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Simulation of personalised haemodynamics by various mounting positions of a prosthetic valve using computational fluid dynamics

  • Markus Bongert EMAIL logo , Marius Geller , Werner Pennekamp and Volkmar Nicolas
Published/Copyright: March 3, 2018

Abstract

Diseases of the cardiovascular system account for nearly 42% of all deaths in the European Union. In Germany, approximately 12,000 patients receive surgical replacement of the aortic valve due to heart valve disease alone each year. A three-dimensional (3D) numerical model based on patient-specific anatomy derived from four-dimensional (4D) magnetic resonance imaging (MRI) data was developed to investigate preoperatively the flow-induced impact of mounting positions of aortic prosthetic valves to select the best orientation for individual patients. Systematic steady-state analysis of blood flow for different rotational mounting positions of the valve is only possible using a virtual patient model. A maximum velocity of 1 m/s was used as an inlet boundary condition, because the opening angle of the valve is at its largest at this velocity. For a comparative serial examination, it is important to define the standardised general requirements to avoid impacts other than the rotated implantation of the prosthetic aortic valve. In this study, a uniform velocity profile at the inlet for the inflow of the aortic valve and the real aortic anatomy were chosen for all simulations. An iterative process, with the weighted parameters flow resistance (1), shear stress (2) and velocity (3), was necessary to determine the best rotated orientation. Blood flow was optimal at a 45° rotation from the standard implantation orientation, which will offer a supply to the coronary arteries.


Corresponding author: Dipl.-Ing. Markus Bongert, Department of Mechanical Engineering, Research Center for BioMedical Technology (BMT), University of Applied Sciences and Arts Dortmund, Sonnenstr. 96, D-44139 Dortmund, Germany, Phone: +49 231 9112 232, Fax: +49 231 9112 696

  1. Author Statement

  2. Research funding: Authors state no funding involved.

  3. Conflict of interest: The authors have no financial interests or relationships that might lead to any conflict of interest.

  4. Informed consent: Informed consent is not applicable.

  5. Ethical approval: This study was performed in accordance with ethical standards laid down in the 1964 WMA Declaration of Helsinki “Ethical Principles for Medical Research Involving Human Subjects” in its actual constitution.

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Received: 2017-06-11
Accepted: 2017-07-24
Published Online: 2018-03-03
Published in Print: 2019-04-24

©2019 Walter de Gruyter GmbH, Berlin/Boston

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