Search results for: pulmonary valve
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 471

Search results for: pulmonary valve

471 Design and Development of a Bi-Leaflet Pulmonary Valve

Authors: Munirah Ismail, Joon Hock Yeo

Abstract:

Paediatric patients who require ventricular outflow tract reconstruction usually need valve construction to prevent valvular regurgitation. They would face problems like lack of suitable, affordable conduits and the need to undergo several operations in their lifetime due to the short lifespan of existing valves. Their natural growth and development are also of concern, even if they manage to receive suitable conduits. Current prosthesis including homografts, bioprosthetic valves, mechanical valves, and bovine jugular veins either do not have the long-term durability or the ability to adapt to the growth of such patients. We have developed a new design of bi-leaflet valve. This new technique accommodates patients’ annular size growth while maintaining valvular patency. A mock circulatory system was set up to assess the hemodynamic performance of the bi-leaflet pulmonary valve. It was found that the percentage regurgitation was acceptable and thus, validates this novel concept.

Keywords: bi-leaflet pulmonary valve, pulmonary heart valve, tetralogy of fallot, mock circulatory system

Procedia PDF Downloads 134
470 Pulmonary Valve Papillary Fibroelastoma: A Case Report of a Fibroelastoma Presenting as a Pulmonary Embolism

Authors: Frazer Kirk, Matthew Yong, Peter Williams, Andrie Strobel

Abstract:

Pulmonary valve papillary fibroelastoma is an exceedingly rare pathology. The experience and literature regarding them are largely anecdotal and based on sporadic, single case reports. Throughout their known history, two features remain salient that they are classically asymptomatic and found incidentally. The demographic profile of those affected is unclear, as reports regarding those affected are mixed, and there is no clear gender or age predominance, although there is some suggestion of a predisposition to affect females. Nor has there been a well-structured epidemiological study of the entity. Interestingly they are becoming more common on peri-mortum examination. Here-after we describe our experience with a symptomatic presentation of pulmonary papillary fibroelastoma masquerading as a pulmonary embolism and its subsequent assessment and management, with intraoperative photography and echocardiography for reference.

Keywords: cardiac tumor, pulmonary valve, fibroelastoma, cardiac surgery

Procedia PDF Downloads 176
469 Design and Development of an Expanded Polytetrafluoroethylene Valved Conduit with Sinus of Valsalva

Authors: Munirah Ismail, Joon Hock Yeo

Abstract:

Babies born with Tetralogy of Fallot, a congenital heart defect, are required to undergo reconstruction surgery to create a valved conduit. As the child matures, the partially reconstructed pulmonary conduit increases in diameter, while the size of the reconstructed valve remains the same. As a result, follow up surgery is required to replace the undersized valve. Thus, in this project, we evaluated the in-vitro performance of a bi-leaflet valve design in terms of percentage regurgitation with increasing artery (conduit) diameters. Results revealed percentage regurgitations ranging from 13% to 34% for conduits tested. It was observed that percentage of regurgitation increased exponentially with increasing diameters. While the amount of regurgitation may seem severe, it is deemed acceptable, and this valve could potentially reduce the frequency of re-operation in the lifetime of pediatric patients.

Keywords: pulmonary heart valve, tetralogy of fallot, expanded polytetrafluoroethylene valve, pediatric heart valve replacement

Procedia PDF Downloads 143
468 Numerical Simulations for Nitrogen Flow in Piezoelectric Valve

Authors: Pawel Flaszynski, Piotr Doerffer, Jan Holnicki-Szulc, Grzegorz Mikulowski

Abstract:

Results of numerical simulations for transonic flow in a piezoelectric valve are presented. The valve is the main part of an adaptive pneumatic shock absorber. Flow structure in the valve domain and the influence of the flow non-uniformity in the valve on a mass flow rate is investigated. Numerical simulation results are compared with experimental data.

Keywords: pneumatic valve, transonic flow, numerical simulations, piezoelectric valve

Procedia PDF Downloads 472
467 Design and Performance Optimization of Isostatic Pressing Working Cylinder Automatic Exhaust Valve

Authors: Wei-Zhao, Yannian-Bao, Xing-Fan, Lei-Cao

Abstract:

An isostatic pressing working cylinder automatic exhaust valve is designed. The finite element models of valve core and valve body under ultra-high pressure work environment are built to study the influence of interact of valve core and valve body to sealing performance. The contact stresses of metal sealing surface with different sizes are calculated and the automatic exhaust valve is optimized. The result of simulation and experiment shows that the sealing of optimized exhaust valve is more reliable and the service life is greatly improved. The optimized exhaust valve has been used in the warm isostatic pressing equipment.

