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PubMed1994

In vitro heart valve testing: steady versus pulsatile flow.

The design of artificial heart valves has traditionally been based on the development of a prototype device which was then subjected to extensive laboratory testing in order to confirm its suitability for clinical use. In the past the in vitro assessment of a valve's performance was based principally on the measurement of parameters such as pressure difference, regurgitation and, more recently, energy losses. Such measurements can be defined as being at the 'macro' level and rarely show any clinically significant differences amongst currently available prostheses. The analytical approach to flow through heart valves has previously been hampered by difficulties experienced in solving the relevant equations of flow particularly in the case of pulsatile conditions. Computational techniques are now available which enable appropriate solutions to be obtained for these problems and consequently provide an opportunity for detailed examination of the 'micro' level of flow disturbances exhibited by the different valves. This present preliminary study is designed to illustrate the use of such an analytical approach to the flow through prosthetic valves. A single topic has been selected for this purpose which is the comparative value of steady versus pulsatile flow testing. A bileaflet valve was chosen for the analysis and a mathematical model of this valve in the aortic position of the Sheffield Pulse Duplicator was created. The theoretical analysis was carried out using a commercially available Computational Fluid Dynamics package, namely, FIDAP, on a SUN MICROSYSTEMS 10-30 workstation.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity↗
PubMed2003

Carotid angioplasty in a pulsatile flow model: factors affecting embolic potential.

OBJECTIVES: Carotid endoluminal intervention is an alternative to surgery but carries a risk of embolic stroke even with distal protection devices. We investigated the clinical features and degree of stenosis related to number and size of emboli during carotid angioplasty. DESIGN: An experimental ex vivo study. MATERIALS: An ex vivo pulsatile flow model was used in which temperature, velocity, flow, pressure and viscosity characteristics were designed to simulate the carotid circulation. METHODS: Carotid endarterectomy specimens excised as intact cylinders (n = 28) were subjected to a standardised angioplasty procedure using radiological guidance. Emboli collected in filters placed distally were counted and sized using microscopy. RESULTS: Median number of emboli during angioplasty was 133 (range 15-1331). Median size of the largest embolus was 700 microns (range 75-2400). Severity of stenosis correlated with increased maximum size (r = 0.55, p = 0.012). Statin therapy >4 weeks pre-operatively was associated with reduced emboli number and size (54 (range 15-748) vs 247 (range 37-1331) [p = 0.023] and 400 microm (range 75-2400) vs 1300 microm (range 600-2200) [p = 0.022]). CONCLUSIONS: In this model a wide range of emboli number and size were produced. Number and size of embolic particles were highest in patients with high-grade stenoses not receiving statin therapy.

Aged↗
PubMed2005

Reduction of compartment compliance increases venous flow pulsatility and lowers apparent vascular compliance: implications for cerebral blood flow hemodynamics.

The global compliance of a fixed-volume, incompressible compartment may play a significant role in determining the inherent vascular compliance. For the intracranial compartment, we propose that the free-displacement of the cerebral spinal fluid (CSF) directly relates to cerebral vascular compliance. To test this hypothesis, an in vivo surrogate intracranial compartment was made by enclosing a rabbit's kidney within a rigid, fluid-filled container. Opening/closing a port atop the box modulated the free flow of box fluid (open-box state). We observed that the pulsatility of the renal venous outflow increased in response to hampering the free flow of fluid in-and-out of the container (closed-box state). To associate the observed pulsatility changes with the compliance changes, a parametric method was proposed for the computation of the apparent compliance (C(app)) of the whole renal vascular system. The calculated C(app) for each experiment's closed-box state was favorably compared to a time-domain compliance assessment method at the mean heart rate. In addition, it was revealed that C(app) in the open-box state was greater than that in the closed-box state only when the calculations were performed at frequencies lower than the heart rate and closer to the ventilation rate. These experimental results support the concept that the vessel compliance of vascular systems enclosed within a rigid compartment is a function of the global compartment compliance.

Animals↗
PubMed2006

Arteriolar blood flow pulsatility in a patient before and after implantation of an axial flow pump.

