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Biomedical subjects

K B Chandran

Publications and source records attributed to K B Chandran.

At least 73 records · Page 4Linked to original sources
PubMed1983

Steady flow development past valve prostheses in a model human aorta. II. Tilting disc valves.

The flow development in the model human aorta with uniform entry as well as with centrally occluding valves mounted at the root of the aorta was described in Part I of this two-paper sequence. Part II deals with the flow development in the model aorta with tilting disc valves mounted at the root of the aorta. Bjork-Shiley and Hall-Kaster tilting disc valves were mounted in three different orientations with respect to the root of the aorta. The velocity profiles and turbulent stresses were measured with laser-Doppler anemometry. Our results under steady flow conditions in the model human aorta show quantitatively that the flow development in the ascending aorta as well as in the brachio-cephalic artery are strongly dependent on the orientation of the tilting disc valves. With the valves tilting towards the outer wall of curvature, our results suggest a tendency for flow separation at the flow divider region of the brachio-cephalic artery.

Aorta↗
PubMed1983

Effect of valve orientation on flow development past aortic valve prostheses in a model human aorta.

The effect of valve orientation on flow development in a model human aorta was studied by means of a qualitative flow visualization technique. The model replicated the geometry of the human aorta and the experiment simulated a physiologically realistic pulsatile flow. The following valves were studied: Starr-Edwards Stellite, Starr-Edwards silicone, Björk-Shiley spherical disc, Björk-Shiley convexo-concave disc, and Hall-Kaster tilting disc. All the valves had a tissue anulus diameter of 27 mm. With the ball-in-cage valves, the flow in the ascending aorta was predominantly axial and uniform throughout systole, while vortex formation was observed downstream from the ball. With the tilting disc valves, the flow development in the aorta was a function of the orientation of the valves. With the major flow orifice directed toward the commissure between the right and noncoronary cusps, the fluid motion was predominantly in the axial direction through early systole. A vortex developed along the wall of lesser curvature of the aorta with the progression of systole. In early diastole, a well-defined flow reversal was observed along the lesser curvature of the aorta. With the major flow orifice directed toward the left coronary cusp, the fluid motion, although predominantly axial, was not uniform in the ascending aorta. Regions of relative stasis present near the wall of greater curvature subsequently developed into a trapped vortex throughout the cardiac cycle. With the major flow orifice directed more posteriorly, an improved fluid dynamic characteristic was observed, and there was no trapped vortex present near the wall of greater curvature. The flow visualization study in the model human aorta suggests that, from a fluid dynamic point of view, orientation of the major flow orifice of the tilting disc valve toward the wall of lesser curvature is not advisable.

Aortic Valve↗
PubMed1982

Physiological pulsatile flow experiments in a model of the human aortic arch.

An experimental investigation of physiologically relevant pulsatile flow in a model of the human aortic arch has been conducted. The model aortic arch flow chamber was fabricated in clear acrylic from an in situ casting of the human aorta and was incorporated in a mock-circulatory system. The model excluded the coronary sinuses and the three major branching arteries of the mid-arch region in order to concentrate only upon the effects of the multi-dimensional curvatures and tapering in the aorta. Furthermore, a flow straightening section was placed upstream to the flow chamber to eliminate any fluid disturbances created by the prosthetic aortic valve used in these studies. The qualitative flow visualization studies in the model aorta revealed the presence of strong secondary fluid motions near the inner wall. These helical flows dissipated during diastole, being greatly affected by the dramatic flow reversals which occurred along the inner wall at the onset of diastole. Quantitative studies were conducted using a three-sensor hot-film velocity probe to determine the axial, radial and tangential velocity components at various cross-sections in the aorta. The results showed rapid reversal of axial velocity near the inner wall at the onset of diastole.

Aorta, Thoracic↗
PubMedDate not supplied

Instantaneous back flow through peripheral clearance of Medtronic Hall tilting disc valve at the moment of closure.

An investigation of the flow dynamics through the peripheral clearance (the gap formed between the occluder tip and the metal housing in the closed position) of a tilting disc heart valve at the moment of valve closure is presented. A Medtronic Hall valve in the mitral position of an in vitro experimental set up is employed to measure the transient pressure pulses near the entrance (ventricular side) and exit (atrial side) of the peripheral clearance at valve closure. Flow within the peripheral clearance is analyzed employing a two-dimensional quasisteady computational fluid dynamics model with the measured peak pressures specified as the boundary conditions inducing the flow. The valve is visualized from its inflow (atrial) side using a stroboscopic lighting technique to investigate the presence of cavitation bubbles within the clearance. The pressure measurements showed that a relatively large pressure drop exists between the entrance and the exit to the clearance for about 0.5 msec at the moment of valve closure. The numerical simulation resulted in relatively large magnitudes of wall shear stress and pressure reduction within the clearance due to the flow established by the large pressure drop between the entrance and the exit. Cavitation bubbles visualized within the peripheral clearance at higher loading rates for valve closure correlated with the presence of large pressure reduction within the clearance. Analysis of the results of this study indicates that the back flow through the clearance at the instant of valve closure may contribute toward injury to formed elements in blood in spite of the short duration of the flow.

