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Biomedical subjects

N H Hwang

Publications and source records attributed to N H Hwang.

70 records · Page 4Linked to original sources
PubMedDate not supplied

Transient pressure signals in mechanical heart valve cavitation.

The purpose of this investigation was to establish a correlation between mechanical heart valve (MHV) cavitation and transient pressure (TP) signals at MHV closure. This correlation may suggest a possible method to detect in vivo MHV cavitation. In a pulsatile mock flow loop, a study was performed to measure TP and observe cavitation bubble inception at MHV closure under simulated physiologic ventricular and aortic pressures at heart rates of 70, 90, 120, and 140 beats/min with corresponding cardiac outputs of 5.0, 6.0, 7.5, and 8.5 L/min, respectively. The experimental study included two bileaflet MHV prostheses: 1) St. Jude Medical 31 mm and 2) Carbomedics 31 mm. High fidelity piezo-electric pressure transducers were used to measure TP immediately before and after the valve leaflet/housing impact. A stroboscopic lighting imaging technique was developed to capture cavitation bubbles on the MHV inflow surfaces at selected time delays ranging from 25 microseconds to 1 ms after the leaflet/housing impact. The TP traces measured 10 mm away from the valve leaflet tip showed a large pressure reduction peak at the leaflet/housing impact, and subsequent high frequency pressure oscillations (HPOs) while the cavitation bubbles were observed. The occurrence of cavitation bubbles and HPO bursts were found to be random on a beat by beat basis. However, the amplitude of the TP reduction, the intensity of the cavitation bubble (size and number), and the intensity of HPO were found to increase with the test heart rate. A correlation between the MHV cavitation bubbles and the HPO burst was positively established. Power spectrum analysis of the TP signals further showed that the frequency of the HPO (cavitation bubble collapse pressures) ranged from 100 to 450 kHz.

Biomedical Engineering↗
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Bileaflet mechanical heart valves at low cardiac output.

Several earlier studies have indicated that bileaflet mechanical heart valves behave irregularly at low cardiac output and low pulse rate conditions, and that their hydrodynamic performances are generally inadequate. The authors conducted in vitro experiments in a pulsatile mock circulatory loop to compare the performance of the St. Jude Medical (SJM) valve and a long body bileaflet prosthesis recently introduced by Medical Carbon Research Institute (MCRI) (Austin, TX). The new MCRI mechanical heart valve model was designed with emphasis on improved hydrodynamic efficacy by introducing a long body with parallel leaflets and by leaflets increasing the flow area. Experimental studies were conducted on five test valves (MCRI 19 mm, MCRI 25 mm, SJM 19 mm, SJM 23 mm, and SJM 29 mm) with cardiac outputs of 2.0, 2.5, 3.0, and 3.5 L/min at a pulse rate of 40 beats/min, and 3.5, 4.0, 4.5, and 5.0 L/min at a pulse rate of 70 beats/min. Transvalvular pressure drop and closure volume were assessed by measuring the instantaneous ventricular and aortic pressures and aortic flow. The leaflet motions of the tested valves were observed by direct video recording using a charge coupled device camera while the flow measurements were being conducted. Testing under simulated physiologic ventricular and aortic pressure waveforms, the results of this study show that the MCRI bileaflets remained fully open during the entire ejection phase, even at very low cardiac output conditions (2.0 L/min). The closure volume (defined as percentage of forward flow volume) increased with decreasing cardiac output, as reported earlier by others. Comparative results also indicate that the MCRI design has nearly a two size pressure drop advantage over the SJM, with significantly smaller closure volume.

Blood Flow Velocity↗
PubMedDate not supplied

Time-frequency analysis of transient pressure signals for a mechanical heart valve cavitation study.

A series of transient pressure signals (TPSs) can be measured using a miniature pressure transducer mounted near the tip of the inflow side of a mechanical heart valve (MHV) occluder during closure. A relationship appears to exist between the intensity and pattern of the TPS and the cavitation potential of a MHV. To study the relationship between MHV cavitation and the TPSs, we installed an MHV in a valve testing chamber of a digitally controlled burst test loop. A charge coupled device (CCD) camera and a personal computer based image grabbing program was used to visualize cavitation bubbles appearing on or near the occluder surface. One bileaflet MHV was used as the model for this study. Cavitation bubbles were observed within 300 microsec of the leaflet/housing impact. The valve was tested at various driving pressures between 100 and 1,300 mmHg. MHV cavitation bubble intensities were qualitatively classified into three categories: 1) strong, 2) weak, and 3) none. Digital images of the MHV occluder inflow surface were recorded simultaneously with the TPSs. TPSs were studied by the time-frequency analysis method (spectrogram) and correlated to MHV cavitation potential. The intensity of the cavitation bubbles was found to be associated with burst test loop driving pressures during leaflet closure.

