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Perivenous application of fibrin glue reduces early injury to the human saphenous vein graft wall in an ex vivo model.

OBJECTIVES: From animal and clinical studies it is known that prevention of 'over-distention' of vein grafts by using extravascular support ameliorates the arterialization process in vein grafts with subsequent more favorable patency. The most ideal support is a biodegradable, porous, elastic graft (Biomaterials, 15 (1994) 83). However, a specific graft meeting these criteria is not available yet. Fibrin glue on the other hand, although used for other purposes in cardiac surgery, theoretically meets the criteria for ideal extravascular support. In this ex vivo study, we evaluated the possible beneficial effect of perivenous application of fibrin glue. METHODS: Segments of human vein graft obtained during CABG procedures in 14 consecutive patients were placed in a side loop of the extracorporeal perfusion circuit. In this way the study vein grafts did meet identical circumstances as the vein grafts implanted. Perfusion in the loop was started with a flow just enough to counteract the collapse of the vein, usually about 8 mm Hg, and alternately around the segments fibrin glue was applied or no perivenous support was administered as control. After 1 min of soldification, perfusion was started with a pressure of about 60 mm Hg (non-pulsatile flow). Perfusion was maintained for 60 min, after which the grafts were collected for light microscopic and electron microscopic assessment. RESULTS: Light microscopy and electron microscopy showed remarkable attenuation of endothelial cell loss and less injury of smooth muscle cells of the circular muscle layer of the media in the fibrin glue supported vein grafts compared to the non-supported group. CONCLUSION: Fibrin glue is able to accomplish adequate external vein graft support, preventing overdistention, in an ex vivo model. This provides a basis for clinical application. Further investigation is necessary to evaluate long-term effects.

Coronary Artery Bypass↗

Virtual angiography for visualization and validation of computational models of aneurysm hemodynamics.

It has recently become possible to simulate aneurysmal blood flow dynamics in a patient-specific manner via the coupling of three-dimensional (3-D) X-ray angiography and cmputational fluid dynamics (CFD). Before such image-based CFD models can be used in a predictive capacity, however, it must be shown that they indeed reproduce the in vivo hemodynamic environment. Motivated by the fact that there are currently no techniques for adequately measuring complex blood velocity fields in vivo, in this paper we describe how cine X-ray angiograms may be simulated for the purpose of indirectly validating patient-sperific CFD models. Mimicking the radiological procedure, a virtual angiogram is constructed by first simulating the time-varying injection of contrast agent into a precomputed, patient-specific CFD model. A time-series of images is then constructed by simulating the attenuation of X-rays through the computed 3-D contrast-agent flow dynamics. Virtual angiographic images and residence time maps, here derived from an image-based CFD model of a giant aneurysm, are shown to be in excellent agreement wiith the corresponding clinical images and residence time maps, but only when the interaction between the quasisteady contrast agent injection and the pulsatile flow are properly accounted for. These virtual angiographic techniques pave the way for validating image-based CFD models against routinely available clinical data, and provide a means of visualizing complex, 3-D blood flow dynamics in a clinically relevant manner. They also clearly show how the contrast agent injection perturbs the noraml blood flow patterns, further highlighting the potential utility of image-based CFD as a window into the true aneurysmal hemodynamics.

Algorithms↗

A unique vascular graft concept for coronary and peripheral applications.

Synthetic vascular grafts for coronary bypass (3-4 mm inner diameter [ID], 40-100 ml/min) continue to fail despite success in high flow peripheral applications. A unique method is presented that uses a fluid dynamic approach to improve patency. A large diameter graft (5-6 mm ID) is used with an arteriovenous (AV) shunt to create a high flow rate (350-650 ml/min); a Venturi flow resistance controls the AV shunt and provides high pressure to the coronary arteries. The resulting graft can supply as many coronary arteries as required by means of side to side anastomoses upstream from the Venturi resistance. The concept was studied in a mock circulation system to analyze fluid dynamics under pulsatile flow. Mathematical models were used to study laminar and turbulent shear stresses and flow distributions over the physiologic range of Reynolds numbers. In vitro testing demonstrated little bovine red blood cell (RBC) hemolysis (0.249 mg Hb/min) compared with other devices. In vivo testing in sheep showed no significant acute changes in pulse rate or blood pressure in response to the shunt. The fluid and mathematical modeling of this concept has additional application in the study of flow past stenoses.

