Device Thrombogenicity Emulator (DTE) - Design optimization methodology for cardiovascular devices: A study in two bileaflet MHV designs

Michalis Xenos, Gaurav Girdhar, Yared Alemu, Jolyon Jesty, Marvin J Slepian, Shmuel Einav, Danny Bluestein

Research output: Contribution to journalArticle

82 Citations (Scopus)

Abstract

Patients who receive prosthetic heart valve (PHV) implants require mandatory anticoagulation medication after implantation due to the thrombogenic potential of the valve. Optimization of PHV designs may facilitate reduction of flow-induced thrombogenicity and reduce or eliminate the need for post-implant anticoagulants. We present a methodology entitled Device Thrombogenicty Emulator (DTE) for optimizing the thrombo-resistance performance of PHV by combining numerical and experimental approaches. Two bileaflet mechanical heart valves (MHV) designs, St. Jude Medical (SJM) and ATS, were investigated by studying the effect of distinct flow phases on platelet activation. Transient turbulent and direct numerical simulations (DNS) were conducted, and stress loading histories experienced by the platelets were calculated along flow trajectories. The numerical simulations indicated distinct design dependent differences between the two valves. The stress loading waveforms extracted from the numerical simulations were programmed into a hemodynamic shearing device (HSD), emulating the flow conditions past the valves in distinct 'hot-spot' flow regions that are implicated in MHV thrombogenicity. The resultant platelet activity was measured with a modified prothrombinase assay, and was found to be significantly higher in the SJM valve, mostly during the regurgitation phase. The experimental results were in excellent agreement with the calculated platelet activation potential. This establishes the utility of the DTE methodology for serving as a test bed for evaluating design modifications for achieving better thrombogenic performance for such devices.

Original languageEnglish (US)
Pages (from-to)2400-2409
Number of pages10
JournalJournal of Biomechanics
Volume43
Issue number12
DOIs
StatePublished - Aug 2010

Fingerprint

Heart Valves
Heart valve prostheses
Platelets
Equipment and Supplies
Platelet Activation
Chemical activation
Blood Platelets
Computer simulation
Direct numerical simulation
Hemodynamics
Shearing
Thromboplastin
Assays
Anticoagulants
Trajectories
Design optimization

Keywords

  • Computational fluid dynamics
  • Mechanical circulation support (MCS)
  • Mechanical heart valves (MHV)
  • Platelet activation
  • Platelet assays
  • Prosthetic heart valves (PHV)
  • Thrombogenic performance

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Rehabilitation
  • Biophysics
  • Biomedical Engineering

Cite this

Device Thrombogenicity Emulator (DTE) - Design optimization methodology for cardiovascular devices : A study in two bileaflet MHV designs. / Xenos, Michalis; Girdhar, Gaurav; Alemu, Yared; Jesty, Jolyon; Slepian, Marvin J; Einav, Shmuel; Bluestein, Danny.

In: Journal of Biomechanics, Vol. 43, No. 12, 08.2010, p. 2400-2409.

Research output: Contribution to journalArticle

Xenos, Michalis ; Girdhar, Gaurav ; Alemu, Yared ; Jesty, Jolyon ; Slepian, Marvin J ; Einav, Shmuel ; Bluestein, Danny. / Device Thrombogenicity Emulator (DTE) - Design optimization methodology for cardiovascular devices : A study in two bileaflet MHV designs. In: Journal of Biomechanics. 2010 ; Vol. 43, No. 12. pp. 2400-2409.
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