Prosthetic valve thrombosis (PVT) is a serious complication affecting prosthetic heart valves. The transvalvular mean pressure gradient (MPG) derived by Doppler echocardiography is a crucial index to diagnose PVT, but may result in false negatives mainly in case of bileaflet mechanical valves (BMVs) in mitral position. This may happen because MPG estimation relies on simplifying assumptions on the transvalvular fluid dynamics or because Doppler examination is manual and operator-dependent. A deeper understanding of these issues may allow for improving PVT diagnosis and management. To this aim, we used in vitro and fluid-structure interaction (FSI) modeling to simulate the function of a real mitral BMV in different configurations: normally functioning and stenotic with symmetric and completely asymmetric leaflet opening, respectively.
Dimasi A, Piloni D, Spreafico L, Votta E, Vismara R, Fiore G, Meskin M, Fusini L, Muratori M, Montorsi P, Pepi M, Redaelli A. Fluid-structure interaction and in vitro analysis of a real bileaflet mitral prosthetic valve to gain insight into Doppler-silent thrombosis. J Biomech Eng 2019 May 4. doi: 10.1115/1.4043664