Animals↗

Effect of breath-holding on pulsatile ocular blood flow measurement in normal subjects.

BACKGROUND: The Valsalva maneuver is known to affect intraocular pressure (IOP). Simple breath-holding may cause IOP elevation. A recent study demonstrated a decrease in pulsatile ocular blood flow (POBF) during forcible exhalation. This study investigated whether breath-holding could affect POBF measurement. METHODS: Thirty-eight healthy young adults were recruited. Their POBF's were measured with an ocular blood flow pneumatonometer. The first set of measurements was made using normal measurement protocol. Three consecutive readings were obtained, and the mean was used for analysis. The second set of measurements was taken after 5-min rest, and the subjects were required to hold their breath during the acquisition period. RESULTS: As previously reported, POBF reduced with increasing myopia. There was no significant change in IOP, pulse rate, POBF, and pulse amplitude between normal protocol and breath-holding condition. POBF and pulse amplitude demonstrated a greater variation, shown by coefficient of variation, when subjects held their breath. CONCLUSIONS: This study found a greater variation in consecutive POBF measurements during breath-holding condition. There was no significant difference in either POBF or pulse amplitude during breath-holding session, probably because of the use of three consecutive measurements, and averaged results were generated from them. It is advised to measure the POBF by taking consecutive readings, and subjects should not hold their breath.

Adult↗

Flow convergence flow rates from 3-dimensional reconstruction of color Doppler flow maps for computing transvalvular regurgitant flows without geometric assumptions: An in vitro quantitative flow study.

OBJECTIVE: This study was designed to develop and test a 3-dimensional method for direct measurement of flow convergence (FC) region surface area and for quantitating regurgitant flows with an in vitro flow system. BACKGROUND: Quantitative methods for characterizing regurgitant flow events such as flow convergence with 2-dimensional color flow Doppler imaging systems have yielded variable results and may not be accurate enough to characterize those more complex spatial events. METHOD: Four differently shaped regurgitant orifices were studied: 3 flat orifices (circular, rectangular, triangular) and a nonflat one mimicking mitral valve prolapse (all 4 orifice areas = 0.24 cm(2)) in a pulsatile flow model at 8 to 9 different regurgitant flow rates (10 to 50 mL/beat). An ultrasonic flow probe and meter were connected to the flow model to provide reference flow data. Video composite data from the color Doppler flow images of the FC were reconstructed after computer-controlled 180 degrees rotational acquisition was performed. FC surface area (S cm(2)) was calculated directly without any geometric assumptions by measuring parallel sliced flow convergence arc lengths through the FC volume and multiplying each by the slice thickness (2.5 to 3.2 mm) over 5 to 8 slices and then adding them together. Peak regurgitant flow rate (milliliters per second) was calculated as the product of 3-dimensional determined S (cm(2)) multiplied by the aliasing velocity (centimeters per second) used for color Doppler imaging. RESULTS: For all of the 4 shaped orifices, there was an excellent relationship between actual peak flow rates and 3-dimensional FC-calculated flow rates with the direct measurement of the surface area of FC (r = 0.99, mean difference = -7.2 to -0.81 mL/s, % difference = -5% to 0%), whereas a hemielliptic method implemented with 3 axial measurements of the flow convergence zone from 2-dimensional planes underestimated actual flow rate by mean difference = -39.8 to -18.2 mL/s, % difference = -32% to -17% for any given orifice. CONCLUSIONS: Three-dimensional reconstruction of flow based on 2-dimensional color Doppler may add quantitative spatial information, especially for complex flow events. Direct measurement of 3-dimensional flow convergence surface areas may improve accuracy for estimation of the severity of valvular regurgitation.

Blood Flow Velocity↗

FRODO pulse sequences: a new means of eliminating motion, flow, and wraparound artifacts.

Magnetic resonance images of the spine, chest, abdomen, and pelvis are commonly degraded by ghost artifacts. The authors have developed a new technique named FRODO (Flow and Respiratory artifact Obliteration with Directed Orthogonal pulses) to suppress these artifacts. Signal from tissues responsible for the artifacts is eliminated by use of radio frequency pulses specifically optimized for high selectivity to saturate proton magnetization over one or more independently defined slabs (large rectangular volumes) of tissue. Ghost artifacts from pulsatile flow in the heart and blood vessels, as well as from respiratory motion and swallowing, are suppressed. Additional applications of this technique include elimination of intraluminal signal in blood vessels and suppression of wraparound artifact along the phase-encoding axis. Preliminary clinical experience suggests that the FRODO technique, in conjunction with other flow compensation methods, may provide a definitive solution to the problem of motion in spine imaging. FRODO pulse sequences may also prove useful for imaging of blood vessels, heart, abdomen, and other areas where motion, flow, or wraparound artifacts limit image quality.

