Modified heart-lung preparation for the evaluation of systolic and diastolic coronary flow in rats

A modified heart-lung preparation of the rat, which permits measuring systolic and diastolic coronary flow separately and enables coronary compliance to be evaluated, is described. The systemic circulation was substituted by a shunt circuit, and the elastic properties of the arterial tree were mimicked by a rubber balloon. Systolic and diastolic coronary flow was evaluated from the pulmonary and aortic flow signal. Integrated phasic pulmonary flow represented right ventricular stroke volume. Integrated phasic systolic aortic flow represented left ventricular stroke volume minus that volume flowing into the coronary arteries during systole, because the aortic flow probe had to be inserted distal to the origin of the coronary vessels. Because right and left ventricular stroke volume was identical under steady-state conditions, the difference between systolic pulmonary and systolic aortic flow resulted in systolic coronary flow. Diastolic coronary flow was measured by means of the retrograde flow through the aortic flow probe. Coronary compliance was calculated according to Frank's windkessel model from coronary resistance and from central diastolic aortic pressure, which decayed exponentially after switching out the rubber balloon and the shunt circuit. It could be shown that the proportion of systolic to diastolic coronary flow depends on coronary compliance.     

Patient-specific modeling of biomechanical interaction in transcatheter aortic valve deployment

The objective of this study was to develop a patient-specific computational model to quantify the biomechanical interaction between the transcatheter aortic valve (TAV) stent and the stenotic aortic valve during TAV intervention. Finite element models of a patient-specific stenotic aortic valve were reconstructed from multi-slice computed tomography (MSCT) scans, and TAV stent deployment into the aortic root was simulated. Three initial aortic root geometries of this patient were analyzed: (a) aortic root geometry directly reconstructed from MSCT scans, (b) aortic root geometry at the rapid right ventricle pacing phase, and (c) aortic root geometry with surrounding myocardial tissue. The simulation results demonstrated that stress, strain, and contact forces of the aortic root model directly reconstructed from MSCT scans were significantly lower than those of the model at the rapid ventricular pacing phase. Moreover, the presence of surrounding myocardium slightly increased the mechanical responses. Peak stresses and strains were observed around the calcified regions in the leaflets, suggesting the calcified leaflets helped secure the stent in position. In addition, these elevated stresses induced during TAV stent deployment indicated a possibility of tissue tearing and breakdown of calcium deposits, which might lead to an increased risk of stroke. The potential of paravalvular leak and occlusion of coronary ostia can be evaluated from simulated post-deployment aortic root geometries. The developed computational models could be a valuable tool for pre-operative planning of TAV intervention and facilitate next generation TAV device design.     

Estimation of changes in instantaneous aortic blood flow by the analysis of arterial blood pressure

The purpose of this study was to introduce and validate a new algorithm to estimate instantaneous aortic blood flow (ABF) by mathematical analysis of arterial blood pressure (ABP) waveforms. The algorithm is based on an autoregressive with exogenous input (ARX) model. We applied this algorithm to diastolic ABP waveforms to estimate the autoregressive model coefficients by requiring the estimated diastolic flow to be zero. The algorithm incorporating the coefficients was then applied to the entire ABP signal to estimate ABF. The algorithm was applied to six Yorkshire swine data sets over a wide range of physiological conditions for validation. Quantitative measures of waveform shape (standard deviation, skewness, and kurtosis), as well as stroke volume and cardiac output from the estimated ABF, were computed. Values of these measures were compared with those obtained from ABF waveforms recorded using a Transonic aortic flow probe placed around the aortic root. The estimation errors were compared with those obtained using a windkessel model. The ARX model algorithm achieved significantly lower errors in the waveform measures, stroke volume, and cardiac output than those obtained using the windkessel model (P < 0.05).     

The geometry of the aortic root in health, at valve disease and after valve replacement

For the design of aortic valve prostheses with a separation-free flow field and minimum pressure drop the geometry of the aortic root is of high importance, since an appropriate adjustment of the prostheses to the surrounding geometry could largely reduce the risk of thromboembolic complications. For the investigation of the geometry of the aortic root 604 angiographic films out of a total stock of 15,000 of the Medical Clinic I were evaluated. The film material was preclassified into five clinical categories according to the patient's data. For each category characteristic geometries could be derived in non-dimensional form.     

