Abstract：
BACKGROUND: In vitro assessment is mandatory for artificial heart valve development. This study aims to investigate the effects of pulse duplicator features on valve responsiveness, conduct a sensitivity analysis across valve prosthesis types, and contribute on the development of versatile pulse duplicator systems able to perform reliable prosthetic aortic valve assessment under physiologic hemodynamic conditions.
METHODS: A reference pulse duplicator was established based on literature. Further optimization process led to new designs that underwent a parametric study, also involving different aortic valve prostheses. These designs were evaluated on criteria such as mean pressure differential and pulse pressure (assessed from high-fidelity pressure measurements), valve opening and closing behavior, flow, and regurgitation. Finally, the resulting optimized setup was tested under five different hemodynamic settings simulating a range of physiologic and pathologic conditions.
RESULTS: The results show that both, pulse duplicator design and valve type significantly influence aortic and ventricular pressure, flow, and valve kinematic response. The optimal design comprised key features such as a compliance chamber and restrictor for diastolic pressure maintenance and narrow pulse pressure. Additionally, an atrial reservoir was included to prevent atrial-aortic interference, and a bioprosthetic valve was used in mitral position to avoid delayed valve closing effects.
CONCLUSIONS: This study showed that individual pulse duplicator features can have a significant effect on valve\'s responsiveness. The optimized versatile pulse duplicator replicated physiologic and pathologic aortic valve hemodynamic conditions, serving as a reliable characterization tool for assessing and optimizing aortic valve performance.
METHODS: A reference pulse duplicator was established based on literature. Further optimization process led to new designs that underwent a parametric study, also involving different aortic valve prostheses. These designs were evaluated on criteria such as mean pressure differential and pulse pressure (assessed from high-fidelity pressure measurements), valve opening and closing behavior, flow, and regurgitation. Finally, the resulting optimized setup was tested under five different hemodynamic settings simulating a range of physiologic and pathologic conditions.
RESULTS: The results show that both, pulse duplicator design and valve type significantly influence aortic and ventricular pressure, flow, and valve kinematic response. The optimal design comprised key features such as a compliance chamber and restrictor for diastolic pressure maintenance and narrow pulse pressure. Additionally, an atrial reservoir was included to prevent atrial-aortic interference, and a bioprosthetic valve was used in mitral position to avoid delayed valve closing effects.
CONCLUSIONS: This study showed that individual pulse duplicator features can have a significant effect on valve\'s responsiveness. The optimized versatile pulse duplicator replicated physiologic and pathologic aortic valve hemodynamic conditions, serving as a reliable characterization tool for assessing and optimizing aortic valve performance.
摘要：
背景：人工心脏瓣膜发育必须进行体外评估。本研究旨在探讨脉冲复制器功能对瓣膜响应性的影响，对瓣膜假体类型进行敏感性分析，并有助于开发能够在生理血液动力学条件下进行可靠的人工主动脉瓣评估的多功能脉冲复制系统。
方法：根据文献建立了参考脉冲复制器。进一步的优化过程导致了经过参数研究的新设计，还涉及不同的主动脉瓣假体。根据平均压差和脉压等标准对这些设计进行了评估（通过高保真压力测量进行评估）。阀门打开和关闭行为，流量,和反流。最后,在模拟一系列生理和病理状况的5种不同的血液动力学设置下,对所得的优化设置进行了测试.
结果：结果表明，脉冲复制器设计和瓣膜类型显着影响主动脉和心室压力，流量,和阀门运动学响应。最佳设计包括关键特征，例如用于舒张压维持和窄脉压的顺应性室和限制器。此外,包括心房储液器以防止心房-主动脉干扰，在二尖瓣位置使用生物瓣膜以避免延迟的瓣膜关闭效应。
结论：这项研究表明，单个脉冲复制器的特征可以对瓣膜的反应性产生显著影响。优化的多功能脉冲复制器复制了生理和病理性主动脉瓣血流动力学条件，作为评估和优化主动脉瓣性能的可靠表征工具。
方法：根据文献建立了参考脉冲复制器。进一步的优化过程导致了经过参数研究的新设计，还涉及不同的主动脉瓣假体。根据平均压差和脉压等标准对这些设计进行了评估（通过高保真压力测量进行评估）。阀门打开和关闭行为，流量,和反流。最后,在模拟一系列生理和病理状况的5种不同的血液动力学设置下,对所得的优化设置进行了测试.
结果：结果表明，脉冲复制器设计和瓣膜类型显着影响主动脉和心室压力，流量,和阀门运动学响应。最佳设计包括关键特征，例如用于舒张压维持和窄脉压的顺应性室和限制器。此外,包括心房储液器以防止心房-主动脉干扰，在二尖瓣位置使用生物瓣膜以避免延迟的瓣膜关闭效应。
结论：这项研究表明，单个脉冲复制器的特征可以对瓣膜的反应性产生显著影响。优化的多功能脉冲复制器复制了生理和病理性主动脉瓣血流动力学条件，作为评估和优化主动脉瓣性能的可靠表征工具。