Abdomen↗

Endothelial cell function, including tissue factor expression, under flow conditions.

Vascular endothelium remains a dynamic interface between blood and the vessel wall. New developments make clear that many antithrombotic and prothrombotic responses of the endothelium depend on flow conditions in an adaptive manner: duration of a certain level of shear stress matters as well as level of shear. In general, over a time course of several hours, endothelium appears to be more actively antithrombotic under moderate shear conditions (e.g., 15 dynes/cm2), and more fibrinolytic under high (e.g., 30 dynes/cm2). Pulsatile flow and cyclic wall stress further modify these responses. Special consideration, moreover, must be given to branch points and regions of irregular geometry (i.e., stenoses, aneurysms) in the circulation. In such locations, predilection sites for thrombosis, lipid uptake, and atherosclerosis, low levels of fluid shear stress (e.g., 0.5 dynes/cm2), large gradients in fluid shear stress, and vessel wall bending stresses all become important. Preliminary work suggests that endothelial cells in such regions can become prothrombotic, leading to localized platelet adhesion/aggregation and fibrin formation on subendothelium and perhaps deeper structures following vessel injury.

Animals↗

Changes in the intraaneurysmal pressure due to HydroCoil embolization.

BACKGROUND AND PURPOSE: The purpose of this study was to measure the changes in the intraaneurysmal fluid pressure and parent vessel flow characteristics resulting from packing the aneurysmal sac with hydrogel-coated coils. METHODS: Platinum coils coated with an expansible hydrogel were used to embolize a silicone model of the basilar tip aneurysm. The intraaneurysmal fluid pressure was measured with a NeuroCare Camino Pressure Micro-Probe at various packing ratios. A programmable pulsatile pump was used to input a physiologically relevant pulsatile flow in the parent artery. RESULTS: The intraaneurysmal fluid pressure did not increase when packing the aneurysm with hydrogel-coated platinum coils, even with a coil density up to 93%. CONCLUSION: Packing the aneurysm with hydrogel-coated coils at a density up to 93% did not increase the intraaneurysmal fluid pressure.

Blood Pressure↗

Pulsatile pressure and flow in arterial stenoses simulated in a mathematical model.

This paper presents the detailed pulsatile pressure and flow velocity patterns inside an axis symmetric stenosis model with 75% constriction. The pressure and velocities have been calculated by solving the Navier-Stokes equations by the finite element method, the velocity profile in a straight tube caused by a pulsating driving pressure has been calculated first and then used as a boundary condition for the stenosis calculations. The results of the mathematical simulations of the stenosis model have been obtained in terms of velocity vectors, streamlines and isobars at 16 different instances in time, each 15 degrees apart during a cardiac cycle. The calculated velocity field shows that a vortex is developed at the wall distal to the stenosis as the velocity decreases from the peak systolic value. At the site of the vortex, a local pressure minimum is found due to the conversion of pressure to kinetic energy. when the flow is reversed, the reversal occurs first along the wall, thus forcing the vortex toward the centre of the tube. As the reverse flow velocity increases, a vortex is also developed at the proximal site of the stenosis.

Arterial Occlusive Diseases↗

A comparison between laser interferometric measurement of fundus pulsation and pneumotonometric measurement of pulsatile ocular blood flow. 2. Effects of changes in pCO2 and pO2 and of isoproterenol.

