An in-vitro investigation of prosthetic heart valve cavitation in blood.

Vapor cavities produced by low pressure fluid flow conditions have been observed in the vicinity of mechanical heart valves for many years. As cavities collapse during pressure recovery, they can produce stresses large enough to cause pitting of the valve occluders and lysing or activation of blood cells. To date, no method has been presented for the quantification of mechanical heart valve cavitation in blood because it has only been detected optically in transparent blood analog fluids. This paper describes a novel method for quantifying cavitation intensities in opaque fluids such as blood. It is based on the detection of high frequency pressure oscillations (35-350 kHz) at a location 4.5 cm proximal to a Björk-Shiley monostrut mitral valve in a mock circulatory loop driven by a Penn State Electric Ventricular Assist Device. The pressure oscillations which result from cavity collapse are used to quantify cavitation intensities in blood. One time domain and three frequency domain parameters have been developed to quantify cavitation intensity during a single valve closure event and over an ensemble of closure events. The time domain parameter is the Root Mean Squared (RMS) value of the pressure signal after it has been high-pass filtered at 35 kHz. The other three parameters are derived from the power spectrum of the pressure signal. One is the maximum value of the power spectrum between 100 and 200 kHz, another is the area under the power spectrum between 35 and 400 kHz, and the last is the volume under a 3-dimensional time vs. frequency vs. power spectrum plot. The parameters are averaged over a random sample of pressure traces to determine an average cavitation intensity for each operating condition studied. In addition, cavitation pressure fluctuations and hemolysis rates were determined simultaneously at several different mock flow loop operating conditions using porcine blood, and the relationships between various measures of cavitation intensity and the associated index of hemolysis have been established. Hemolysis was shown to increase with cavitation intensity.