Multilaboratory particle image velocimetry analysis of the FDA benchmark nozzle model to support validation of computational fluid dynamics simulations.

This study is part of a FDA-sponsored project to evaluate the use and limitations of computational fluid dynamics (CFD) in assessing blood flow parameters related to medical device safety. In an interlaboratory study, fluid velocities and pressures were measured in a nozzle model to provide experimental validation for a companion round-robin CFD study. The simple benchmark nozzle model, which mimicked the flow fields in several medical devices, consisted of a gradual flow constriction, a narrow throat region, and a sudden expansion region where a fluid jet exited the center of the nozzle with recirculation zones near the model walls. Measurements of mean velocity and turbulent flow quantities were made in the benchmark device at three independent laboratories using particle image velocimetry (PIV). Flow measurements were performed over a range of nozzle throat Reynolds numbers (Re(throat)) from 500 to 6500, covering the laminar, transitional, and turbulent flow regimes. A standard operating procedure was developed for performing experiments under controlled temperature and flow conditions and for minimizing systematic errors during PIV image acquisition and processing. For laminar (Re(throat)=500) and turbulent flow conditions (Re(throat)≥3500), the velocities measured by the three laboratories were similar with an interlaboratory uncertainty of ∼10% at most of the locations. However, for the transitional flow case (Re(throat)=2000), the uncertainty in the size and the velocity of the jet at the nozzle exit increased to ∼60% and was very sensitive to the flow conditions. An error analysis showed that by minimizing the variability in the experimental parameters such as flow rate and fluid viscosity to less than 5% and by matching the inlet turbulence level between the laboratories, the uncertainties in the velocities of the transitional flow case could be reduced to ∼15%. The experimental procedure and flow results from this interlaboratory study (available at http://fdacfd.nci.nih.gov) will be useful in validating CFD simulations of the benchmark nozzle model and in performing PIV studies on other medical device models.

Effects of thrombosed vena cava filters on blood flow: flow visualization and numerical modeling.

Inferior vena cava (IVC) filters are used to prevent pulmonary embolism (PE) in patients with deep vein thrombosis for whom anticoagulation is contraindicated. IVC filters have been shown to be effective in trapping embolized clots and preventing PE; however, among the commercially available designs, the optimal balance of clot capture efficiency, clot dissolution, and prevention of to vena cava occlusion is unknown. Clot capture efficiency has been quantified in numerous in vitro studies, in which model clots are released into a mock circulation system, with the relative capture efficiency of various IVC filters analyzed statistically. In general, two-stage filters have been found to be more efficient than one-stage filters. However, other factors may play a role in the ultimate dissolution of clots and in the overall effect of the resulting blood flow on caval vasculature. Clot dissolution has been shown to increase with increasing wall shear stress, while low and oscillating wall shear stresses are known to have a deleterious effect on vessel walls, causing intimal hyperplasia. This paper describes the effect of IVC filters on blood flow, velocity patterns, and wall shear stress by flow visualization and computational fluid dynamics.

Role of fluid dynamics on the healing of an in vivo tissue engineered vascular graft.

A polyester (PET) reinforced fibrin-FN-VEGF-TGFbeta vascular graft, formed by a four-step preclotting technique of a porous PET arterial graft, shows the overlapping inflammation, proliferation, and remodeling steps of normal wound healing when implanted in the descending thoracic aorta (DTA) position in the dog, forming a surface layer of endothelial cells. While the DTA grafts readily healed (i.e., endothelialized), similar grafts implanted in the carotid-femoral artery position did not fully heal. Since the initial phases of healing were shown to be dependent upon the transport of blood-borne constituents to the graft surface, the extent of healing appears to be dependent on the fluid dynamics present in the artery-graft-artery construct. The length of the noncompliant graft, the construction of the anastomoses, bends in the construct, graft diameter, and graft compliance can affect the fluid dynamics in the implant, and thus the healing of the graft. This has clinical relevance for the testing and development of new vascular graft materials.

Effects of an artery/vascular graft compliance mismatch on protein transport: a numerical study.

Small-diameter vascular graft failure by intimal hyperplasia and thrombosis may result from flow disturbances and disruption of chemical transport in the fluid at the distal anastomosis, because of compliance mismatch between the graft and host artery. In previous studies. lower-than-normal wall shear stress (WSS), particle trapping, and high particle residence times were observed at the distal anastomosis due to a pulsatile tubular expansion effect caused by nonuniform radial deformations. This study was undertaken to examine effects of compliance and radius mismatch on the distribution of a model protein released at the graft-fluid interface. Finite element simulations of end-to-end vascular grafting were performed under pulsatile flow, using fluid-structure coupling to give physiologic wall displacements. Results showed that protein is convected smoothly downstream in a uniform compliant tube. A compliance mismatch disturbed the transport, causing positive and negative gradients in the concentration profile at the distal anastomosis. This was seen when the graft and artery radii were matched at zero pressure and at mean arterial pressure; low WSSs were only observed in the former case. Thus the distal intimal hypertrophy seen in noncompliant grafts may be caused partly by decreased WSS, and partly by concentration gradients of dissolved chemicals affecting chemotaxis of cells.

Improved statistical characterization of prosthetic heart valve hydrodynamics using a performance index and regression analysis.

BACKGROUND AND AIMS OF THE STUDY: The ISO 5840 Standard (Cardiovascular implants - Cardiac valves) currently requires a minimum of three test samples per size for hydrodynamic testing. Typically, the only statistical analysis performed is a descriptive analysis, with the mean (+/- SE) given for each size and cardiac output (CO). The study aim was to develop better statistical methods, incorporating regression analysis of a performance index, equal to the effective orifice area divided by the tissue annulus area. The analysis is performed on the full dataset, with size and CO as independent variables. METHODS: Hydrodynamic data of Ionescu-Shiley pericardial valves from a published study were used to compare the two analysis methods. Three samples each of size 19, 23 and 27 mm valves were tested at COs of 4.2, 5.6, 7.0 and 8.4 l/min. Descriptive statistics were performed for each size and CO. Regression analysis was also performed on the full dataset. Confidence intervals (CI) were calculated for each statistical method and compared. RESULTS: The regression equation that best fitted the data was: Performance Index (PI) = -1.63 + (0.011 x CO) + (0.167 x size) - (0.0036 x size2). All four parameter estimates were significantly different from zero (p <0.02). The SE of the mean was 0.015 for COs of 4.2 or 8.4 l/min, and 0.013 for COs of 5.6 or 7.0 l/min, less than that of nine of 12 of the individual descriptive analysis. CI for the regression analysis were substantially tighter, averaging one-third the width of those of the descriptive statistics. CONCLUSION: The tighter CI resulting from the regression analysis allows a better comparison of the PI to an objective performance criterion. Such methods should be considered for inclusion in the new version of the ISO 5840 standard for prosthetic heart valves.