PURPOSE: We have shown in the companion paper that, under baseline conditions, there is a high degree of association between laser interferometrically measured fundus pulsation amplitude (FPA) and pneumotonometrically measured pulse amplitude (PA) and pulsatile ocular blood flow (POBF). The present study investigated the effect of high pCO2, of high pO2 and of isoproterenol on POBF as assessed with laser interferometry and pneumotonometry. METHODS: Pneumotonometry and laser interferometry were performed in young healthy subjects during breathing of 100% O2 (n = 10; hyperoxia) and of 5% CO2 + 95% air (n = 8; hypercapnia). In addition these parameters were studied during stepwise increasing doses of isoproterenol, a beta-receptor agonist (n = 8). RESULTS: Inhalation of 5% CO2 + 95% air increased FPA (24 +/- 12%, p < 0.001), PA (26 +/- 13%, p < 0.001) and POBF (15 +/- 8%, p = 0.002). Inhalation of 100% O2 decreased FPA (-5 +/- 7%, p = 0.027), but did not change PA or POBF. The effect of 100% O2 inhalation on FPA in the optic disc was more pronounced (-11% to -20%) than in the macula. Isoproterenol caused a dose-dependent increase in FPA, PA and POBF (p < 0.001). The association between the induced changes in FPA and PA or POBF was highly significant. CONCLUSIONS: The present study shows that FPA can be taken as a valid relative measure of pulsatile choroidal blood flow. Our results in the optic disc indicate that FPA at the neuroretinal rim and at the cup is influenced by retinal and choroidal circulation.

Adrenergic beta-Agonists↗

[Semiquantitative analysis of intrarenal arterial Doppler flow spectra in healthy adults].

In a prospective study on 60 healthy adults, 38 men and 22 women (age range, 20-70 years), semiquantitative analyses of intrarenal arterial Doppler waveforms were performed by means of colour duplex sonography under standardised conditions. Furthermore, the effect of heart rate on calculation of renoparenchymal arterial Doppler spectra was evaluated. A total of 115 normal kidneys were studied, giving the following normal values (mean +/- standard deviation): resistance index (RI): 57 +/- 4.5%, pulsatility index (PI): 89 +/- 13%, pulsatile flow index (PFI): 65 +/- 6%. There were no different values for men and women. The normal renal resistance indices, however, were found to be age dependent, with increasing trend of RI and PI and decreasing trend of PFI with increasing age, most probably due to a corresponding increase of vascular resistance and mean arterial blood pressure. In an experimental study, we found a significant decrease of RI and PI and an increase of PFI paralleling the increase of heart rate. To eliminate the effect of heart rate on renal resistance indices, i.e. for interindividual comparison of data or intraindividual follow-up, measurements of indices can be corrected for a standardised heart rate by using regression equations. The results of our studies emphasise that interpretations of semiquantitative calculations of renal Doppler waveforms should be performed in consideration of extrarenal factors, for example the patient's age and heart rate.

Adult↗

In vitro set-up of modified Blalock Taussig shunt: vascular resistance-flow relationship.

BACKGROUND: A modified Blalock-Taussig (mBT) shunt is an anastomosis created between the systemic and pulmonary arterial tree in order to improve pulmonary blood flow in neonates and children with congenital heart disease. The aim of this study was to assess vascular resistance-flow relationship in an in vitro set-up of a modified Blalock Taussig shunt. METHODS: A shunt set-up was constructed with the vessels of a sheep. A modified BT shunt was anastomosed between an innominate (brachiocephalic) and a right pulmonary artery. A Medos pump (ventricular assist device) was used to create pulsatile flow. Three different mean pulmonary artery flow rates (Q PA ) were applied. Once mean pulmonary and mean aortic flows (Q AO ) were fixed, shunt flow rates for twelve different pulmonary vascular resistances (R p ) were investigated. RESULTS: For all three pulmonary flow rates, the shunt flow decreased with increasing pulmonary resistance. In addition, systemic flow decreased compared to pulmonary flow. When pulmonary flow rate was set at 800 ml/min and aorta flow rate at 900 ml/min, the distribution of flow between pulmonary and systemic organs flow rates ranged between 69% - 70% and 30% - 31% respectively. Similarly, when both pulmonary and aorta flow rates were set at 900 ml/min, pulmonary and systemic organ flows ranged between 73% - 77% and 23% - 27% respectively. For pulmonary and aorta flow rates of 1000 ml/min and 900 ml/min, respectively, the distribution of flow between pulmonary and systemic organ flow rates varied between 79% - 83% and 17% - 21% respectively. CONCLUSION: Knowledge of the relationship between vascular resistances and flow in this surgically created in vitro mBT shunt set-up may be helpful in the clinical management of the patients whose survival is crucially dependent on the blood flow distribution between the pulmonary and systemic circulation.

Anastomosis, Surgical↗

Flow pattern and shear stress distribution of distal end-to-side anastomoses. A comparison of the instantaneous velocity fields obtained by particle image velocimetry.