In a patient with end stage ischemic heart failure scheduled for implantation of an axial flow pump small arteriolar flow pattern was recorded using a novel intravital microscope. Preoperative arteriolar blood flow velocity was highly pulsatile, ranging from about 7 to 16 mm per second in a 12.8 microm diameter arteriole. After implantation of the pump, this pulsatility was abrogated and arteriolar blood flow velocity changed instantaneously with changes in pump speed (eg, 2 mm/s at 5,000 rpm vs 3.5 mm/s at 8,000 rpm in an 8.9 microm diameter arteriole). This lack of flow velocity oscillations may have profound long-term effects on shear stress regulated arteriolar remodeling.

Arterioles↗
PubMed2006

Developing pulsatile flow in a deployed coronary stent.

A major consequence of stent implantation is restenosis that occurs due to neointimal formation. This patho-physiologic process of tissue growth may not be completely eliminated. Recent evidence suggests that there are several factors such as geometry and size of vessel, and stent design that alter hemodynamic parameters, including local wall shear stress distributions, all of which influence the restenosis process. The present three-dimensional analysis of developing pulsatile flow in a deployed coronary stent quantifies hemodynamic parameters and illustrates the changes in local wall shear stress distributions and their impact on restenosis. The present model evaluates the effect of entrance flow, where the stent is placed at the entrance region of a branched coronary artery. Stent geometry showed a complex three-dimensional variation of wall shear stress distributions within the stented region. Higher order of magnitude of wall shear stress of 530 dyn/cm2 is observed on the surface of cross-link intersections at the entrance of the stent. A low positive wall shear stress of 10 dyn/cm2 and a negative wall shear stress of -10 dyn/cm2 are seen at the immediate upstream and downstream regions of strut intersections, respectively. Modified oscillatory shear index is calculated which showed persistent recirculation at the downstream region of each strut intersection. The portions of the vessel where there is low and negative wall shear stress may represent locations of thrombus formation and platelet accumulation. The present results indicate that the immediate downstream regions of strut intersections are areas highly susceptible to restenosis, whereas a high shear stress at the strut intersection may cause platelet activation and free emboli formation.

Animals↗
PubMed1994

Derivation of shear rates from near-wall LDA measurements under steady and pulsatile flow conditions.

Atherosclerosis, thrombosis, and intimal hyperplasia are major forms of cardiovascular diseases in the United States. Previous studies indicate a significant correlation between hemodynamics, in particular, wall shear rate, and pathology of the arterial walls. While results of these studies implicate morphologic and functional changes related to wall shear rate magnitude, a standard technique for wall shear rate measurement has not been established. In this study, theoretical and in-vitro experimental fully developed steady and physiologic pulsatile flow waveforms have been used to obtain velocity profiles in the near-wall region. The estimated wall shear rates from these results are compared to the theoretical value to assess the accuracy of the approximating technique. Experimentally obtained results from LDA suggest that in order to minimize the error in velocity data, and subsequently, the wall shear rate, the first measured velocity has to be 500 microns away from the wall. While a linear approximation did not produce errors larger than 16.4 percent at peak systole, these errors substantially increased as the velocity magnitudes decreased during late systole and diastole. Overall, a third degree polynomial curve fit using four points produced the most accurate estimation of wall shear rate through out the cardiac cycle. Results of higher degree curve-fitting functions can be unpredictable due to potential oscillations of the function near the wall. Hence, based on the results of this study, use of a linear approximation is not recommended; a third degree curve-fitting polynomial, using four points provided the most accurate approximation for these flow waveforms.

Bias↗
PubMedDate not supplied

Pulsatile flow past a cylinder: an experimental model of flow in an artificial lung.

The focus of this study is an experimental apparatus that serves as a model for studying blood flow in a total artificial lung (TAL), a prototype device intended to serve as a bridge to lung transplantation or that supports pulmonary function during the treatment of severe respiratory failure. The TAL consists of hollow cylindrical fibers that oxygen-rich air flows through and oxygen-poor blood flows around. Because gas diffusivity in the TAL is very small, a convection mechanism dominates the gas transport, which is why we focus on the velocity around the fibers (modeled as a 0.05-cm-in-diameter and 5-cm-long cylinder). We designed a low-speed water tunnel to study the flow mechanism around the cylinder, across which the flow is generated by a linear actuator that allows different flow patterns to mimic the flow in a TAL. We tested the flow in the test section by numerical simulation and by the particle image velocimetry method to study the flow profile. The results show a uniform flow near the centerline of the water tunnel where the cylinder is placed. This decreases the effects of free-stream turbulence in the shear layers and reduces the uncertainty in determining the flow patterns around the cylinder. Knowledge gained from the flow around one cylinder (fiber) is beneficial for understanding vortex formation around multiple cylinders. We present a summary of vortex formation behind a cylinder for Reynolds numbers (Re) of 1, 3, and 5 and Stokes numbers (Ns) of 0.18 to 0.37; results show that higher Re and Ns favor vortex formation. These findings regarding the parameter range for vortex formation may provide principles for designing artificial lungs to enhance convective mixing. We anticipate that the pulsatile flow circuit presented here can be used to mimic the flow not only in TALs but in other physiological systems.

