In vitro fluid dynamic characteristics of Ionescu-Shiley and Carpentier-Edwards tissue bioprostheses

In the study reported here, the in vitro fluid dynamic characteristics of the Ionescu-Shiley (calf pericardial) and Carpentier-Edwards (porcine) aortic tissue valves were studied. The experiments conducted were pressure drop measurements, leaflet photography, flow visualization, and velocity measurements. The pressure drop studies indicated that both types of tissue valves created relatively large pressure drops. These pressure drops were larger than those observed with the corresponding sizes of Bjork-Shiley, Hall-Kaster, and St. Jude aortic prostheses. The photographs of the opening of the valve leaflets indicated that the tissue valves do not open as ideally as do the natural valves. It was also observed that the Ionescu-Shiley aortic valves opened more symmetrically and with reproducibility than the corresponding Carpentier-Edwards aortic valves. Velocity and shear stress measurements made with a laser-Doppler anemometer indicated that the flow that emerged from the leaflets for both types of tissue valves was like a jet and could lead to turbulent shear stress on the order of 1,000-3,000 dynes/cm2. Such turbulent shear stresses could be harmful to blood components. The jet-type flow could also damage the endothelial lining of the wall of the ascending aorta. The velocity measurements also indicated an annular region of stagnant fluid between the outflow surfaces of the leaflets and the flow channel wall. Such a region could lead to the build-up of thrombotic, fibrotic, and/or calcific material on the outflow surfaces of the leaflets. Both types of valve designs, however, created relatively low wall shear stresses and regurgitant volumes.