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4D Flow MRI quantification of blood flow patterns, turbulence and pressure drop in normal and stenotic prosthetic heart valves
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Kangwon Natl Univ, South Korea.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery. Linköping University, Center for Medical Image Science and Visualization (CMIV). Oslo Univ Hosp, Norway.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping. Linköping University, Center for Medical Image Science and Visualization (CMIV).ORCID iD: 0000-0003-1395-8296
2019 (English)In: Magnetic Resonance Imaging, ISSN 0730-725X, E-ISSN 1873-5894, Vol. 55, p. 118-127Article in journal (Refereed) Published
Abstract [en]

Purpose: To assess valvular flow characteristics and pressure drop in a variety of normal and stenotic prosthetic heart valves (PHVs) using 4D Flow MRI. Materials and methods: In-vitro flow phantoms with four different PHVs were studied: Medtronic-Hall tilting disc, St. Jude Medical standard bileaflet (STJM), Medtronic CoreValve Evolut R and Edwards SAPIEN 3. The valvular flow characteristics were investigated in normal and stenotic PHVs by using 4D Flow MRI. Results: The results showed that each valve provided a different amount of signal loss in the 4D Flow MRI. The defect size of the signal loss from each valve was 37.5 mm, 39.0 mm, 37.5 mm and 51.0 mm for the Tilting disk, STJM, SAPIEN 3 and CoreValve, respectively. The 4D Flow MRI-based estimation of the elevation of the pressure drop through the stenotic PHV using both Bernoulli-based and turbulence-based methods correlated well with the true values for the Tilting disc, STJM and SAPIEN 3 valve. However, the obstructive hemodynamics in the stenotic CoreValve was not clearly identified due to the large signal void from the long struts, resulting in a severe underestimation of the pressure drop using 4D Flow MRI. Conclusion: The Tilting disc, STJM and SAPIEN 3 valves provided reasonable estimates of peak velocity, turbulence production and the corresponding pressure drop. In contrast, the large strut of the CoreValve and corresponding signal void prevented accurate measurements of the velocity and turbulence production; therefore, 4D Flow MRI prediction of the pressure drop through the CoreValve was not feasible.

Place, publisher, year, edition, pages
ELSEVIER SCIENCE INC , 2019. Vol. 55, p. 118-127
Keywords [en]
Turbulence; Reynolds stress; Pressure drop; Magnetic resonance imaging; Phase contrast MRI; 4D PC-MRI; 4D Flow MRI
National Category
Medical Laboratory and Measurements Technologies
Identifiers
URN: urn:nbn:se:liu:diva-153497DOI: 10.1016/j.mri.2018.09.024ISI: 000452245800014PubMedID: 30266627OAI: oai:DiVA.org:liu-153497DiVA, id: diva2:1274653
Note

Funding Agencies|European Union Seventh Framework Programme, European-Union (FP7/2007-2013) [310612]; Swedish Research Council, Sweden [2013-6077, 2014-6191]; Basic Science Research Program through the National Research Foundation of Korea, South Korea (NRF) - Ministry of Education [2018R1D1A1A02043249]

Available from: 2019-01-02 Created: 2019-01-02 Last updated: 2019-03-25

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The full text will be freely available from 2019-09-26 11:27
Available from 2019-09-26 11:27

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Ha, HojinEscobar Kvitting, John-PederDyverfeldt, PetterEbbers, Tino
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Division of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of Thoracic and Vascular SurgeryCenter for Medical Image Science and Visualization (CMIV)Department of Clinical Physiology in Linköping
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