High-Resolution Measurements of Leakage Flow Inside the Hinge of a Large-scale Bileaflet Mechanical Heart Valve Hinge Model

Purpose It is believed that non-physiological leakage flow through hinge gaps during diastole contributes to thrombus formation in Bileaflet Mechanical Heart Valves (BMHVs). Because of the small scale and difficulty of experimental access, fluid dynamics inside the hinge cavity has not yet been characterised in detail. The objective is to investigate small-scale structure inside the hinge experimentally, and gain insight into its role in stimulating cellular responses. Methods An optically accessible scaled-up model of a BMHV hinge was designed and built, preserving dynamic similarity to a clinical BMHV. Particle Image Velocimetry (PIV) was used to visualize and quantify the flow fields inside the hinge at physiological Reynolds number and dimensionless pressure drop. The flow was measured at in-plane and out-of-plane spatial resolution of 32 and 86 μ m, respectively, and temporal resolution of 297 μs. Results Likely flow separation on the ventricular surface of the cavity has been observed for the first time, and is a source of unsteadiness and perhaps turbulence. The shear stress found in all planes exceeds the threshold of platelet activation, ranging up to 168 Pa. Conclusions The scale-up approach provided new insight into the nature of the hinge flow and enhanced understanding of its complexity. This study revealed flow features that may induce blood element damage.