Biophysical Phenomena↗
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Application of an unstructured grid algorithm to artificial heart valve simulations.

The time varying flow pattern in the vicinity of mechanical heart valves (MHV) is fairly complex: it involves multiple passages and moving leaflets. The numeric simulation of unsteady flows in these multiple passages with moving boundaries presents a major challenge to computational fluid dynamics (CFD). Two major difficulties in the numeric simulation of MHV flows are 1) the generation of a body fitted grid within the multipassage device and 2) moving leaflets. The conventional finite difference and finite volume scheme obtained by using a structured grid have serious deficiencies in these applications. To fit the grid lines with the various angles of the moving MHV, the grid may often become too skewed for accurate numeric solution. To overcome these deficiencies, significant effort and attention should be placed on the grid generation and moving grid scheme. We present an unstructured moving grid finite volume method for heart valve simulations. The Navier-Stokes equations are discretized on a general tetrahedral mesh by using a finite volume scheme. With this scheme, the mesh can be automatically generated with any commercial software. The method is applied to a tilting disk (Medtronic Hall 29mm, Medtronic, Inc., Minneapolis, MN) heart valve, and results are compared with that of the steady flow solutions. Significant differences between steady and unsteady flow solutions are observed.

Algorithms↗
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On transport of suspended particulates in tube flow.

Blood cells suspended in shear flows exhibit much larger dispersive motions than those predicted by the Stokes-Einstein formula for Brownian diffusion. The lateral migration and the erratic motions of the 8 microns red blood cells (RBC) is thought to be analogous to a diffusive process. It is shown that the often cited convective-diffusion theory may not be an adequate model for describing the transverse migration of suspended cells in blood flow. A comprehensive review of both the classical theory and of contemporary work in particle transport is presented, with particular emphasis on low Reynolds number tube flows. The mechanisms of Taylor dispersion, the effects of Brownian perturbations on translational and rotational motions of the suspended particles in shear fields, and the influence of integratable and chaotic advections, are individually examined. The classical experiment by Segre and Silberberg (1962) lead us to believe that particle hydrodynamics may play an important role in transverse migrations. In this light, we have further examined the hydrodynamic aspects of the so-called "tubular pinch" effect, the lateral migration of rigid spheres. We have also discussed the transverse motions of liquid drops, and the reversibility of the organization of suspensions in transport. The convective accelerations in the entrance region of a tube can produce relative velocities between fluid medium and various type of particulates if there is a difference in density. The deformable RBC, an "active-type" particle, can provide feedback to the flow from both mass and momentum considerations; the more rigid platelet, a "passive-type" particle, will experience a much smaller relative velocity as compared to the RBC. We may expect that particles of different densities are transported to different equilibrium annular positions before entering the fully developed flow region. The erratic, lateral movement of suspended particulates in steady laminar tube flow can be described by the usual Lagrangian coordinates.

Biological Transport↗
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On the transport of a suspended particle in flow through the entrance region of a tube.

The motion of a single, spherical particle, released at different radial positions at the inlet of the entrance region of a straight circular laminar flow tube (Re = 260), was studied theoretically. Radial migration of the particle, either toward the tube center or toward the tube wall, was predicted. Based on the hypothesis that the particle experienced a lift force which was produced by the vorticity in the boundary layer and a velocity difference between the center of the suspended particle and the fluid medium, an inertia-vorticity fluid dynamic model was formulated to analyze the particle radial motions. Computational flow dynamics (CFD) solutions obtained from a 9.8 mm diameter tube model included the resulting particle loci for three particle radii (a = 0.1 cm, 0.085 cm, 0.050 cm), with the particle entry at various radial positions. The computation also covered a range of different particle entry speeds. The results showed that the particle migrates toward the tube center if it lags behind the medium in the core region; otherwise, it migrates toward the tube wall. Additional flow experiments were conducted in a circular (2R = 10.2 mm), 300 mm long straight tube. A small polystyrene sphere (2a = 1.72 mm, density rho p = 1.014 g.cm-3) was released at the inlet (X = 0, eta/R = 0.48) with two dimesionless release velocities (omega p = 0, and omega p > 1.0). The recorded particle traces agree well with the computational model.

