Analysis of Energy and Pressure in the Sinus with Different Blood Pressures after Bioprosthetic Aortic Valve Replacement.

Vogl, Brennan; Sularz, Agata; Ahn, Sunyoung; Gadhave, Rajat; Lilly, Scott; Thourani, Vinod; Lindman, Brian; Alkhouli, Mohamad; Hatoum, Hoda

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 ( ∇ 2 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, ∇ 2 P , and EDR. With an elevated DBP, there was an increase in the total coronary flow and ∇ 2 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.

HEART valve prosthesis implantation; PARTICLE image velocimetry; AORTIC valve transplantation; DIASTOLIC blood pressure; SYSTOLIC blood pressure

Annals of Biomedical Engineering, 2024, Vol 52, Issue 12, p3228

0090-6964

Academic Journal

10.1007/s10439-024-03587-w