Comparative Study of Wall-Shear Stress at the Ascending Aorta for Different Mechanical Heart Valve Prostheses

Smartphone-based particle tracking velocimetry for the in vitro assessment of coronary flows

The present study adopts a smartphone-based approach for the experimental characterization of coronary flows. Technically, Particle Tracking Velocimetry (PTV) measurements were performed using a smartphone camera and a low-power continuous wave laser in realistic healthy and stenosed phantoms of left anterior descending artery with inflow Reynolds numbers approximately ranging from 20 to 200. A Lagrangian-Eulerian mapping was performed to convert Lagrangian PTV velocity data to a Eulerian grid. Eulerian velocity and vorticity data obtained from smartphone-based PTV measurements were compared with Particle Image Velocimetry (PIV) measurements performed with a smartphone-based setup and with a conventional setup based on a high-power double-pulsed laser and a CMOS camera. Smartphone-based PTV and PIV velocity flow fields substantially agreed with conventional PIV measurements, with the former characterized by lower average percentage differences than the latter. Discrepancies emerged at high flow regimes, especially at the stenosis throat, due to particle image blur generated by smartphone camera shutter speed and image acquisition frequency. In conclusion, the present findings demonstrate the feasibility of PTV measurements using a smartphone camera and a low-power light source for the in vitro characterization of cardiovascular flows for research, industrial and educational purposes, with advantages in terms of costs, safety and usability.

A Recombinant Fusion Construct between Human Serum Albumin and NTPDase CD39 Allows Anti-Inflammatory and Anti-Thrombotic Coating of Medical Devices

Medical devices directly exposed to blood are commonly used to treat cardiovascular diseases. However, these devices are associated with inflammatory reactions leading to delayed healing, rejection of foreign material or device-associated thrombus formation. We developed a novel recombinant fusion protein as a new biocompatible coating strategy for medical devices with direct blood contact. We genetically fused human serum albumin (HSA) with ectonucleoside triphosphate diphosphohydrolase-1 (CD39), a promising anti-thrombotic and anti-inflammatory drug candidate. The HSA-CD39 fusion protein is highly functional in degrading ATP and ADP, major pro-inflammatory reagents and platelet agonists. Their enzymatic properties result in the generation of AMP, which is further degraded by CD73 to adenosine, an anti-inflammatory and anti-platelet reagent. HSA-CD39 is functional after lyophilisation, coating and storage of coated materials for up to 8 weeks. HSA-CD39 coating shows promising and stable functionality even after sterilisation and does not hinder endothelialisation of primary human endothelial cells. It shows a high level of haemocompatibility and diminished blood cell adhesion when coated on nitinol stents or polyvinylchloride tubes. In conclusion, we developed a new recombinant fusion protein combining HSA and CD39, and demonstrated that it has potential to reduce thrombotic and inflammatory complications often associated with medical devices directly exposed to blood.

Possible Early Generation of Physiological Helical Flow Could Benefit the Triflo Trileaflet Heart Valve Prosthesis Compared to Bileaflet Valves

Background—Physiological helical flow in the ascending aorta has been well documented in the last two decades, accompanied by discussions on possible physiological benefits of such axial swirl. Recent 4D-MRI studies on healthy volunteers have found indications of early generation of helical flow, early in the systole and close to the valve plane. Objectives—Firstly, the aim of the study is to investigate the hypothesis of premature swirl existence in the ventricular outflow tract leading to helical flow in the valve plane, and second to investigate the possible impact of two different mechanical valve designs on the preservation of this early helical flow and its subsequent hemodynamic consequences. Methods—We use a pulse duplicator with an aortic arch and High-Speed Particle Image Velocimetry to document the flow evolution in the systolic cycle. The pulse-duplicator is modified with a swirl-generating insert to generate early helical flow in the valve plane. Special focus is paid to the interaction of such helical flow with different designs of mechanical prosthetic heart valves, comparing a classical bileaflet mechanical heart valve, the St. Jude Medical Regent valve (SJM Regent BMHV), with the Triflo trileaflet mechanical heart valve T2B version (Triflo TMHV). Results—When the swirl-generator is inserted, a vortex is generated in the core flow, demonstrating early helical flow in the valve plane, similar to the observations reported in the recent 4D-MRI study taken for comparison. For the Triflo trileaflet valve, the early helical flow is not obstructed in the central orifice, similar as in the case of the natural valve. Conservation of angular momentum leads to radial expansion of the core flow and flattening of the axial flow profile downstream in the arch. Furthermore, the early helical flow helps to overcome separation at the outer and inner curvature. In contrast, the two parallel leaflets for the bileaflet valve impose a flow straightener effect, annihilating the angular momentum, which has a negative impact on kinetic energy of the flow. Conclusion—The results imply better hemodynamics for the Triflo trileaflet valve based on hydrodynamic arguments under the discussed hypothesis. In addition, it makes the Triflo valve a better candidate for valve replacements in patients with a pathological generation of nonaxial velocity in the ventricle outflow tract.

Evaluating medical device and material thrombosis under flow: current and emerging technologies

This review highlights the importance of flow in medical device thrombosis and explores current and emerging technologies to evaluate dynamic biomaterial Thrombosis in vitro.