Potential Applications of Computational Fluid Dynamics for Predicting Hemolysis in Mitral Paravalvular Leaks

Abstract

Paravalvular leaks (PVLs) may lead to hemolysis. In vitro shear stress forces above 300 Pa cause erythrocyte destruction. PVL channel dimensions may determine magnitude of shear stress forces that affect erythrocytes; however, this has not been tested. It remains unclear how different properties of PVL channels contribute to presence of hemolysis. A model of a left ventricle was created based on data from computer tomography with Slicer software PVLs of various shapes and sizes were introduced. Blood flow was simulated using ANSYS Fluent software. The following variables were examined: wall shear stress, shear stress in fluid, volume of PVL channel with shear stress exceeding 300 Pa, and duration of exposure of erythrocytes to shear stress values above 300 Pa. In all models, shear stress forces exceeded 300 Pa. Shear stress increased with blood flow rates and cross-sectional areas of any PVL. There was no linear relationship between cross-sectional area of a PVL and volume of a PVL channel with shear stress > 300 Pa. Blood flow through mitral PVLs is associated with shear stress above 300 Pa. Cross-sectional area of a PVL does not correlate with volume of a PVL channel with shear stress > 300 Pa and duration of exposure of erythrocytes to shear stress > 300 Pa.

Prediction of Hemodynamic-Related Hemolysis in Carotid Stenosis and Aiding in Treatment Planning and Risk Stratification Using Computational Fluid Dynamics

“…The information obtained thanks to imaging methods allowed for the visualization of stenoses and the creation of accurate CFD simulation models. CFD simulations can be a valuable tool in a wide range of blood flows in the circulatory system [10,27,[63][64][65][66][67][68][69][70][71][72][73], providing valuable information for physicians. CFD can provide information on high shear stress [10,[63][64][65], which is one of the factors causing blood hemolysis, which negatively affects patients' health [74].…”

“…CFD simulations can be a valuable tool in a wide range of blood flows in the circulatory system [10,27,[63][64][65][66][67][68][69][70][71][72][73], providing valuable information for physicians. CFD can provide information on high shear stress [10,[63][64][65], which is one of the factors causing blood hemolysis, which negatively affects patients' health [74]. In addition, computational methods allow for the improvement of stents [75][76][77][78][79][80][81][82] used in PCI, or allow one to obtain "virtual" results of FFR measurements [83][84][85][86][87][88].…”

Quality of life after percutaneous paravalvular leak closure – a prospective registry

“…LDH is a marker of hemolysis and has to be assessed after every percutaneous PVL closure, because in some cases hemolysis develops de novo or worsens after the procedure [ 3 ]. Based on computational fluid dynamics simulations we recently reported that some degree of hemolysis is always present in the case of PVLs even when this pathology does not manifest clinically [ 23 ]. Therefore it is expected that successful closure should decrease LDH levels.…”

Mitral Paravalvular Leak 3D Printing from 3D-Transesophageal Echocardiography

“…Studies are underway to better understand how various properties of PVL channels can influence the likelihood of hemolysis. 11 The success of those complex structural procedures may depend on efficient multimodality imaging, which includes not only echocardiography and CCT but also novel imaging technologies such as 3D printing. 12–14…”