Quantitation of the turbulent stress distribution downstream of normal, diseased and artificial aortic valves in humans.
Damage to blood corpuscles seems to be related to the magnitude and exposure time of the turbulent shear stresses (TSS). According to in vitro studies the critical TSS level for lethal erythrocyte and thrombocyte damage is 150-400 N/m2, for exposure times within physiological ranges. To study the distribution of TSS in the human ascending aorta, a hot-film anemometer needle probe was used to register blood velocities at 41 evenly distributed measuring points in the cross-sectional area 5-6 cm downstream of the aortic annulus. Measurements were made in the ascending aorta after normal aortic valves (prior to coronary bypass surgery), after stenotic aortic valves, and after implantation of either St. Jude Medical or Starr Edwards Silastic Ball valves. Three-dimensional visualization of velocity profiles were performed and Reynolds normal stresses (RNS) were calculated within 50-ms overlapping time windows in systole. By coordinating the mean RNS for each time window and for all 41 measuring points, 2-dimensional color-coded mapping of the RNS distribution was made. Based on the velocity profiles and the RNS distribution a relative blood damage index (RBDI) was calculated to incorporate the magnitude and exposure time for RNS in the entire cross-sectional area into one parameter. Turbulent shear stresses were estimated by using a previously determined correlation equation between RNS and TSS. After normal aortic valves, RNS was below 4 N/m2.(ABSTRACT TRUNCATED AT 250 WORDS)
Nygaard
H
H
Department of Thoracic and Cardiovascular Surgery, Skejby Sygehus, Aarhus University Hospital, Denmark.
Paulsen
P K
PK
Hasenkam
J M
JM
Kromann-Hansen
O
O
Pedersen
E M
EM
Rovsing
P E
PE
D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000503:physiopathology / Q000601:surgery*; D001783:Blood Flow Velocity / Q000502:physiology; D003196:Computer Graphics; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D006439:Hemodynamics / Q000502:physiology*; D006461:Hemolysis / Q000502:physiology; D006801:Humans; D017078:Laser-Doppler Flowmetry / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology*; D011474:Prosthesis Design; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*