Keywords: exhaust valve, sealing, ultra-high pressure, isostatic pressing

Procedia PDF Downloads 270
466 In Vitro Evaluation of an Artificial Venous Valve

Authors: Joon Hock Yeo, Munirah Ismail

Abstract:

Chronic venous insufficiency is a condition where the venous wall or venous valves fail to operate properly. As such, it is difficult for the blood to return from the lower extremities back to the heart. Chronic venous insufficiency affects many people worldwide. In last decade, there have been many new and innovative designs of prosthetic venous valves to replace the malfunction native venous valves. However, thus far, to the authors’ knowledge, there is no successful prosthetic venous valve. In this project, we have developed a venous valve which could operate under low pressure. While further testing is warranted, this unique valve could potentially alleviate problems associated with chronic venous insufficiency.

Keywords: prosthetic venous valve, bi-leaflet valve, chronic venous insufficiency, valve hemodynamics

Procedia PDF Downloads 158
465 Normally Closed Thermoplastic Microfluidic Valves with Microstructured Valve Seats: A Strategy to Avoid Permanently Bonded Valves during Channel Sealing

Authors: Kebin Li, Keith Morton, Matthew Shiu, Karine Turcotte, Luke Lukic, Teodor Veres

Abstract:

We present a normally closed thermoplastic microfluidic valve design that uses microstructured valve seats to locally prevent the membrane from bonding to the valve seat during microfluidic channel sealing. The microstructured valve seat reduces the adhesion force between the contact surfaces of the valve seat and the membrane locally, allowing valve open and close operations while simultaneously providing a permanent and robust bond elsewhere to cover and seal the microfluidic channel network. Dynamic valve operation including opening and closing times can be tuned by changing the valve seat diameter as well as the density of the microstructures on the valve seats. The influence of the microstructured valve seat on the general flow behavior through the microfluidic devices was also studied. A design window for the fabrication of valve structure is identified and discussed to minimize the fabrication complexity.

Keywords: hot-embossing, injection molding, microfabrication, microfluidics, microvalves, thermoplastic elastomer

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464 Numerical Study of a Butterfly Valve for Vibration Analysis and Reduction

Authors: Malik I. Al-Amayreh, Mohammad I. Kilani, Ahmed S. Al-Salaymeh

Abstract:

This works presents a Computational Fluid Dynamics (CFD) simulation of a butterfly valve used to control the flow of combustible gas mixture in an industrial process setting. The work uses CFD simulation to analyze the flow characteristics in the vicinity of the valve, including the velocity distributions, streamlines and path lines. Frequency spectrum of the pressure pulsations downstream the valves, and the vortex shedding allow predicting the torque fluctuations acting on the valve shaft and the possibility of generating mechanical vibration and resonance. These fluctuations are due to aerodynamic torque resulting from fluid turbulence and vortex shedding in the valve vicinity. The valve analyzed is located in a pipeline between two opposing 90o elbows, which exposes the valve and the surrounding structure to the turbulence generated upstream and downstream the elbows at either end of the pipe. CFD simulations show that the best location for the valve from a vibration point of view is in the middle of the pipe joining the elbows.

Keywords: butterfly valve vibration analysis, computational fluid dynamics, fluid flow circuit design, fluctuation

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463 Computational Fluid Dynamics Simulation and Comparison of Flow through Mechanical Heart Valve Using Newtonian and Non-Newtonian Fluid

Authors: D. Šedivý, S. Fialová

Abstract:

The main purpose of this study is to show differences between the numerical solution of the flow through the artificial heart valve using Newtonian or non-Newtonian fluid. The simulation was carried out by a commercial computational fluid dynamics (CFD) package based on finite-volume method. An aortic bileaflet heart valve (Sorin Bicarbon) was used as a pattern for model of real heart valve replacement. Computed tomography (CT) was used to gain the accurate parameters of the valve. Data from CT were transferred in the commercial 3D designer, where the model for CFD was made. Carreau rheology model was applied as non-Newtonian fluid. Physiological data of cardiac cycle were used as boundary conditions. Outputs were taken the leaflets excursion from opening to closure and the fluid dynamics through the valve. This study also includes experimental measurement of pressure fields in ambience of valve for verification numerical outputs. Results put in evidence a favorable comparison between the computational solutions of flow through the mechanical heart valve using Newtonian and non-Newtonian fluid.

