Study of haemodynamics of Chitra Valve in mitral position- a single centre experience
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Date
2019-12
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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.