Comparison between gradient-dependent hydraulic conductivities of roots using the root pressure probe: the role of pressure propagations and implications for the relative roles of parallel radial pathways

Hydrostatic pressure relaxations with the root pressure probe are commonly used for measuring the hydraulic conductivity (Lp(r)) of roots. We compared the Lp(r) of roots from species with different root hydraulic properties (Lupinus angustifolius L. 'Merrit', Lupinus luteus L. 'Wodjil', Triticum aestivum L. 'Kulin' and Zea mays L. 'Pacific DK 477') using pressure relaxations, a pressure clamp and osmotic gradients to induce water flow across the root. Only the pressure clamp measures water flow under steady-state conditions. Lp(r) determined by pressure relaxations was two- to threefold greater than Lp(r) from pressure clamps and was independent of the direction of water flow. Lp(r) (pressure clamp) was two- to fourfold higher than for Lp(r) (osmotic) for all species except Triticum aestivum where Lp(r) (pressure clamp) and Lp(r) (osmotic) were not significantly different. A novel technique was developed to measure the propagation of pressure through roots to investigate the cause of the differences in Lp(r). Root segments were connected between two pressure probes so that when root pressure (P(r)) was manipulated by one probe, the other probe recorded changes in P(r). Pressure relaxations did not induce the expected kinetics in pressure in the probe at the other end of the root when axial hydraulic conductance, and probe and root capacitances were accounted for. An electric circuit model of the root was constructed that included an additional capacitance in the root loaded by a series of resistances. This accounted for the double exponential kinetics for intact roots in pressure relaxation experiments as well as the reduced response observed with the double probe experiments. Although there were potential errors with all the techniques, we considered that the measurement of Lp(r) using the pressure clamp was the most unambiguous for small pressure changes, and provided that sufficient time was allowed for pressure propagation through the root. The differences in Lp(r) from different methods of measurement have implications for the models describing water transport through roots and the potential role of aquaporins.     

Fluid dynamics of aortic root dilation in Marfan syndrome

Aortic root dilation and propensity to dissection are typical manifestations of the Marfan Syndrome (MS), a genetic defect leading to the degeneration of the elastic fibres. Dilation affects the structure of the flow and, in turn, altered flow may play a role in vessel dilation, generation of aneurysms, and dissection. The aim of the present work is the investigation in-vitro of the fluid dynamic modifications occurring as a consequence of the morphological changes typically induced in the aortic root by MS. A mock-loop reproducing the left ventricle outflow tract and the aortic root was used to measure time resolved velocity maps on a longitudinal symmetry plane of the aortic root. Two dilated model aortas, designed to resemble morphological characteristics typically observed in MS patients, have been compared to a reference, healthy geometry. The aortic model was designed to quantitatively reproduce the change of aortic distensibility caused by MS. Results demonstrate that vorticity released from the valve leaflets, and possibly accumulating in the root, plays a fundamental role in redirecting the systolic jet issued from the aortic valve. The altered systolic flow also determines a different residual flow during the diastole.     

Systolic fluid–structure interaction model of the congenitally bicuspid aortic valve: assessment of modelling requirements

A transient fluid–structure interaction (FSI) model of a congenitally bicuspid aortic valve has been developed which allows simultaneous calculation of fluid flow and structural deformation. The valve is modelled during the systolic phase (the stage when blood pressure is elevated within the heart to pump blood to the body). The geometry was simplified to represent the bicuspid aortic valve in two dimensions. A congenital bicuspid valve is compared within the aortic root only and within the aortic arch. Symmetric and asymmetric cusps were simulated, along with differences in mechanical properties. A moving arbitrary Lagrange–Euler mesh was used to allow FSI. The FSI model requires blood flow to induce valve opening and induced strains in the region of 10%. It was determined that bicuspid aortic valve simulations required the inclusion of the ascending aorta and aortic arch. The flow patterns developed were sensitive to cusp asymmetry and differences in mechanical properties. Stiffening of the valve amplified peak velocities, and recirculation which developed in the ascending aorta. Model predictions demonstrate the need to take into account the category, including any existing cusp asymmetry, of a congenital bicuspid aortic valve when simulating its fluid flow and mechanics.     