Keywords: computational modeling, dynamic mesh, mechanical heart valve, non-Newtonian fluid

Procedia PDF Downloads 354
462 Optimal Design of 3-Way Reversing Valve Considering Cavitation Effect

Authors: Myeong-Gon Lee, Yang-Gyun Kim, Tae-Young Kim, Seung-Ho Han

Abstract:

The high-pressure valve uses one set of 2-way valves for the purpose of reversing fluid direction. If there is no accurate control device for the 2-way valves, lots of surging can be generated. The surging is a kind of pressure ripple that occurs in rapid changes of fluid motions under inaccurate valve control. To reduce the surging effect, a 3-way reversing valve can be applied which provides a rapid and precise change of water flow directions without any accurate valve control system. However, a cavitation occurs due to a complicated internal trim shape of the 3-way reversing valve. The cavitation causes not only noise and vibration but also decreasing the efficiency of valve-operation, in which the bubbles generated below the saturated vapor pressure are collapsed rapidly at higher pressure zone. The shape optimization of the 3-way reversing valve to minimize the cavitation effect is necessary. In this study, the cavitation index according to the international standard ISA was introduced to estimate macroscopically the occurrence of the cavitation effect. Computational fluid dynamic analysis was carried out, and the cavitation effect was quantified by means of the percent of cavitation converted from calculated results of vapor volume fraction. In addition, the shape optimization of the 3-way reversing valve was performed by taking into account of the percent of cavitation.

Keywords: 3-Way reversing valve, cavitation, shape optimization, vapor volume fraction

Procedia PDF Downloads 338
461 A Case of Postpartum Pulmonary Edema Induced by Oxytocin

Authors: May Zaw, Amber Latif, William Lim

Abstract:

Postpartum dyspnea can be due to many causes, such as pulmonary embolism, amniotic fluid embolism, and peripartum cardiomyopathy, but less frequently due to acute pulmonary edema. The incidence of acute pulmonary edema during pregnancy and in the postpartum period has been estimated to be around 0.08%. About half of the cases are attributed to tocolytic therapy. Herein, we present a case of a young woman presenting with acute hypoxia after induction of labor with oxytocin and found to have acute pulmonary edema. This case aims to illustrate and add to a growing body of literature regarding oxytocin-induced acute pulmonary edema and highlights the importance of recognizing the rare complication of oxytocin and necessary interventions to avoid complications. Oxytocin-induced pulmonary edema is a relatively uncommon condition, but physicians should have a high index of suspicion to initiate timely intervention and avoid fetal complications.

Keywords: pulmonary, pregnancy, oxytocin, postpartum

Procedia PDF Downloads 53
460 Automatic Fluid-Structure Interaction Modeling and Analysis of Butterfly Valve Using Python Script

Authors: N. Guru Prasath, Sangjin Ma, Chang-Wan Kim

Abstract:

A butterfly valve is a quarter turn valve which is used to control the flow of a fluid through a section of pipe. Generally, butterfly valve is used in wide range of applications such as water distribution, sewage, oil and gas plants. In particular, butterfly valve with larger diameter finds its immense applications in hydro power plants to control the fluid flow. In-lieu with the constraints in cost and size to run laboratory setup, analysis of large diameter values will be mostly studied by computational method which is the best and inexpensive solution. For fluid and structural analysis, CFD and FEM software is used to perform large scale valve analyses, respectively. In order to perform above analysis in butterfly valve, the CAD model has to recreate and perform mesh in conventional software’s for various dimensions of valve. Therefore, its limitation is time consuming process. In-order to overcome that issue, python code was created to outcome complete pre-processing setup automatically in Salome software. Applying dimensions of the model clearly in the python code makes the running time comparatively lower and easier way to perform analysis of the valve. Hence, in this paper, an attempt was made to study the fluid-structure interaction (FSI) of butterfly valves by varying the valve angles and dimensions using python code in pre-processing software, and results are produced.

Keywords: butterfly valve, flow coefficient, automatic CFD analysis, FSI analysis

Procedia PDF Downloads 207
459 Structural Performance Evaluation of Power Boiler for the Pressure Release Valve in Consideration of the Thermal Expansion

Authors: Young-Hun Lee, Tae-Gwan Kim, Jong-Kyu Kim, Young-Chul Park

Abstract:

In this study, Spring safety valve Heat - structure coupled analysis was carried out. Full analysis procedure and performing thermal analysis at a maximum temperature, them to the results obtained through to give an additional load and the pressure on the valve interior, and Disc holder Heat-Coupled structure Analysis was carried out. Modeled using a 3D design program Solidworks, For the modeling of the safety valve was used 3D finite element analysis program ANSYS. The final result to be obtained through the Analysis examined the stability of the maximum displacement and the maximum stress to the valve internal components occurring in the high-pressure conditions.