Animals↗
PubMed1995

Systolic anterior motion of the mitral valve in hypertrophic cardiomyopathy: an in vitro pulsatile flow study.

Hypertrophic cardiomyopathy, or HCM, is a relatively common disease which results in the hospitalization of more than 13,000 patients every year. It is characterized by a thickening of the interventricular septum and by systolic anterior motion, or SAM, of the mitral valve, which occurs when the distal tip of the mitral leaflets contacts the hypertrophied septum during systole and obstructs the left ventricular outflow tract. Using an in vitro pulsatile flow model of the left ventricle, the objective of the study was to investigate the relationship between the ventricular flow field and the mechanism of SAM and to specifically address the hypothesis that papillary muscle displacement can alter left ventricular flow patterns and create drag forces that can initiate SAM. Flow visualization revealed the presence in the ventricle of a large organized recirculation region throughout diastole. Besides maintaining the mitral leaflets close to the posterior wall, normally positioned papillary muscles also caused the diastolic vortex to help the mitral valve close near the posterior wall while simultaneously prepositioning the upcoming systolic outflow stream close to the septum, thereby minimizing the flow forces acting on the mitral valve. In contrast, the anterior displacement of the papillary muscles moves the entire mitral apparatus into the outflow tract. It also reverses the direction of the recirculating diastolic flows: The diastolic vortex now promotes the initiation of SAM by displacing the closing mitral leaflets anteriorly and by positioning the systolic outflow stream close to the posterior wall. These events lead to the creation of form drag forces as the systolic flow impacts the posterior side of the mitral leaflets, initiating SAM.

Cardiac Output↗
PubMed2000

Estimation of pressure gradients in pulsatile flow from magnetic resonance acceleration measurements.

A method for estimating pressure gradients from MR images is demonstrated. Making the usual assumption that the flowing medium is a Newtonian fluid, and with appropriate boundary conditions, the inertial forces (or acceleration components of the flow) are proportional to the pressure gradients. The technique shown here is based on an evaluation of the inertial forces from Fourier acceleration encoding. This method provides a direct measurement of the total acceleration defined as the sum of the velocity derivative vs. time and the convective acceleration. The technique was experimentally validated by comparing MR and manometer pressure gradient measurements obtained in a pulsatile flow phantom. The results indicate that the MR determination of pressure gradients from an acceleration measurement is feasible with a good correlation with the true measurements (r = 0.97). The feasibility of the method is demonstrated in the aorta of a normal volunteer. Magn Reson Med 44:66-72, 2000.

Adult↗
PubMed1986

In vitro pulsatile flow velocity and shear stress measurements in the vicinity of mechanical mitral heart valve prostheses.

A three beam laser Doppler anemometer system was used to study the flow fields created by various types of mitral heart valve prostheses under physiological pulsatile flow conditions. The prosthetic valves studied were: Beall caged disc valve, Bjork-Shiley tilting disc valve, Medtronic-Hall tilting disc valve and St. Jude bileaflet valve. The results indicate that all four prosthetic valve designs studied create very disturbed flow fields with elevated turbulent shear stresses and regions of flow separation and/or stagnation. The observed elevated turbulent shear stresses could cause sublethal and/or lethal damage to red cells and platelets. The regions of flow separation and/or stagnation, could lead to thrombus formation and/or tissue overgrowth on the valve structure, as observed on clinically recovered prosthetic valves.

Blood Flow Velocity↗
PubMed1977

Perfusion cooling by pulsatile flow.

