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Title: Study of haemodynamics of Chitra Valve in mitral position- a single centre experience
Authors: Kiran Chowdlu Kalappa
Issue Date: Dec-2019
Publisher: SCTIMST
Abstract: In India, a large number of people suffer Rheumatic heart disease and related complications. It is estimated that six out of every 1000 children suffer Rheumatic fever between the age of five and fifteen years. The major cause of long term morbidity and mortality due to Rheumatic fever is the result of heart valve dysfunction. Valve replacement is considered the therapy to avoid risk of heart failure and death. Although mechanical heart valves (MHV) have evolved a level of universal acceptance, they have never reached a level of performance comparable to that of the natural valve of the heart. Consequently mechanical heart valve implantation is not always an ideal solution. There is continual obligation to better understand the mechanical behaviour of mechanical heart valves in vitro and in vivo, to study the effects and presence of thrombosis, haemolysis, cavitation, transvalvular pressure fluctuations, high level of stress and certainly the association and interaction of all these conditions. Apparently the flow through pivoted leaflets of mechanical heart valves induces a combination of flow characteristics, which are clearly dependent on the specific valve design and orientation that could result too many pathological condition. All these conditions reduce the efficiency of the heart being in a state far from natural. Clinical practice has demonstrated that the orientation of MHV's greatly effects the postoperative performance of the left ventricle. The second most common heart operation is valve replacement surgery. Cardiac valve are intended to fully replace a diseased natural valve and thus replacement has been established clinical practice for more than four decades. Today more than 1.5 lakh valves are replaced worldwide per year. The most commonly replaced valves are the mitral and aortic valves due to the high pressure loads on the left atrium and left ventricle of the heart. Any of the four valves can become either too leaky (regurgitation) or too tight (stenotic). The two major problems related to the blood flow are thrombus formation and haemolysis, which damage the red blood cells. It is well known that the shear stress in the fluid and the flow separation around the valve are blamed for such disastrous phenomenon, therefore, it is obvious that there is a need for more effective heart valve to be designed to present these types of situation from occurring.
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