Three-dimensional flow analysis of a mechanical bileaflet mitral prosthesis.

The Jyros (JR) and the Advancing The Standard (ATS) valves were compared with the St. Jude Medical (SJM) valve in the mitral position to study the effects of design differences, installed valve orientation to the flow, and closing sounds using particle tracking velocimetry and particle image velocimetry methods utilizing a high-speed video flow visualization technique to map the velocity field. Sound measurements were made to confirm the claims of the manufacturers. Based on the experimental data, the following general conclusions can be made: On the vertical measuring plane which passes through the centers of the aortic and the mitral valves, the SJM valve shows a distinct circulatory flow pattern when the valve is installed in the antianatomical orientation; the SJM valve maintains the flow through the central orifice quite well; the newer curved leaflet JR valve and the ATS valve, which does not fully open during the peak flow phase, generates a higher but divergent flow close to the valve location when the valve was installed anatomically. The antianatomically installed JR valve showed diverse and less distinctive flow patterns and slower velocity on the central measuring plane than the SJM valve did, with noticeably lower valve closing noise. On the velocity field directly below the mitral valve that is normal to the previous measuring plane, the three valves show symmetrical twin circulations due to the divergent nature of the flow generated by the two inclined half discs; the SJM valve with centrally downward circulation is contrasted by the two other valves with peripherally downward circulation. These differences may have an important role in generation of the valve closing sound.