Organ temperature changes and the temperature gradient between organs with cooling and rewarming were studied in rabbits using pulsatile flow perfusion. The temperature gradient between organs was within 3 degrees C. At the initial stage of cooling and rewarming, organ temperatures changed rapidly. During circulatory arrest, organ temperatures rose gradually. Brain temperature changes were similar to other organs.

Animals↗
PubMed1986

A new pulsatile flow visualization method using a photochromic dye with application to Doppler ultrasound.

A nonintrusive method for the visualization of pulsatile flow velocity profiles is described. The method is based on the use of a photochromic dye that is added to the fluid being studied and a nitrogen laser which excites the dye producing a marker "line" whose movement can be photographed. A microcomputer is used as a system controller, to coordinate the system timing and to manage the data transfer. The method used for analysis of the photographs to determine the velocity profiles is described. Examples are presented of instantaneous velocity profiles obtained from velocity waveforms that are similar to those of the femoral artery. In addition, application of the system for studying the relationship between Doppler ultrasound spectral recordings and flow velocity profiles is discussed.

Biomedical Engineering↗
PubMed1985

[Critical study of the measurement of pulsatile flow in arteritis patients. Value of non-invasive electromagnetic flowmetry].

Hemodynamics of an arteriopathy of lower limbs can be assessed by determination of arterial pressure and flow, the two variables being both useful and complementary. Arterial flow can be measured in two ways: mean arterial flow (plethysmographic or isotopic methods) cannot differentiate the different stages of arteriopathy sufficiently; a more specific method is by determination of pulsatile arterial flow. A non-invasive electromagnetic flowmeter method was developed for measuring pulsatile arterial flow in the upper third of the leg. Specificity in normal subjects was 100% in males and 98% in females, and selectivity 100% in stages II and III and 95% at stage I. The method is therefore specific, sensitive and very reproducible. Whereas pulsatile flow alters in a linear manner with distal arterial pressure when the latter is less than 100 mm Hg, this is no longer the case above this threshold. Calf flow, and particularly its relation to pulsatility measured at rest, is correlated with results of Strandness's test; it is not essential therefore to conduct an exercise tolerance test. Finally, the non-invasive electromagnetic flowmeter investigation is an excellent means of monitoring effects of certain drugs with vascular (vaso-active) or cardiac (nitroglycerin) activity, and of tobacco.

Arteritis↗
PubMedDate not supplied

A numerical study of magnetic resonance images of pulsatile flow in a two dimensional carotid bifurcation: a numerical study of MR images.

A numerical method to simulate magnetic resonance angiographic images is proposed. The new method greatly simplifies the calculation of the average phase in a voxel, the bottleneck of previous simulations, and reduces the computation time by more than a factor of 5. Both the Navier-Stokes and the Bloch equations are solved on the same mesh to obtain the distributions of the modulus and phase of the magnetization. The data in the frequency domain are reordered according to the gating strategy to generate the final images. Pulsatile flow through a 2D normal carotid bifurcation is considered as a test case. Images for magnetic resonance angiography with an uncompensated gradient waveform, a velocity-compensated gradient waveform and an uncompensated short-TE gradient waveform are compared. Systolic gating images are shown to have degraded image quality. Images acquired with diastolic-gating have little variation in magnetization strength throughout the pulsatile cycle and provide a better representation of the vessel lumen.

Algorithms↗
PubMed2002

Accuracy of real-time three-dimensional echocardiography for quantifying right ventricular volume: static and pulsatile flow studies in an anatomic in vitro model.

