The effects of implantation techniques on platelet activation in a mechanical heart valve - A numerical study

A numerical simulation of pulsatile turbulent flow was conducted past a St. Jude Medical MHV in the aortic position, to study the effects of valve implantation technique on the tnromboembolic potential of the valve. The effects of valve orientation and the suturing technique employed were examined in terms of the thromboembolic potential of the valve. It was demonstrated that the combination of a valve that is not aligned with the axis of the blood flow and subannularly sutured pledgets, produced accelerating jet flow through the valve orifices and a wider wake of periodic shed vortices in the valve's leaflets wake. Platelets paths that exposed the platelets to the highest shear levels led them to entrapment within the shed vortices, indicating an increased risk of cardioembolism via the potential free emboli formation in the wake.