Recent groundbreaking work by Kilner et al.  demonstrated that a healthy functioning heart redirects the flow through the left ventricle (LV) in an asymmetric manner, which results in an energy conserving mechanism. Heart valve replacement alters the physiological operation of the heart significantly affecting its hemodynamic performance. As a result, orientation and valve design could play a significant role in the energy efficient operation of the heart; therefore, orienting MHVs so that flow disturbances are minimized enhances the hemodynamic performance of the LV.
Characterization of Hemodynamic Performance and Degree of Flow Redirection in the Left Ventricle Dependent on the Mitral Mechanical Heart Valve Orientation
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Pierrakos, O, Vlachos, PP, Telionis, DP, Yazdani, S, & Etebari, A. "Characterization of Hemodynamic Performance and Degree of Flow Redirection in the Left Ventricle Dependent on the Mitral Mechanical Heart Valve Orientation." Proceedings of the ASME 2002 International Mechanical Engineering Congress and Exposition. Advances in Bioengineering. New Orleans, Louisiana, USA. November 17–22, 2002. pp. 275-276. ASME. https://doi.org/10.1115/IMECE2002-32570
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