Transient pressure at closing of a monoleaflet mechanical heart valve prosthesis: mounting compliance effect.

An in vitro experimental study was performed to investigate the mounting compliance effect on the occluder closing dynamics and the transient pressure at the closing of the mitral Medtronic Hall (MH) mechanical heart valve (MHV). The closing velocity and the transient pressure were simultaneously measured at heart rates of 70, 90, 120, and 140 beats/minute with cardiac outputs of 5.0, 6.0, 7.5, and 8.5 liters/minute, respectively. The experiment was conducted under simulated physiologic ventricular and aortic pressures in a pulsatile mock flow loop. The characteristics of the transient pressure were investigated by detailed mapping of the transient pressure field in the atrial chamber using high frequency pressure transducers. Simultaneous measurements of the occluder closing velocity and the transient pressure around the seat stop of the MH showed that the transient pressure generated on the inflow side dropped below the vapor pressure of liquid during the occluder's sudden deceleration at closing. The amplitude of the transient pressure reduction (TR) was proportional to the occluder approaching velocity. The development of the transient pressure in the rigid and flexible mountings were significantly different. In the rigid mounting (RM), the pressure was reduced below the liquid's vapor pressure and maintained below -350 mmHg for approximately 180 microseconds. Strong signals of high frequency pressure oscillations (HPO) were recorded in the transient pressure traces. The timing of the HPO was found to be consistent with that of the cavitation bubble collapse as observed by others. In the flexible mounting (FM), TR also occurred, but recovered quickly and was followed immediately by a positive pressure spike. Relatively weak HPO appeared in the transient pressure trace. The mapping of the transient pressure field showed that both the transient pressure reduction (on the major orifice side) or rise (on the minor orifice side) as well as the HPO were locally generated near the valve occluder surface. The transient pressure attenuated with distance away from the occluder surface. The HPO were detectable as far as 40 mm away from the occluder surface. The rigid mounting pressure signals showed characteristically two occurrences of high frequency pressure oscillations. The HPO with smaller amplitude occurred first after the initiation of the TR, followed by a burst of strong HPO at about 450 microseconds. It is believed that they were the result of the collapse of cavitation bubbles. The strong HPO did not appear in the flexible mounting signals. The study indicated that the mounting compliance played a significant role in the MHV cavitation inception and the subsequent bubble growth. It also suggested the possibility of detecting the cavitation by using a high frequency pressure transducer positioned in the atrial chamber.