Kevin D. Lau

Mitral valve dynamics in structural and fluid–structure interaction models

Modelling and simulation of heart valves is a challenging biomechanical problem due to anatomical variability, pulsatile physiological pressure loads and 3D anisotropic material behaviour. Current valvular models based on the finite element method can be divided into: those that do model the interaction between the blood and the valve (fluid–structure interaction or ‘wet’ models) and those that do not (structural models or ‘dry’ models). Here an anatomically sized model of the mitral valve has been used to compare the difference between structural and fluid–structure interaction techniques in two separately simulated scenarios: valve closure and a cardiac cycle. Using fluid–structure interaction, the valve has been modelled separately in a straight tubular volume and in a U-shaped ventricular volume, in order to analyse the difference in the coupled fluid and structural dynamics between the two geometries. The results of the structural and fluid–structure interaction models have shown that the stress distribution in the closure simulation is similar in all the models, but the magnitude and closed configuration differ. In the cardiac cycle simulation significant differences in the valvular dynamics were found between the structural and fluid–structure interaction models due to difference in applied pressure loads. Comparison of the fluid domains of the fluid–structure interaction models have shown that the ventricular geometry generates slower fluid velocity with increased vorticity compared to the tubular geometry. In conclusion, structural heart valve models are suitable for simulation of static configurations (opened or closed valves), but in order to simulate full dynamic behaviour fluid–structure interaction models are required.

Fluid-structure interaction study of the edge-to-edge repair technique on the mitral valve

The effect of functional mitral regurgitation has been investigated in an anatomically sized, fluid-structure interaction mitral valve model, where simulated correction has been performed by applying: (1) edge-to-edge repair with annuloplasty and (2) edge-to-edge repair only. Initially defined in an open unstressed/corrected configuration, fluid-structure interaction simulations of diastole have been performed in a rigid ventricular volume. Comparison of the maximum principal stresses (during diastole) in the normal and repaired models has shown that the magnitude of stress in the repaired scenarios is ~200% greater. The combined edge-to-edge and annuloplasty procedure was found to spread the induced stresses across the free margin of the leaflets, whereas without annuloplasty a localised stress concentration in the region of the suture was observed. Fluid flow downstream of the corrected configurations was able to achieve the same magnitude as in the normal case, although the flow rate was impaired. The maximum flow rate was found to be reduced by 44-50% with the peak flow rate shifted from the end of the diastole in the normal case to the start in the repaired cases.

Magnetic cell delivery for peripheral arterial disease: A theoretical framework

PURPOSE Our aim was to compare different magnet arrangements for magnetic cell delivery to human lower leg arteries and investigate the theoretical targeting efficiency under realistic flow conditions as a possible treatment after angioplasty. Additionally the potential of scaling down or translating the magnetic actuation device for preclinical studies was explored. METHODS Using finite element methods, the magnetic field distribution was calculated in 3D for the optimization of magnet arrangements. Computational fluid dynamics simulations were performed for the human posterior tibial artery with the geometry and boundary condition data derived from magnetic resonance imaging (MRI) studies. These simulations were used to trace the trajectories of cells for an optimized magnet arrangement. Additionally the behavior of cells close to the vessel wall was investigated using a fluid-structure interaction model. RESULTS The optimal magnet for the lower leg arteries was a Halbach cylinder k3 variety (12 elements with 900 rotation steps for the magnetization orientation). With this magnet, numerical simulations predict a targeting efficiency of 6.25% could be achieved in the posterior tibial artery for cells containing 150 pg iron. Similar simulations, which were scaled down to rabbit dimensions while keeping the forces acting on a cell constant, lead to similar predicted targeting efficiencies. Fluid dynamic and fluid-structure interaction simulations predict that magnetically labeled cells within a 0.5% radii distance to the vessel wall would be attracted and remain at the wall under physiological flow conditions. CONCLUSIONS First pass capture of magnetically labeled cells under pulsatile flow conditions in human lower leg arteries leads to low targeting efficiencies. However, this can be increased to almost 100% by stopping the blood flow for 5 min. A magnetic actuation device can be designed for animal models that generate magnetic forces achievable for cells in human leg arteries.