Biomechanical Phenomena↗
PubMedDate not supplied

Dynamics of a mechanical monoleaflet heart valve prosthesis in the closing phase: effect of squeeze film.

An analysis of the dynamics of a mechanical monoleaflet heart valve prosthesis in the closing phase is presented. The backflow velocity of the fluid and the pressure distribution on the occluder during the closing phase were computed using a control volume approach in the unsteady state. Using moment equilibrium principles on the occluder motion and the squeeze film dynamics of the fluid between the occluder and the guiding strut at the instant of impact, the velocity of the occluder tip and the impact force between the occluder and the guiding struts were computed. The dynamics of fluid being squeezed between the occluder and the guiding struts are accounted for by Reynolds' equation. The effect of the fluid being squeezed between the occluder and the guiding strut was to reduce the velocity of the occluder tip at the instant of valve closure as well as to dampen the fluttering of the occluder before coming to rest in the fully closed position. The squeeze film fluid pressure changed rapidly from a high positive value (10 MPa) to a relatively large negative value (-15 MPa) in < 1 msec. The results of this study may be extended for the analysis of cavitation inception and mechanical stresses on the formed elements and valve components, as well as to estimate the endurance limits of prosthetic valves.

Biomechanical Phenomena↗
PubMedDate not supplied

Flow dynamics across end-to-end vascular bypass graft anastomoses.

In this article, a numerical simulation of steady flow across an end-to-end vascular bypass graft anastomosis is presented. In vitro experiments were performed to determine the variations in the conduit cross section at the anastomosis. Penrose surgical drainage tubing was used to simulate an artery and was anastomosed with Polytetrafluoroethylene (PTFE) vascular grafts using a continuous suturing technique. Artery to artery anastomosis was simulated by suturing two Penrose tubing segments. The anastomotic specimens were subject to static transmural pressure in the physiologic range to determine the instantaneous diameter and compliance as a function of the distance from the anastomotic site. The experimentally determined geometries were used to simulate steady flow through an end-to-end anastomosis using the finite analytic (FA) numerical solution technique. The results demonstrated a region of flow separation 2 mm distal to the Penrose tubing-Penrose tubing anastomosis (simulating an artery-artery anastomosis) at higher transmural pressures. Moreover, wall shear stresses increased proximal to the anastomosis in flow from the Penrose tubing to the graft. In flow from the graft to the Penrose tubing, low wall shear stresses were observed distal to the anastomosis. Flow separation was observed distal to the anastomosis at higher transmural pressures with uniform inlet velocity condition. The region of low shear stress in flow from PTFE graft to the Penrose tubing was located nearer to the anastomosis with thin wall grafts than that with standard wall thickness grafts. Our steady flow model studies suggest a correlation between regions of low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia in end-to-end anastomoses.

Anastomosis, Surgical↗
PubMedDate not supplied

A hypothesis regarding vascular acoustic emission accompanying arterial injury induced by balloon angioplasty.

Stress-induced structural damage is often accompanied by sound release. This behavior is known as acoustic emission (AE). We hypothesize that vascular injury such as that produced by balloon angioplasty is associated with AE. Postmortem human peripheral arterial specimens were randomly partitioned into test (n = 10) and control segments (n = 10). Test segments were inserted into a pressurization circuit and subjected to two consecutive hydrostatic pressurizations. Amplitude, frequency, and energy content of the AE signals released during pressurization were quantified. Test and matched control segments subsequently underwent identical histological processing. Pressure-induced tissue trauma was estimated via computerized histomorphometric analysis of the resulting slides (n = 100). Vascular acoustic emission (VAE) signals exhibited an amplitude range of +/- 5.0 mu bars and were observed to occur during periods of increasing intraluminal pressure. The VAE signal power within the monitored bandwidth was concentrated below 350 Hz. More than 25 times as much VAE energy was released during the first pressurization as during the second: 1,855 +/- 513.8 mJ vs. 73 +/- 44.9 mJ (mean +/- SEM, p < 0.006). Estimates of circumferential intimal wall stress at AE onset averaged 170 kPa, slightly below reported values of arterial tissue rupture strength. Histomorphometric estimates of tissue trauma was greater for the test than their matched control segments (p < 0.0001). These preliminary data suggest that detectable acoustic energy is released by vascular tissue subjected to therapeutic stress levels. Histological analysis suggest that the underlying source of sound energy may be related to tissue trauma, independent of histological preparation artifacts. From this preliminary work, we conclude that VAE may be a fundamental property accompanying vascular tissue trauma, which may have applications to improving balloon angioplasty outcomes.

