Brennan Vogl, Agata Sularz, Sunyoung Ahn, Rajat Gadhave, Scott Lilly, Vinod Thourani, Brian Lindman, Mohamad Alkhouli, Hoda Hatoum
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引用次数: 0
Abstract
Purpose
To investigate the effect of changing systolic and diastolic blood pressures (SBP and DBP, respectively) on sinus flow and valvular and epicardial coronary flow dynamics after TAVR and SAVR.
Methods
SAPIEN 3 and Magna valves were deployed in an idealized aortic root model as part of a pulse duplicating left heart flow loop simulator. Different combinations of SBP and DBP were applied to the test setup and the resulting change in total coronary flow from baseline (120/60 mmHg), effective orifice area (EOA), and left ventricular (LV) workload, with each combination, was assessed. In addition, particle image velocimetry was used to assess the Laplacian of pressure (\({\nabla }^{2}\text{P}\)) in the sinus, coronary and main flow velocities, the energy dissipation rate (EDR) in the sinus and the LV workload.
Results
This study shows that under an elevated SBP, there is an increase in the total coronary flow, EOA, LV workload, peak velocities downstream of the valve, \({\nabla }^{2}\text{P}\), and EDR. With an elevated DBP, there was an increase in the total coronary flow and \({\nabla }^{2}\text{P}\). However, EOA and LV workload decreased with an increase in DBP, and EDR increased with a decrease in DBP.
Conclusions
Blood pressure alters the hemodynamics in the sinus and downstream flow following aortic valve replacement, potentially influencing outcomes in some patients.
期刊介绍:
Annals of Biomedical Engineering is an official journal of the Biomedical Engineering Society, publishing original articles in the major fields of bioengineering and biomedical engineering. The Annals is an interdisciplinary and international journal with the aim to highlight integrated approaches to the solutions of biological and biomedical problems.