Animals↗
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Venturi pressure cannot cause cavitation in mechanical heart valve prostheses.

Surface pitting of certain mechanical heart valve (MHV) explants has prompted investigation into possible causes of cavitation during MHV operation. Leaflets of a 29 mm MHV were glued shut with B-datum (BD) gaps fixed at 0.0089, 0.0174, and 0.0219 cm. Each BD gap setting was tested in a steady flow chamber, with leakage flow established at transvalvular pressures (delta P) of 20 to 200 mmHg. Laser Doppler velocimeter (LDV) velocity measurements were recorded 220 microns distal to the BD, along with leakage flowrates. Maximum LDV velocities were compared with those calculated using the mass conservation equation. At identical P, the LDV flow velocities for the three BD settings were found to be approximately equal. This indicates a geometric independence of the leakage flow velocity. At atmospheric pressure, the local velocity necessary to cavitate blood as a liquid is approximately 13 m/sec. These results demonstrate that the leakage velocity is insufficient to cause cavitation. A simplified theoretical model is proposed to illustrate the necessary delta P to produce Venturi related cavitation.

Blood Flow Velocity↗
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The closing velocity of Baxter Duromedic heart valve prostheses.

The closing velocity of a mechanical heart valve (MHV) leaflet has been conventionally related to the valve sound, and possibly to recently observed MHV cavitation phenomenon. Presently, the MHV leaflet terminal closing velocity has been indirectly assessed either by listening to the valve sound and/or averaging over the closing period. Leaflet motion during the closing phase is not uniform. Using a laser sweeping technique developed in this laboratory, an experimental study was carried out to analyze the closing motion of Baxter Duromedic (DM) 29 mm mitral MHVs. The results were compared with that of a St. Jude Mechanical (SJ) 29 mm mitral MHV, using the same technique. The in vitro experiment was carried out by mounting the testing MHV at the mitral position of a mock circulatory testing facility, with heart rates ranging from 70-120 beats/min, ventricular pressure slopes (dp/dt) from 1800-5600 mmHg/sec, and cardiac outputs from 5.0-7.5 liters/min. This paper introduces the laser sweeping technique developed for precision monitoring of MHV leaflet motion, and presents the detailed leaflet motions within the last 3 degrees before final closure. The experimental results showed that the final closing velocity of DM, which is known to generate a louder valve sound and has a shorter closing period than that of SJ, actually has approximately the same closing velocity within the range of the experiment. Theoretical analysis further confirms that a short closing period may not lead to a higher leaflet final closing velocity.

Biomechanical Phenomena↗
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Flow phenomena in compliant and noncompliant arteriovenous grafts.

Oscillatory flows at venous anastomoses of two end-to-side angioaccess grafts were studied using: 1) a noncompliant Gore-Tex polytetrafluoroethylene (PTFE) graft and 2) a longitudinal compliant Ultraflex graft. The study was done in a transparent flow model fabricated from a femoral-to-femoral arteriovenous loop graft (AVLG) surgically implanted in dogs. The 6 mm x 25 cm loop graft reproduces that of the brachial artery-cephalic vein hemodialysis angioaccess loop graft commonly used in patients. At a pulse rate of 70 beats/min and blood flow of 0.7 L/min, flow visualization was done using a 15 mW He-Ne laser and a cylindrical lens system which converts the incident laser beam into a thin parallel light plane. Hydrogen bubble technique was used to illustrate the flow field at selected planes. Phasic pressure and flow oscillations were observed in the hypertensive host vein. The pressure wave arrived at the venous anastomosis with higher amplitude and shorter time of travel in the Gore-Tex graft than in the Ultraflex graft. The differences in wave attenuations and wave transmission time between grafts resulted in apparent changes of flow pattern in both the proximal (heart side) and distal (foot side) veins. The negative lags between the flow peaks in the distal vein and proximal artery are explained by the phasic pressure gradients measured at the anastomoses. Spectral analysis was done on the venous thrills, which are characteristic of almost all clinical AVLG implants. The power spectra taken at 60, 70, 90, and 120 beats/min clearly demonstrated a concentration of fluctuation energy at about 100 Hz in the Gore-Tex AVLG.

Animals↗
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Vortex shedding in bileaflet heart valve prostheses.