OBJECTIVE: To describe the local hemodynamics and pressure losses of crural bypass anastomoses using instantaneous velocity fields acquired by particle image velocimetry (PIV). METHODS: Silastic models of a Taylor patch, a Miller cuff and a femoro-crural patch prosthesis (FCPP) were attached to a circuit driven by a Berlin Heart, providing a pulsatile flow with an amplitude of 450 to 25 ml/min (mean 200 ml/min). An outflow resistance of 0.5 mmHg/ml/min (peripheral resistance units, PRU) was modeled using small silastic tubes providing a phase shift of -12 degrees between flow and pressure curves. The working fluid consisted of a glycerine/water mixture with a viscosity of 4 mPas. Hollow glass spheres with a mean size of 9-13 microm were used as tracer particles. Instantaneous velocity fields were obtained by means of PIV and shear rates as well as shear stresses were calculated. Triggered by the flowmeter signal, 10 measurements at 100 ms intervals per cardiac cycle were obtained. The pressures were measured on the inflow and at both distal outflows. The resulting mean pressure losses due to flow separation and distal fluid acceleration were calculated. RESULTS: Inside the Taylor patch anastomosis a large flow separation at the hood containing a clockwise rotating vortex was found. Additionally a smaller flow separation at the heel and a flow stagnation zone on the floor of the recipient artery were observed. Conversely, inside the Miller cuff a counterclockwise rotating vortex was seen inside a large heel flow separation. The FCPP also showed typical separation areas at the hood and heel of the anastomosis, although these were smaller compared to the other anastomoses. Inside the FCPP anastomosis no vortex creation was observed throughout the cardiac cycle. The mainstream velocities at the inlet levels were comparable for the three anastomoses. A significant fluid acceleration was present at the antegrade as well as the retrograde outlets of the Taylor and Miller cuff, while the fluid acceleration at the antegrade outflow of the FCPP was small, which was attributed to the end-to-end configuration of the antegrade FCPP leg. The calculated normalized antegrade and retrograde pressure losses for the Taylor form were 0.90 and 0.88, for the Miller cuff 0.89 and 0.86 and for the FCPP 0.94 and 0.86, respectively. The shear stresses inside the flow separations of the three anastomoses were significantly lower than normal wall shear stresses. High shear stress levels were found inside the transition zones between flow separation and high velocity mainstream. CONCLUSIONS: The flow pattern inside cuffed or funnel shaped anastomoses consists of large flow separation zones, which are thought to be associated with intimal hyperplasia development. In addition, fluid accelerations at the distal outlets result in pressure losses, which may contribute to impaired crural perfusion.

Anastomosis, Surgical↗

Mechanical responses of a compliant electrospun poly(L-lactide-co-epsilon-caprolactone) small-diameter vascular graft.

To design a "mechano-active" small-diameter artificial vascular graft, a tubular scaffold made of elastomeric poly(L-lactide-co-epsilon-caprolactone) fabrics at different wall thicknesses was fabricated using an electrospinning (ELSP) technique. The wall thickness of the fabricated tube (inner diameter; approximately 2.3-2.5 mm and wall thickness; 50-340 microm) increased proportionally with ELSP time. The wall thickness dependence of mechanical responses including intraluminal pressure-induced inflation was determined under static and dynamic flow conditions. From the compliance-related parameters (stiffness parameter and diameter compliance) measured under static condition, the smaller the wall thickness, the more compliant the tube. Under dynamic flow condition (1 Hz, maximal/minimal pressure of 90 mmHg/45 mmHg) produced by a custom-designed arterial circulatory system, strain, defined as the relative increase in diameter per pulse, increased with the decrease in wall thickness, which approached that of a native artery. Thus, a mechano-active scaffold that pulsates synchronously by responding to pulsatile flow was prepared using elastomeric PLCL as a base material and an ELSP technique.

Animals↗

Pulse pressure-induced transmural fluid flux increases bovine aortic smooth muscle cell apoptosis in a mitogen activated protein kinase dependent manner.