Experimental investigation of steady flow through a model of the human aortic arch

Steady flow through a model of the human aortic arch has been studied with hot-film anemometry. A three sensor hot-film velocity probe was inserted into an acrylic flow chamber fabricated from the in situ casting of a human aorta, and the axial, radial and tangential velocity profiles were determined for steady flows in the region of the aortic arch. These studies demonstrated the presence of a potential core throughout the arch region, with a concomitant boundary layer adjacent to the inner wall of curvature of the arch. Trapped secondary flows in this fluid layer along the inner wall were quantitatively determined. Our steady flow studies in the model human aortic arch suggests that a shear-dependent mass transfer mechanism may play a significant role in the development and propagation of atherosclerotic lesions in this segment of the human cardiovascular system.     

Detection of Clostridium botulinum toxin A using a fiber optic-based biosensor.

A rapid, sensitive, analytical method for the detection of Clostridium botulinum toxin has been developed. The fiber optic-based biosensor utilizes the evanescent wave of a tapered optical fiber for signal discrimination. A 50 mW argon-ion laser, which generates laser light at 514 nm, is used in conjunction with an optical fiber probe that is tapered at the distal end. Antibodies specific for C. botulinum are covalently attached to the surface of the tapered fiber. The principle of the system is a sandwich immunoassay using rhodamine-labeled polyclonal anti-toxin A immunoglobin G (IgG) antibodies for generation of the specific fluorescent signal. Various anti-toxin antibodies were immobilized to the fibers. Affinity-purified polyclonal horse anti-toxin A antibodies performed better than the IgG fraction from the same horse serum or than the monoclonal anti-toxin A antibody BA11-3. Botulinum toxin could be detected within a minute, at concentrations as low as 5 ng/ml. The reaction was highly specific and no response was observed against tetanus toxin.     

Ventriculo-aortic junction in human root. A geometric approach

With advances in tissue engineering and improvement of surgical techniques, stentless biological valves and valve-sparing procedures have become alternatives to traditional aortic valve replacement with stented bioprostheses or mechanical valves. New surgical techniques preserve the advantages of native valves but require better understanding of the anatomical structure of the aortic root. Silicone rubber was injected in fresh aortic roots of nine human cadavers under the physiological closing pressure of 80 mmHg. The casts reproduced every detail of the aortic root anatomy and were used to digitize 27 leaflet attachment lines (LALs) of the aortic valves. LALs were normalized and described with a mathematical model. LALs were found to follow a pattern with the right coronary being the largest followed by the non-coronary and then the left coronary. During diastole, the aortic valve LAL can be described by an intersection between a created tube and an extruded parabolic surface. This geometrical definition of the LAL during end diastole gives a better understanding of the aortic root anatomy and could be useful for heart valve design and improvement of aortic valve reconstruction technique.     

A computational fluid-structure interaction analysis of a fiber-reinforced stentless aortic valve

The importance of the aortic root compliance in the aortic valve performance has most frequently been ignored in computational valve modeling, although it has a significant contribution to the functionality of the valve. Aortic root aneurysm or (calcific) stiffening severely affects the aortic valve behavior and, consequently, the cardiovascular regulation. The compromised mechanical and hemodynamical performance of the valve are difficult to study both 'in vivo' and 'in vitro'. Computational analysis of the valve enables a study on system responses that are difficult to obtain otherwise. In this paper a numerical model of a fiber-reinforced stentless aortic valve is presented. In the computational evaluation of its clinical functioning the interaction of the valve with the blood is essential. Hence, the blood-tissue interaction is incorporated in the model using a combined fictitious domain/arbitrary Lagrange-Euler formulation, which is integrated within the Galerkin finite element method. The model can serve as a diagnostic tool for clinical purposes and as a design tool for improving existing valve prostheses or developing new concepts. Structural mechanical and fluid dynamical aspects are analyzed during the systolic course of the cardiac cycle. Results show that aortic root compliance largely influences the valve opening and closing configurations. Stresses in the delicate parts of the leaflets are substantially reduced if fiber-reinforcement is applied and the aortic root is able to expand.     

