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Left Ventricular Vortex Under Mitral Valve Edge-to-Edge Repair
Yingying Hu1, Liang Shi, Siva Parameswaran
1Department of Mechanical Engineering, Texas Tech University, 7th St. and Boston Ave., PO Box 41021, Lubbock 79409-1021, TX, USA.
Cardiovascular Engineering and Technology
|June 14, 2011
Summary
Mitral valve edge-to-edge repair (ETER) creates jets that impact the left ventricle wall, increasing energy loss and reducing filling efficiency. Maintaining a larger orifice area may mitigate these effects.
Area of Science:
- Cardiovascular fluid dynamics
- Biomedical engineering
- Cardiac surgery
Background:
- Mitral valve edge-to-edge repair (ETER) alters mitral valve (MV) geometry and left ventricle (LV) filling dynamics.
- Understanding the impact of ETER on LV vortex formation and energy dissipation during diastole is crucial.
Purpose of the Study:
- To investigate the fluid mechanics of left ventricle (LV) vortex formation during diastole following mitral valve (MV) edge-to-edge repair (ETER).
Main Methods:
- Developed a computational MV-LV model simulating MV ETER.
- Modeled MV leaflets as a semi-prolate sphere with circular orifices, neglecting chordae.
- Utilized FLUENT software for simulating blood flow through the MV and within the LV.
Main Results:
- ETER generated two jets impinging the LV wall, causing significant energy loss near the impingement zone.
- Two vortex rings formed around the jets and dissipated by the end of diastole.
- Increased total orifice area inversely correlated with total energy loss and transmitral pressure drop.
Conclusions:
- ETER-induced jets impinge the LV wall, leading to major energy dissipation and reduced LV filling efficiency.
- Maintaining a larger orifice area post-ETER may not significantly increase diastolic energy loss or pressure drop.
- An adverse atrio-ventricular pressure gradient near end-diastole might contribute to MV closure.
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