Intraventricular Vortex Interaction between Transmitral Flow and Paravalvular Leak

Daisuke Morisawa, Ahmad Falahatpisheh, Eleonora Avenatti, Stephen H. Little, Arash Kheradvar

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Paravalvular leak (PVL) is a complication of transcatheter aortic valve replacement. Despite its marked clinical impact, no previous study has reported how PVL affects the intraventricular fluid dynamics. This study aims to delineate vortex interaction between PVL and transmitral flow and the influence of PVL orifice location on intraventricular fluid dynamics using Echocardiographic Particle Image Velocimetry. Three different conditions of no PVL, anterior PVL and posterior PVL were experimentally studied and clinically compared. Circulation, impulse, kinetic energy (KE) and change in KE (ΔKE) were calculated. As well, vortex formation analyses and streamline description were performed to study vortex interactions. The anterior PVL jet streamed into the LV and interfered with the transmitral flow. Posterior PVL jet formed a large clockwise vortex and collided with transmitral flow, which resulted in flow disturbance. Compared to no PVL condition, average circulation, impulse, KE and ΔKE increased in presence of PVL. In conclusion, we found that PVL jets lead to abnormal vortex formation that interfere with natural advancement of transmitral flow, and negatively affect the LV fluid dynamics parameters. PVL orifice location strongly affects the intraventricular vortex formation, and posterior PVL may have more negative effects compared to anterior PVL.

Original languageEnglish (US)
Article number15657
JournalScientific Reports
Volume8
Issue number1
DOIs
StatePublished - Oct 23 2018

ASJC Scopus subject areas

  • General

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