Video-Based Measuring of Quality Parameters for Tricuspid Xenograft Heart Valve Implants

Abstract

Abstract-Defective heart valves are often replaced by implants in open-heart surgery. Both mechanical and biological implants are available. Among biological implants, xenograft ones-i.e., valves grafted from animals such as pigs, are widely used. Good implants should exhibit certain typical anatomical and functional characteristics to successfully replace the native tissue. Here, we describe a video-based system for measuring quality parameters of xenograft heart valve implants, including the area of the orifice and the fluttering of the valves' leaflets, i.e., their flaps (or cusps). Our system employs automatic methods that provide a precise and reproducible way to infer the quality of an implant. The automatic analysis of both a valve's orifice and the fluttering of its leaflets offers a more comprehensive quality assessment than current, mostly manual methods. We focus on valves with three leaflets, i.e., aortic, pulmonary, and tricuspid valves.Index Terms-Fluttering quantification, heart valve implants, image analysis, quality measures.

Thinner biological tissues induce leaflet flutter in aortic heart valve replacements

“…The two-dimensional (2D) signal data from the free-edge displacement are analyzed and quantified using the frequency spectrum analysis operations outlined in Materials and Methods. These 3D computational data from the free edge provide information that is similar to the 2D data that can be measured using experimental methods (21,32); however, the full 3D FSI simulation provides significantly more detailed information on the valve. Additional tracking curves along different directions of each leaflet can also be analyzed to comprehensively capture the flutter behavior over the entire valve.…”

“…A recent analytical study proposed a mathematical model to predict the critical flow speed of flutter onset as a function of valve properties, including tissue thickness (30). In terms of quantifying leaflet flutter, recent experimental work has proposed different methods to track the leaflet free-edge motion with varying levels of accuracy (21,31,32). While these previous investigations have made some efforts to examine and quantify leaflet flutter, the existing studies are limited in number and have been restricted by current experimental approaches that are challenging to perform, especially for individual valve variables, and measurement techniques that provide limited information about the flutter characteristics.…”

“…One such factor is leaflet flutter, a phenomenon that has been observed in human and prosthetic heart valve tissues (12)(13)(14)(15) and has been previously associated with increased calcification, tearing, and early fatigue failure over the valve lifetime (16)(17)(18)(19)(20). Consequently, studies aimed at characterizing valve functionality have identified fluttering of the leaflets in the blood flow as a crucial quality criterion in prosthetic valve designs that incorporate biological tissues (21).…”

Quantification of leaflet flutter in bioprosthetic heart valves using fluid-structure interaction analysis

“…In the experimental realm, as in the works of Condurache et al [16] and Avelar et al Newland [47], can be performed:…”

“…Experimental works have been completed to establish methods for quantifying the flutter of BHV leaflets. These approaches utilize different methods for tracking the leaflet free edge motion with varying levels of accuracy [15,16].…”