Fluid-Structure Interaction Simulation of the Edge-to-Edge Repair of the Mitral Valve in Functional and Degenerative States

The most common dysfunction of the mitral valve (MV) is mitral valve regurgitation (MVR) which accounts for approximately 70% of native MV dysfunction [1]. During closure, abnormal amounts of retrograde flow enter the left atrium altering ventricular haemodynamics, an issue which can lead to cardiac related pathologies. MVR is caused by a variety of different mechanisms which are either degenerative (myxomatous degeneration) or functional (annular dilation or papillary muscle displacement) [2]. Correction of MVR is performed by repairing existing valve anatomy or replacement with a prosthetic substitute, however repair is preferred as mortality rates are reduced (2.0% against 6.1% for replacement) along with other valve related complications [3]. A common and popular method of repair is the edge-to-edge repair (ETER), which aims to correct MVR by surgically connecting the regurgitant region through reducing the inter-leaflet distance. Although MV function is improved in systole, induced stresses are significantly increased in diastole where the MV is typically in a low state of stress. In order to assess the effect of this technique in diastole, where the dynamics of both the MV and ventricular filling are disrupted it is required to use fluid-structure interaction (FSI) modelling techniques. Here a FSI model of the of the MV has been described, using this model the resulting induced stresses from the ETER in both functional and degenerative states of the MV have been simulated and assessed using the explicit finite element code LS-DYNA.© 2012 ASME

Magnetic cell delivery for peripheral arterial disease: A theoretical framework: Magnetic cell delivery to lower leg arteries

PURPOSE Our aim was to compare different magnet arrangements for magnetic cell delivery to human lower leg arteries and investigate the theoretical targeting efficiency under realistic flow conditions as a possible treatment after angioplasty. Additionally the potential of scaling down or translating the magnetic actuation device for preclinical studies was explored. METHODS Using finite element methods, the magnetic field distribution was calculated in 3D for the optimization of magnet arrangements. Computational fluid dynamics simulations were performed for the human posterior tibial artery with the geometry and boundary condition data derived from magnetic resonance imaging (MRI) studies. These simulations were used to trace the trajectories of cells for an optimized magnet arrangement. Additionally the behavior of cells close to the vessel wall was investigated using a fluid-structure interaction model. RESULTS The optimal magnet for the lower leg arteries was a Halbach cylinder k3 variety (12 elements with 900 rotation steps for the magnetization orientation). With this magnet, numerical simulations predict a targeting efficiency of 6.25% could be achieved in the posterior tibial artery for cells containing 150 pg iron. Similar simulations, which were scaled down to rabbit dimensions while keeping the forces acting on a cell constant, lead to similar predicted targeting efficiencies. Fluid dynamic and fluid-structure interaction simulations predict that magnetically labeled cells within a 0.5% radii distance to the vessel wall would be attracted and remain at the wall under physiological flow conditions. CONCLUSIONS First pass capture of magnetically labeled cells under pulsatile flow conditions in human lower leg arteries leads to low targeting efficiencies. However, this can be increased to almost 100% by stopping the blood flow for 5 min. A magnetic actuation device can be designed for animal models that generate magnetic forces achievable for cells in human leg arteries.

Magnetic cell delivery for peripheral arterial disease

PURPOSE Our aim was to compare different magnet arrangements for magnetic cell delivery to human lower leg arteries and investigate the theoretical targeting efficiency under realistic flow conditions as a possible treatment after angioplasty. Additionally the potential of scaling down or translating the magnetic actuation device for preclinical studies was explored. METHODS Using finite element methods, the magnetic field distribution was calculated in 3D for the optimization of magnet arrangements. Computational fluid dynamics simulations were performed for the human posterior tibial artery with the geometry and boundary condition data derived from magnetic resonance imaging (MRI) studies. These simulations were used to trace the trajectories of cells for an optimized magnet arrangement. Additionally the behavior of cells close to the vessel wall was investigated using a fluid-structure interaction model. RESULTS The optimal magnet for the lower leg arteries was a Halbach cylinder k3 variety (12 elements with 900 rotation steps for the magnetization orientation). With this magnet, numerical simulations predict a targeting efficiency of 6.25% could be achieved in the posterior tibial artery for cells containing 150 pg iron. Similar simulations, which were scaled down to rabbit dimensions while keeping the forces acting on a cell constant, lead to similar predicted targeting efficiencies. Fluid dynamic and fluid-structure interaction simulations predict that magnetically labeled cells within a 0.5% radii distance to the vessel wall would be attracted and remain at the wall under physiological flow conditions. CONCLUSIONS First pass capture of magnetically labeled cells under pulsatile flow conditions in human lower leg arteries leads to low targeting efficiencies. However, this can be increased to almost 100% by stopping the blood flow for 5 min. A magnetic actuation device can be designed for animal models that generate magnetic forces achievable for cells in human leg arteries.