OBJECTIVE: The complex structural geometry of the right ventricle hinders accurate assessment of right ventricular volume and function on conventional two-dimensional echocardiography. We sought to evaluate the accuracy of real-time three-dimensional echocardiography for quantifying the volume of the right ventricle in an in vitro experimental study. METHODS: We developed 39 anatomically accurate latex phantoms of human and porcine right ventricles (range, 24-108 mL) for 39 static and 10 pulsatile models. Real-time three-dimensional scanning was performed with the models placed in a water bath and with a 3.5-MHz probe. In the dynamic models a pulsatile flow pump generated 2 different stroke volumes (29 and 64 mL/beat). Static chamber volumes and stroke volumes were verified by water displacement, which served as a reference standard. Three-dimensional echo right ventricle volumes were determined by tracing derived B- and C-scans, using the Simpson rule. RESULTS: Multiple regression analyses showed an excellent correlation between real-time three-dimensional echocardiographic determinations and the static volumes (B-scan, r = 0.99; C-scan, r = 0.98; P < .001), as well as stroke volumes in the dynamic model (B-scan, r = 0.90; C-scan, r = 0.86; P < .001). However, the C-scans tended to underestimate cavity and stroke volumes more than the B-scans (mean difference for static volume: B-scan, 1.4% +/- 9.8%; C-scan, -7.4% +/- 8.0%; P < .001; mean difference for stroke volumes: B-scan, 3.0% +/- 19.1%; C-scan, -2.5% +/- 20.9%; P < .001). CONCLUSIONS: Real-time three-dimensional echocardiography can accurately quantify right ventricle cavity volumes and stroke volumes without geometric assumptions.

Animals↗
PubMed1991

Cinematics and sticking of heart valves in pulsatile flow test.

The aim of the project was to develop laboratory test devices for studies of the cinematics and sticking behaviour of technical valve protheses. The second step includes testing technical valves of different types and sizes under static and dynamic conditions. A force-deflection balance was developed in order to load valve rims by static radial forces until sticking or loss of a disc (sticking- and clamping-mould point) with computer-controlled force deflection curves. A second deflection device was developed and used for prosthetic valves in the aortic position of a pulsatile mock circulation loop with simultaneous video-cinematography. The stiffness of technical valve rims varied between 0.20 (St. Jude) and about 1.0 N/micron (metal rim valves). The stiffness decreased significantly with increasing valve size. Sticking under pulsatile flow conditions was in good agreement with the static deflection measurements. Hence, valve sticking with increasing danger of thrombus formation is more likely with a less stiff valve rim. In the case of forces acting perpendicularly to the pendulum axis, the clamping mould-point of the valve can be reached, followed by disc dislodgement.

Heart Valve Prosthesis↗
PubMed1992

Pulsatile flow visualization in a model of the human abdominal aorta and aortic bifurcation.

The infrarenal abdominal aorta and aortic bifurcation are frequent sites of atherosclerosis. The local hemodynamics are considered to be atherogenetic factors; a detailed description of these flow fields is, therefore, essential to understand their relationship to atherosclerosis. The aim of this study was, therefore, to provide such detailed information using a flow visualization technique in an anatomically realistic flow model of the abdominal aorta and its main branches in which the complex pulsatile flow waveforms and flow rates were simulated for two physiologic flow conditions (rest and exercise). At rest, the particle path lines in the suprarenal abdominal aorta were straight with no visible signs of flow reversal. Vortices were initiated opposite to the main branches. In the infrarenal aorta, large flow separation zones formed at the posterior aortic wall and at the lateral walls in the aortic bifurcation during systolic deceleration, and flow reversal was present during diastole. Under exercise conditions, the particle path lines were straight, and only slight flow reversal was seen. This study emphasizes, that rather than being a straight tube with forward-moving fluid, the abdominal aorta has to be considered as a complex part of the arterial tree. Distinct local hemodynamic qualities of importance for explaining atherogenesis were pointed out. At rest, the suprarenal abdominal aorta had much less complicated flow characteristics than the infrarenal abdominal aorta where the distal, posterior vessel wall and the lateral walls of the bifurcation were sites of flow patterns thought to be associated with atherosclerosis. During exercise, the infrarenal flow patterns changed dramatically away from the flow patterns associated with the induction of atherosclerosis.

Adult↗
PubMed1985

Projective imaging of pulsatile flow with magnetic resonance.

Noninvasive angiography with magnetic resonance is demonstrated. Signal arising in all structures except vessels that carry pulsatile flow is eliminated by means of velocity-dependent phase contrast, electrocardiographic gating, and image subtraction. Background structures become in effect transparent, enabling the three-dimensional vascular tree to be imaged by projection to a two-dimensional image plane. Image acquisition and processing are accomplished with entirely conventional two-dimensional Fourier transform magnetic resonance imaging techniques. When imaged at 0.6 tesla, vessels 1 to 2 millimeters in diameter are routinely detected in a 50-centimeter field of view with data acquisition times less than 15 minutes. Studies of normal and pathologic anatomy are illustrated in human subjects.

Angiography↗