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强彦, 段天赐, 张民祖, 祁亮, 魏列江. 不同生理状态下主动脉双叶机械心脏瓣膜流场特性PIV实验研究. 力学学报, 2024, 56(4): 1-11. DOI: 10.6052/0459-1879-23-563
引用本文: 强彦, 段天赐, 张民祖, 祁亮, 魏列江. 不同生理状态下主动脉双叶机械心脏瓣膜流场特性PIV实验研究. 力学学报, 2024, 56(4): 1-11. DOI: 10.6052/0459-1879-23-563
QIANG Yan, DUAN Tianci, ZHANG Minzu, QI Liang, WEI Liejiang. Experimental study of aortic bmhv flow characteristics under different physiological conditions using piv. Chinese Journal of Theoretical and Applied Mechanics, 2024, 56(4): 1-11. DOI: 10.6052/0459-1879-23-563
Citation: QIANG Yan, DUAN Tianci, ZHANG Minzu, QI Liang, WEI Liejiang. Experimental study of aortic bmhv flow characteristics under different physiological conditions using piv. Chinese Journal of Theoretical and Applied Mechanics, 2024, 56(4): 1-11. DOI: 10.6052/0459-1879-23-563

不同生理状态下主动脉双叶机械心脏瓣膜流场特性PIV实验研究

EXPERIMENTAL STUDY OF AORTIC BMHV FLOW CHARACTERISTICS UNDER DIFFERENT PHYSIOLOGICAL CONDITIONS USING PIV

  • 摘要: 人工心脏瓣膜(PHV)替换发生病变的原生瓣膜是目前治疗瓣膜性心脏病的主要方法, 其中双叶机械心脏瓣膜(BMHV)因其耐久性在临床上被广泛使用. 瓣膜置换术后会出现血栓栓塞等并发症, 这与机械瓣结构改变主动脉生理性血流模式直接相关. 本研究搭建了生理性左心脉动流血液循环装置, 使用基于医学CT影像制备的真实人体主动脉根部硅胶模型, 采用可调节压力的透明腔体安置主动脉根部模型, 来模拟动脉顺应性对血液流动的影响. 并模拟出入口负荷条件, 分别在健康、心衰以及运动三种不同生理压力和流量条件下, 使用粒子图像测速(PIV)技术获取完整心动周期上血液通过主动脉双叶机械瓣的平面流场数据, 采用速度分布、涡量分布、剪切应力分析评价双叶机械瓣在主动脉根部、窦腔与升主动脉处的血流流场特性, 研究不同生理状态对血液跨瓣流动的影响, 为术前瓣膜选择、术后患者康复治疗提供理论依据与实验数据支持. 研究结果表明, 在运动生理状态下较大的心排出量(CO = 14.6 L/min)导致血液以2.2 m/s的峰值速度冲击主动脉窦与升主动脉相连接处的壁面, 壁面存在最大数值为2.8 N/m2的剪切应力, 且在整个收缩期内最大剪切应力都超过1.4 N/m2, 易使胶原蛋白和组织因子暴漏在流动的血液中导致血小板活化, 为血栓的形成提供有利环境, 瓣膜置换术后应避免后患者长时间处于运动状态, 以减少溶血导致的血栓栓塞等风险.

     

    Abstract: Prosthetic heart valve (PHV) replacement for diseased native valves stands as the primary therapeutic modality for valvular heart diseases. Bileaflet mechanical heart valves (BMHV) are extensively employed in clinical practice due to their commendable durability. Post-valve replacement, complications such as thromboembolism emerge, intricately linked to alterations in the physiological blood flow pattern induced by the structural changes in mechanical valves. In this study, a physiologically pulsatile left heart flow circulation system was constructed. A realistic human aortic root silicone model, derived from medical CT images, was utilized, and a transparent chamber with adjustable pressure housed the aortic root model to simulate the impact of arterial compliance on blood flow. Simulating inlet and outlet loading conditions under varying physiological pressures and flow rates corresponding to healthy, heart failure, and exercise states, Particle Image Velocimetry (PIV) technology was employed to capture planar flow field data throughout a complete cardiac cycle as blood passed through a bileaflet mechanical valve in the aortic root. Velocity distribution, vorticity distribution, and shear stress analysis were conducted to assess the blood flow characteristics of the bileaflet mechanical valve at the aortic root, sinus, and ascending aorta. The study investigated the influence of different physiological states on transvalvular blood flow, providing theoretical foundations and experimental data support for preoperative valve selection and postoperative patient rehabilitation. Results revealed that, under exercise conditions with an elevated cardiac output (CO = 14.6 L/min), blood exhibited a peak velocity of 2.2 m/s, impacting the wall at the junction of the aortic sinus and ascending aorta. The wall experienced a maximum shear stress of 2.8 N/m2, surpassing 1.4 N/m2 throughout the entire systolic phase, potentially leading to the exposure of collagen and tissue factor in the flowing blood, triggering platelet activation. Hence, postoperative patients are advised to avoid prolonged periods of physical activity to mitigate the risk of hemolysis-induced thromboembolism.

     

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