve replacement. The aim of this study was to evaluate the fluid dynamics of the ATS 3F Enable SHV in the ascending aorta and their influence on the aortic wall in an in vitro setup. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> A two-dimensional particle image velocimetry study with an image rate of 15 Hz was conducted to evaluate the fluid dynamics of the SHV in the aortic flow field. The prosthesis (diameter, 23 mm) was placed inside a silicone mock aorta under pulsatile flow conditions. Velocities, vorticity, and strain rate were obtained and calculated with a fixed frequency (70 Hz) at constant stroke volume (70 mL). </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> 3F Enable showed a jet flow type profile with a maximum velocity of 1.01 ± 0.13 m/s during peak flow phase (PFP). The jet flow was surrounded by ambilateral vortices with a slightly higher percentage of clockwise than counterclockwise vorticity (377 ± 57/s vs 389 ± 76/s), strain rate (370 ± 79/s for elongation vs — 370 ± 102/s for contraction) was nearly similar. The point-of-interest analysis revealed a higher velocity for bottom compared with upper aortic wall (0.28 ± 0.07 m/s vs 0.31 ± 0.06 m/s, P = 0.024). All values were lower during acceleration and deceleration phase compared with PFP. </jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p> The peak flow of the 3F Enable SHV seems to be little higher compared with native aortic valves, thus simulating nearly physiologic conditions. Vorticity and strain rate are high during PFP and low during other phases and might have an influence on the aortic wall as well. </jats:p></jats:sec>

Transcatheter aortic valves produce unphysiological flows which may contribute to thromboembolic events: An in-vitro study

“…A number of pure liquids and liquid solutions have been used in other studies to simulate blood, including pure water (Falahatpisheh and Kheradvar, 2012, Van Steenhoven and Van Dongen, 1979, Wendt et al, 2012), saline solution (Akutsu et al, 2008, Bottio et al, 2004, Ducci et al, 2013, Grigioni et al, 2000) and a water–glycerol solution (Azadani et al, 2009, Bullen and Rogers, 1968, Grigioni et al, 2003, Guivier-Curien et al, 2009, Kadem et al, 2005, Kadem et al, 2006, Lim et al, 1994, Lim et al, 1998, Stühle et al, 2011, Yoganathan et al, 1986). When using a laser-based technique such as PIV, it is essential to minimise the optical distortion due to the refraction occurring at the interface between different media in complex geometries.…”

The 3f Enable sutureless bioprosthesis: Early results, safeguards, and pitfalls

“…It offers the advantages of the tubular shape, imitating the function of the aortic valve and yielding good hemodynamic outcomes. [10][11][12][13][14] Our experience is based on 60 patients, and to date it is the second largest published single-center study. 15 We currently consider this prosthesis to be the best choice for patients aged more than 80 years (70-79 years with euro-SCORE II >5) requiring aortic valve replacement.…”

Comparison of flow dynamics of Perimount Magna and Magna Ease aortic valve prostheses

“…The combination with a fi xed peripheral resistance resulted in a ventricular pressure of 120/80 mm Hg, whereas aortic pressure presented values of 118/75 mm Hg. The physiological fl ow loop was switched " on " approximately 10 min before PIV recording [27] .…”

“…Performing PIV experiments we were able to clearly distinguish between the four characteristic phases during the cardiac cycle [14,16] . Our PIV system and the post-processing software allowed the evaluation of detailed information about dynamical behavior of both valves in the aorta [27,28] . We could detect a high range of all measured values during our PIV measurement.…”