A novel servo-control system that imposes desired aortic input impedance on in situ rat heart

To clarify the pathophysiological role of dynamic arterial properties in cardiovascular diseases, we attempted to develop a new control system that imposes desired aortic impedance on in situ rat left ventricle. In 38 anesthetized open-chest rats, ascending aortic pressure and flow waveforms were continuously sampled (1,000 Hz). Desired flow waveforms were calculated from measured aortic pressure waveforms and target impedance. To minimize the difference between measured and desired aortic flow waveforms, the computer generated commands to the servo-pump, connected to a side branch of the aorta. By iterating the process, we could successfully control aortic impedance in such a way as to manipulate compliance and characteristic impedance between 60 and 160% of their respective native values. The error between desired and measured aortic flow waveforms was 70 +/- 34 microl/s (root mean square; 4.4 +/- 1.4% of peak flow), indicating reasonable accuracy in controlling aortic impedance. This system enables us to examine the importance of dynamic arterial properties independently of other hemodynamic and neurohumoral factors in physiological and clinical settings.     

Hydraulic propagation of pressure along immature and mature xylem vessels of roots of Zea mays measured by pressure-probe techniques

Turgor pressure was measured in cortical cells and in xylem elements of excised roots and roots of intact plants of Zea mays L. by means of a cell pressure probe. Turgor of living and hence not fully differentiated late metaxylem (range 0.6–0.8 MPa) was consistently higher than turgor of cortical cells (range 0.4–0.6 MPa) at positions between 40 and 180 mm behind the root tip. Closer to the tip, no turgor difference between the cortex and the stele was measured. The turgor difference indicated that late-metaxylem elements may function as nutrient-storage compartments within the stele. Excised roots were attached to the root pressure probe to precisely manipulate the xylem water potential. Root excision did not affect turgor of cortical cells for at least 8 h. Using the cell pressure probe, the propagation of a hydrostatic pressure change effected by the root pressure probe was recorded in mature and immature xylem elements at various positions along the root. Within seconds, the pressure change propagated along both early and late metaxylems. The half-times of the kinetics, however, were about five times smaller for the early metaxylem, indicating they are likely the major pathway of longitudinal water flow. The hydraulic signal dissipated from the source of the pressure application (cut end of the root) to the tip of the root, presumably because of radial water movement along the root axis. The results demonstrate that the water status of the growth zone and other positions apical to 20 mm is mainly uncoupled from changes of the xylem water potential in the rest of the plant.Abbreviations and Symbols CPP cell pressure probe - EMX early metaxylem - LMX Late metaxylem - P_c cell turgor - P_r root pressure - RPP root pressure probe - t_1/2,c half-time of water exchange across a single cell - t_1/2 half-time of water exchange across multiple cells We thank Antony Matista for his expert assistance in the construction and modification of instruments. The work was supported by grant DCB8802033 from the National Science Foundation and grant 91-37100-6671 from USDA, and by the award of a Feodor Lynen-Fellowship from the Alexander von Humboldt-Foundation (Germany) to J.F.     

Rooting characteristics of two widely distributed woody plant species growing in different karst habitats of southwest China

