Annals of Biomedical Engineering

, Volume 38, Issue 3, pp 769–773 | Cite as

On the Left Ventricular Vortex Reversal after Mitral Valve Replacement

  • Gianni Pedrizzetti
  • Federico Domenichini
  • Giovanni Tonti


The blood flow in the human left ventricle is known to develop a vortical motion that should facilitate the ejection of blood into the primary circulation. This study shows that such a rotary motion can be totally reversed after the implant of a prosthetic valve. This phenomenon, in agreement with clinical observation, appears mostly imputable to the symmetry of the implant. The reversed rotation increases energy dissipation and modifies the pressure distribution with the potential development of new pathologies. The results provide preliminary, physically based, elements for the improvement of surgical procedures or prosthesis.


Cardiac fluid dynamics Vortex dynamics Left ventricular flow 


  1. 1.
    Daebritz, S. H., J. S. Sachweh, B. Hermanns, B. Fausten, A. Franke, J. Groetzner, B. Klosterhalfen, and B. J. Messmer. Introduction of a flexible polymeric heart valve prosthesis with special design for mitral position. Circulation 108II:134–139, 2003.Google Scholar
  2. 2.
    Domenichini, F. On the consistency of the direct forcing method in the fractional step solution of the Navier-Stokes equations. J. Comp. Phys. 227:6372–6384, 2008.CrossRefGoogle Scholar
  3. 3.
    Domenichini, F., G. Pedrizzetti, and B. Baccani. Three-dimensional filling flow into a model left ventricle. J. Fluid Mech. 539:179–198, 2005.CrossRefGoogle Scholar
  4. 4.
    Gharib, M., E. Rambod, A. Kheradvar, D. J. Sahn, and J. O. Dabiri. Optimal vortex formation as an index of cardiac health. Proc. Natl. Acad. Sci. USA 109:6205–6308, 2006.Google Scholar
  5. 5.
    Hong, G. R., G. Pedrizzetti, G. Tonti, P. Li, P. Wei, J. K. Kim, A. Bawela, S. Liu, N. Chung, H. Houle, J. Narula, and M. A. Vannan. Characterization and quantification of vortex flow in the human left ventricle by contrast echocardiography using vector particle image velocimetry. J. Am. Coll. Cardiol. Imaging 1:705–717, 2008.Google Scholar
  6. 6.
    Kheradvar, A., H. Houle, G. Pedrizzetti, G. Tonti, T. Belcik, M. Ashraf, J. R. Lindner, M. Gharib, and D. Sahn. Echographic particle image velocimetry: a novel technique for quantification of left ventricular blood vorticity pattern. J. Am. Soc. Echocardiogr. 2009. doi: 10.1016/j.echo.2009.09.007.
  7. 7.
    Kilner, P. J., G. Z. Yang, A. J. Wilkes, R. H. Mohiaddin, D. N. Firmin, and M. H. Yacoub. Asymmetric redirection of flow through the heart. Nature 404:759–761, 2000.CrossRefPubMedGoogle Scholar
  8. 8.
    Machler, H., M. Perthel, G. Reiter, U. Reiter, M. Zink, P. Bergmann, A. Waltensdorfer, and J. Laas. Influence of bileaflet prosthetic mitral valve orientation on left ventricular flow—an experimental in vivo magnetic resonance imaging study. Eur. J. Cardiothorac. Surg. 26:747–753, 2004.CrossRefPubMedGoogle Scholar
  9. 9.
    Narula, J., M. A. Vannan, and A. N. De Maria. Of that waltz in my heart. J. Am. Coll. Cardiol. 49:917–920, 2007.CrossRefPubMedGoogle Scholar
  10. 10.
    Pedrizzetti, G., and F. Domenichini. Nature optimizes the swirling flow in the human left ventricle. PRL 95:1080101, 2005.CrossRefGoogle Scholar

Copyright information

© Biomedical Engineering Society 2010

Authors and Affiliations

  • Gianni Pedrizzetti
    • 1
  • Federico Domenichini
    • 2
  • Giovanni Tonti
    • 3
  1. 1.D.I.C.A.University of TriesteTriesteItaly
  2. 2.Department of Civil and Environmental EngineeringUniversity of FirenzeFirenzeItaly
  3. 3.SS. Annunziata HospitalSulmonaItaly

Personalised recommendations