Fetal Transcatheter Trileaflet Heart Valve Hemodynamics: Implications of Scaling on Valve Mechanics and Turbulence

• Published in: Annals of biomedical engineering 2020-06, Vol.48 (6), p.1683-1693
• Main Authors: Hatoum, Hoda, Gooden, Shelley, Heitkemper, Megan, Blum, Kevin M., Zakko, Jason, Bocks, Martin, Yi, Tai, Wu, Yen-Lin, Wang, Yadong, Breuer, Christopher K., Dasi, Lakshmi Prasad
• Format: Article
• Language: English
• Subjects: Adult; Alloys; Aluminum; Balloon treatment; Biochemistry; Biological and Medical Physics; Biomedical and Life Sciences; Biomedical Engineering and Bioengineering; Biomedicine; Biophysics; Classical Mechanics; Dynamic similarity; Evaluation; Fetus; Fetuses; Fluid dynamics; Fluid flow; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation; Heart valves; Heart Valves - physiology; Hemodynamics; Humans; Implantation; Orifices; Original Article; Particle image velocimetry; Reynolds number; Shear stress; Stress, Mechanical; Stresses; Systole; Turbulence; Turbulent flow; Zinc
• ISSN: 0090-6964; 1573-9686
• DOI: 10.1007/s10439-020-02475-3

The scarcity of data available on the best approach for pulmonary fetal valve replacement or implantation necessitate an investigation on whether practices using adult transcatheter valves could be translated to fetal applications. The objective of this study is to evaluate the hemodynamic characteristics and the turbulent properties of a fetal sized trileaflet transcatheter pulmonary valve in comparison with an adult balloon-expandable valve in order to assess the possibility of designing valves for fetal applications using dynamic similarity. A 6 mm fetal trileaflet valve and a 26 mm SAPIEN 3 valve were assessed in a pulse duplicator. Particle image velocimetry was performed. Pressure gradient (Δ P ), effective orifice area (EOA), regurgitant fractions (RF), pinwheeling indices (PI) and turbulent stresses were evaluated. Δ P was 8.56 ± 0.139 and 7.76 ± 0.083 mmHg with fetal valve and SAPIEN respectively ( p