Acoustics↗
PubMedDate not supplied

Hemodynamic comparisons of polyurethane trileaflet and bioprosthetic heart valves.

Hemodynamic comparison of two polyurethane prosthetic heart valves with a bioprosthetic valve is presented. The valves were incorporated in a pulse duplicator simulating physiologic pulsatile flow, and comparisons between the valves were made on the transvalvular pressure drop, percent regurgitation, valve orifice area, rate of opening and closing as well as the performance index. The results showed that the functional characteristics of the polyurethane valve compared favorably with that of the bioprosthetic valve. The polyurethane valve can be a viable and inexpensive alternative, especially for short-term use in a total artificial heart as a bridge to transplant.

Bioprosthesis↗
PubMedDate not supplied

Confirmation and initial documentation of thoracic and abdominal aortic helical flow. An ultrasound study.

Aortic helical flow may play an important role in plaque deposition, dissection formation, and organ perfusion. The authors have previously demonstrated, using in vitro flow models and transesophageal echocardiography, that helical flow begins in the mammalian aortic arch and continues into the descending thoracic aorta. The purpose of this study was to confirm thoracic aortic helical flow and document its extent into the abdominal aorta using direct measurements. Twelve mongrel dogs underwent surgery with exposure of the abdominal aorta up to the diaphragm. Six of the 12 underwent further thoracotomy with thoracic aorta exposure. Color Doppler ultrasound images were obtained using a 5 megaHz esophageal transducer, hand held, directly applied, and visually aligned for transverse aortic imaging. Helical flow was considered present with the appearance of red/blue hemicircles during a systolic wave when the aorta was imaged transversely. All six dogs that had thoracotomy showed clockwise thoracic aortic helical flow (along the direction of blood flow) at the retro left ventricular region. In all dogs, clockwise helical flow was demonstrated to and immediately beyond the renal arteries. In 11 of 12 dogs, clockwise helical flow was demonstrated 7 cm below the renal arteries. The study confirms the presence of helical flow in the thoracic aorta and documents its extent into the abdominal aorta below the level of the renal arteries. The teleologic flow pattern of mammals may extend to other classes of vertebrates and must be accounted for in studies of endothelial shear and flow separation. In addition, tangential velocities imparted by helical flow may affect organ perfusion.

Animals↗
PubMedDate not supplied

In vivo demonstration of cavitation potential of a mechanical heart valve.

Cavitation is implicated as the cause of pitting and erosion of explanted mechanical heart valves that failed. Previous in vitro studies demonstrated transient negative pressure spikes upstream of mechanical heart valves at the instant of leaflet closure. When the magnitude of the transient negative pressure spike is below the vapor pressure of the fluid flowing across the mechanical valve, cavitation bubbles have been documented near the valve housing or occluder disc. To test for the presence of transient negative pressure spikes that are conducive to cavitation in vivo, we measured left atrial pressure at the valve orifice after mitral valve replacement. Mitral valves were replaced with 27 mm prostheses in 10 goats (50-60 kg). Control animals (Group 1, n = 5) received pericardial valves. Study animals (Group 2, n = 5) received bileaflet pyrolytic carbon valves. Pressure was recorded from a high frequency atrial transducer at hyperdynamic and hypodynamic states. Transient negative pressure spikes did not occur in any Group 1 animal. Transient negative pressure spikes below the vapor pressure of blood (-713 mm Hg) were recorded in four of five Group 2 animals at the hyperdynamic state: -900, -950, -800, -400, and -1,400 mm Hg (p = 0.048 Group 1 versus Group 2, Fisher's exact test). No cavitation potential exists in vivo after bioprosthetic valve implantation. Transient negative pressure spikes below the vapor pressure of blood occur in vivo at hyperdynamic physiologic states when this bileaflet pyrolytic carbon valve is implanted in the mitral position. These studies demonstrate the potential for cavitation with implanted mechanical valves in vivo.

Animals↗