A series of studies claimed that deep root development of plant established in karst regions was facilitated by fractured bedrock beneath the shallow soils; however, bedrock is not a uniform medium for root proliferation. We hypothesized plant species that survived in different karst habitats had some other rooting characteristics rather than deep penetration. To test the hypothesis, coarse root systems of two widely distributed woody species (one tree and one shrub) growing in three typical rocky karst habitats (shallow soil, loose rocky soil and exposed rock) were excavated in karst region of southwest China. Root systems were investigated based on four parameters: maximum rooting depth, maximum radial extent, root tapering pattern and root curvature. In all the three habitats, maximum rooting depths were no deeper than 120 and 40 cm for the tree and shrub species, respectively. Maximum radial extents were extremely large compared with maximum rooting depth, indicating that rooting characteristics were dominated by horizontal extension rather than deep penetration. Roots of both species growing in shallow soil habitat tapered gradually and curved slightly, which was consistent with the specific characteristics of this habitat. On the contrary, roots of the tree species growing in the other two habitats tapered rapidly but curved slightly, while roots of the shrub species tapered gradually but curved strongly. It was speculated that limited depths and rapid tapering rates of the tree roots were likely compensated by their utmost radial extensions, while the shrub species might benefit from its root curvature as the associated root tropisms may increase the ability of root to encounter more water and contribute to potentially high resource absorption efficiency. Our results highlight the importance of taking shallow-rooted species into account in understanding the distribution of natural plant communities and predicting future vegetation dynamics in karst regions.     

RAPID HYPOTHERMIC CARDIOPLEGIA AND AIR VENTING WITH AN AORTIC ROOT CANNULA

A newly designed aortic root perfusion cannula (ARC) is described that accomplishes a double purpose. Not only does it allow rapid inflow into the root of the aorta for induction of hypothermic cardioplegia, but it also provides an effective air vent after completion of the procedure. This technique simplifies air venting at the end of open heart operations.     

Pressure losses in non-Newtonian flow through rigid wall tapered tubes

Pressure drop and pressure gradient were measured in steady Newtonian and non-Newtonian flow through tapered tubes having angles of taper, alpha, between 0.5 degree and 1.25 degrees. Aqueous solutions of polyacrylamide, characterized as power law fluids, were used for the non-Newtonian flow measurements. These solutions had power law parameters similar in magnitude to those of blood. The pressure drop-flow rate data compared well with the predictions of a semi-empirical flow model over a large range of flow rates (Re alpha up to 10 for Newtonian flow and 5.7 for non-Newtonian flow). The pressure gradient increased with distance, z, into the taper as the radius decreased. The linear relationship between pressure gradient and z, derived by Oka (Biorheology, 10, 207-212, 1973) was found to be valid only when alpha z was small. For the tapered tubes examined here, agreement was confined to the region near the inlet. If higher order terms in alpha z were taken into account the agreement was extended further into the taper. However, under higher flow conditions, when the inertial losses are not negligible, the semi-empirical model provides much better estimates of pressure gradient.     

Numerical Modeling of Intraventricular Flow during Diastole after Implantation of BMHV

This work presents a numerical simulation of intraventricular flow after the implantation of a bileaflet mechanical heart valve at the mitral position. The left ventricle was simplified conceptually as a truncated prolate spheroid and its motion was prescribed based on that of a healthy subject. The rigid leaflet rotation was driven by the transmitral flow and hence the leaflet dynamics were solved using fluid-structure interaction approach. The simulation results showed that the bileaflet mechanical heart valve at the mitral position behaved similarly to that at the aortic position. Sudden area expansion near the aortic root initiated a clockwise anterior vortex, and the continuous injection of flow through the orifice resulted in further growth of the anterior vortex during diastole, which dominated the intraventricular flow. This flow feature is beneficial to preserving the flow momentum and redirecting the blood flow towards the aortic valve. To the best of our knowledge, this is the first attempt to numerically model intraventricular flow with the mechanical heart valve incorporated at the mitral position using a fluid-structure interaction approach. This study facilitates future patient-specific studies.     

Root hydraulic properties of spruce measured with the pressure probe

The root pressure probe was used for the first time to measure the hydraulic properties of entire root systems of youngPicea abies. Hydraulic conductance was measured by osmotic and hydrostatic pressure relaxation techniques. Osmotic experiments were conducted by changing the nutrient solution and hydrostatic experiments by causing flow across the root with the pressure probe and with external pressure applied to the root system or to the cut stem of the excised root system. Usually,Picea abies root systems did not develop appreciable root pressure (< 0.02 MPA) and could be induced to reach a root pressure of 0.07 MPa by treating with KNO₃. In general, hydraulic conductance of the root system was large, but it was much smaller in the osmotic than in the hydrostatic experiments. Both hydrostatic techniques gave similar results. The results were explainable by a composite transport model of the root.