A Three-dimensional Analysis of Flow in the Pivot Regions of an ATS Bileaflet Valve

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Abstract
Bileaflet heart valves are currently the most commonly implanted type of mechanical prosthetic valve, because of their low transvalvular pressure drop, centralised flow and durability. However, in common with all mechanical heart valves, implanted bileaflet valves show an inherent tendency for blood clot formation at the valve site. Fluid dynamical phenomena associated with blood clotting are elevated blood shear stresses and regions of persistent blood recirculation, particularly when both occur together. Using three-dimensional CFD modelling, combined with enlarged scale experimental modelling, we investigated the blood flow through the ATS bileaflet valve during forward flow, with particular attention to the leaflet pivot regions. Recirculating regions were found both within and downstream of the valve housing ring. Qualitative assessment of the entire cardiac cycle suggested that recirculating blood within the housing ring will be washed away whilst the valve is closed, but as with all bileaflet valve designs recirculating blood downstream of the valve may have a residence time much longer than one cardiac cycle.