BACKGROUND: Mechanical forces associated with blood flow are critical in the regulation of vascular smooth muscle cell (VSMC) growth, migration, differentiation, and apoptosis as fundamental features in the pathogenesis of vascular disease. We investigated the effect of pulse pressure on VSMC apoptosis. METHODS: Using a perfused transcapillary co-culture system, bovine thoracic aortic SMC (BASMC) were exposed to increases in pulsatile flow (0.3-17 ml/min) hence pulse pressure (amplitude of pulse 6-50 mmHg in the absence or presence of bovine aortic endothelial cells (BAEC). The extent of apoptosis was determined by measuring caspase-3 activity, the levels of pro- and anti-apoptotic Bcl-2 family proteins, FasL and cellular apoptosis susceptibility (CAS) protein expression and the extent of DNA fragmentation. RESULTS: Changes in pulse pressure resulted in a significant force- and time-dependent increase in caspase-3 activity in BASMC. This effect was maximal after 6 h, independent of BAEC presence, and attenuated following inhibition of mitogen-activated protein kinase (MAPK) activity with PD98059. In parallel cultures, there was a significant increase in Bad and Bax expression, concomitant with an increase in DNA fragmentation, and a significant decrease in Bcl-2 and Bcl-XL expression. The pro-apoptotic effects of pulse pressure were specific differentiated cells but independent of p53, in as much as FasL and CAS expression were enhanced in differentiated adult but decrease in de-differentiated embryonic cells in response to flow. CONCLUSIONS: These results suggest that pulse pressure promotes phenotypically distinct VSMC apoptosis in vitro in an endothelial-independent, MAPK-dependent, manner.

Animals↗

A blood analogue for the experimental study of flow-related thrombosis at prosthetic heart valves.

It is shown that a flowing mixture of unpasteurised cow's milk, rennet and calcium chloride will deposit solid clot in vitro in the neighbourhood of certain kinds of flow obstruction and hydrodynamic disturbance particularly associated with deposition and thrombus formation in a similar stream of blood. The milk and blood deposits are similar in physical structure, both on a microscopic and a gross scales. For established kinds of artificial heart valves, the growth sequence and developed patterns of milk clotting obtained in vitro with pulsatile flows at physiological rates closely resemble patterns of thrombus reported clinically for valves of the same type in vivo. It appears that these phenomena, for which a tentative explanation is outlined, can form the basis of a convenient and rapid experimental method for evaluating in vitro the effects of design changes on the thrombogenicity of artificial heart valves and other cardiovascular devices in vivo. The milk system also shows promise as an aid in fundamental experimental studies of mechanisms of flow-related thrombosis.

Animals↗

Differential diagnosis of pulsatile neck masses by Doppler color flow imaging.

A pulsatile neck mass (PNM) requires careful judgment in its evaluation, and it is difficult and inaccurate to diagnose a PNM only by physical examination, even though a thrill or bruit is present. Doppler colorflow imaging (DCI) was performed as an initial evaluation in nine patients with PNMs. Intravenous digital subtraction angiography, intra-arterial angiography, X-ray computed tomography, and magnetic resonance imaging were performed in selected cases. The DCI revealed seven vascular masses (three tortuosities of the common carotid artery, two tortuosities of the brachiocephalic artery, one pseudoaneurysm, and one traumatic arteriovenous fistula) and two nonvascular masses (one neurofibroma and one metastatic lymph node). The clinical diagnoses of all the vascular masses were defined by DCI. In nonvascular masses, fine-needle aspiration biopsy could be performed relatively safely and accurately by monitoring the feeding artery or the common carotid artery by DCI. This method was quite useful for the initial evaluation in the differential diagnosis of PNMs.

Adult↗

An instrument for the measurement of in vitro velocity and turbulent shear stress in the immediate vicinity of prosthetic heart valves.

The measurements of velocity and turbulent shear stress in the immediate vicinity of prosthetic heart valves play a vital role in their design and evaluation. In the past, hot-wire/film and one-component laser Doppler anemometer (LDA) systems have been used extensively. Hot-wire/film anemometers, however, have some serious disadvantages, such as not being able to measure the directionality of the flow, disturbing the flow field with the probe, and requiring frequent calibration. One-component LDA systems do not have these problems, but they cannot measure turbulent shear stresses directly. Since these measurements are essential, and are not available in the open literature, a two-component LDA system was assembled to measure velocity and turbulent shear stress fields under pulsatile flow conditions. The experimental methodology used to create an in vitro data base of velocity and turbulent shear stress fields in the immediate vicinity of various designs of prosthetic heart valve in current clinical use is also discussed in this paper.

Aortic Valve↗