A dynamic study of two geometrically similar bileaflet heart valve prostheses (HVP) was performed using a physiologic mock circulatory flow loop. The HVPs studied were the 25 mm St. Jude Medical (SJM) and the 25 mm Carbomedics (CMI) in the aortic position and the 27 mm SJM and 27 mm CMI in the mitral position. All data were collected at a heart rate of 70 beats/min and a cardiac output of 5.0 L/min. Flow visualization was conducted in the transparent flow chambers of the pulsatile mock circulatory flow loop using a 15 mW He-Ne laser light source. A cylindrical lens and optics system converted the incident laser beam into a thin parallel light plane, and 420 microns tracer particles were suspended in the testing fluid to illuminate the flow field at selected planes. Frame-by-frame analysis of the 16 mm high-speed cine provides detailed phasic flow patterns in the vicinity of the HVP. A series of still photographs of flow patterns, taken at approximately 22.5 degrees phase intervals, are sequentially presented for each HVP. In the aortic position, a Karman-like vortex pattern appears downstream of the SJM at the end of the ejection phase. The CMI exhibits a rather symmetrical ejection flow pattern that turns into random motion immediately after the onset of ejection. In the mitral position, the SJM again exhibits a strong core flow during ventricular filling, whereas the CMI produces a more diffuse pattern during the same period. A pair of vortices shed from both the SJM and CMI are clearly visible toward the end of the ventricular filling phase. The vortex mechanisms are discussed in light of leaflet boundary layer formation.

Aortic Valve↗
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Closing behavior of a new bileaflet mechanical heart valve.

Recently, the in vivo cavitation potential has become a primary concern among manufacturers of new mechanical heart valves (MHV). An experimental/computational program was designed to investigate each of the flow parameters involved. It was established that the closing velocity of the leaflet holds the key to MHV cavitation. One of the novel concepts of the new bileaflet mechanical heart valve (1205-MHV) was its ability to operate with a relatively small angular excursion that led to a much smaller closure velocity at impact (as compared with control valves). This is believed to significantly reduce the cavitation potential. The 1205-MHV is characterized by a longer valve body, with the hinges protruding further upstream. The unique design allows the valve the freedom to open as much as 90 degrees. The closure velocities are reduced by a smaller leaflet excursion (50 degrees), combined with a floating hinge that allows absorption of part of the impact energy at closure. The impact velocities of the 1205-MHV leaflets at closure were measured by a laser sweeping technique that monitored the leaflet closing motion with a precision of 5 microseconds within the last 3 degrees before impact. The 27 mm 1205-MHV (the largest size) was tested in the program by mounting the valve in the mitral position of a physiologic mock circulatory loop. The valve was tested at 70, 90, and 120 bpm. The results were compared with those of a St. Jude Medical 29 mm MHV. The closure velocities measured with the 1205-MHV were significantly lower than those measured with the control valve.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Flow Velocity↗
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Possible femoral "steal" syndrome following femoral-femoral bypass.

1. The results of a clinical study of two patients who exhibited transitory donor limb ischemia without angiographic evidence of donor limb occlusive arterial disease following femoral-femoral bypass has been reported. 2. Although the circulation seemed to have been diminished in the donor limb following creation of a femoral-femoral bypass, the acute development of ischemia, there may have been other causes for the donor limb ischemia.

Aged↗
PubMedDate not supplied

Dynamic characterization of a new accelerated heart valve tester.

This paper presents a new accelerated prosthetic heart valve tester prototype that incorporates a camshaft and poppet valves. A three element Windkessel system is used to mimic the afterload of the human systemic circulation. The device is capable of testing eight valves simultaneously at a rate up to 1,250 cycles/min, while the flow rate, the pressure, and the valve loading can be monitored and adjusted individually. The tester was characterized and calibrated using a set of eight Carpentier-Edwards bioprostheses at a flow rate varying between 3 and 5 L/min. The experiment was carried out with the pressure difference across the closed heart valve maintained between 140 and 190 mmHg. Smooth and complete opening and closing of the valve leaflets was achieved at all cycling rates. This confirms that the velocity profiles approaching the test valves were uniform, an important factor that allows the test valves to open and close synchronously each time.

Animals↗
PubMedDate not supplied

Hydrodynamics of a long-body bileaflet mechanical heart valve.

A new bileaflet substitute mechanical heart valve (MHV) that incorporates an optimal length-to-annulus ratio for improved hydrodynamic efficiency was recently introduced. Efforts have been made on this new prosthesis to use the current advances in carbon materials and design technology to achieve higher net forward flow with minimal energy loss for the smaller aortic valves, while reducing regurgitant closure volume for the larger size valves by an elongated orifice. Benchtop experiments performed in a pulsatile flow loop, under simulated physiologic conditions, substantiated these improvements as claimed.

Aortic Valve↗