Keywords: finite element method, spring safety valve, gap, stress, strain, deformation

Procedia PDF Downloads 338
458 Warning about the Risk of Blood Flow Stagnation after Transcatheter Aortic Valve Implantation

Authors: Aymen Laadhari, Gábor Székely

Abstract:

In this work, the hemodynamics in the sinuses of Valsalva after Transcatheter Aortic Valve Implantation is numerically examined. We focus on the physical results in the two-dimensional case. We use a finite element methodology based on a Lagrange multiplier technique that enables to couple the dynamics of blood flow and the leaflets’ movement. A massively parallel implementation of a monolithic and fully implicit solver allows more accuracy and significant computational savings. The elastic properties of the aortic valve are disregarded, and the numerical computations are performed under physiologically correct pressure loads. Computational results depict that blood flow may be subject to stagnation in the lower domain of the sinuses of Valsalva after Transcatheter Aortic Valve Implantation.

Keywords: hemodynamics, simulations, stagnation, valve

Procedia PDF Downloads 264
457 High-Fidelity 1D Dynamic Model of a Hydraulic Servo Valve Using 3D Computational Fluid Dynamics and Electromagnetic Finite Element Analysis

Authors: D. Henninger, A. Zopey, T. Ihde, C. Mehring

Abstract:

The dynamic performance of a 4-way solenoid operated hydraulic spool valve has been analyzed by means of a one-dimensional modeling approach capturing flow, magnetic and fluid forces, valve inertia forces, fluid compressibility, and damping. Increased model accuracy was achieved by analyzing the detailed three-dimensional electromagnetic behavior of the solenoids and flow behavior through the spool valve body for a set of relevant operating conditions, thereby allowing the accurate mapping of flow and magnetic forces on the moving valve body, in lieu of representing the respective forces by lower-order models or by means of simplistic textbook correlations. The resulting high-fidelity one-dimensional model provided the basis for specific and timely design modification eliminating experimentally observed valve oscillations.

Keywords: dynamic performance model, high-fidelity model, 1D-3D decoupled analysis, solenoid-operated hydraulic servo valve, CFD and electromagnetic FEA

Procedia PDF Downloads 148
456 Internal Leakage Analysis from Pd to Pc Port Direction in ECV Body Used in External Variable Type A/C Compressor

Authors: M. Iqbal Mahmud, Haeng Muk Cho, Seo Hyun Sang, Wang Wen Hai, Chang Heon Yi, Man Ik Hwang, Dae Hoon Kang

Abstract:

Solenoid operated electromagnetic control valve (ECV) playing an important role for car’s air conditioning control system. ECV is used in external variable displacement swash plate type compressor and controls the entire air conditioning system by means of a pulse width modulation (PWM) input signal supplying from an external source (controller). Complete form of ECV contains number of internal features like valve body, core, valve guide, plunger, guide pin, plunger spring, bellows etc. While designing the ECV; dimensions of different internal items must meet the standard requirements as it is quite challenging. In this research paper, especially the dimensioning of ECV body and its three pressure ports through which the air/refrigerant passes are considered. Here internal leakage test analysis of ECV body is being carried out from its discharge port (Pd) to crankcase port (Pc) when the guide valve is placed inside it. The experiments have made both in ordinary and digital system using different assumptions and thereafter compare the results.

Keywords: electromagnetic control valve (ECV), leakage, pressure port, valve body, valve guide

Procedia PDF Downloads 371
455 Design and Optimization of Flow Field for Cavitation Reduction of Valve Sleeves

Authors: Kamal Upadhyay, Zhou Hua, Yu Rui

Abstract:

This paper aims to improve the streamline linked with the flow field and cavitation on the valve sleeve. We observed that local pressure fluctuation produces a low-pressure zone, central to the formation of vapor volume fraction within the valve chamber led to air-bubbles (or cavities). Thus, it allows simultaneously to a severe negative impact on the inner surface and lifespan of the valve sleeves. Cavitation reduction is a vitally important issue to pressure control valves. The optimization of the flow field is proposed in this paper to reduce the cavitation of valve sleeves. In this method, the inner wall of the valve sleeve is changed from a cylindrical surface to the conical surface, leading to the decline of the fluid flow velocity and the rise of the outlet pressure. Besides, the streamline is distributed inside the sleeve uniformly. Thus, the bubble generation is lessened. The fluid models are built and analysis of flow field distribution, pressure, vapor volume and velocity was carried out using computational fluid dynamics (CFD) and numerical technique. The results indicate that this structure can suppress the cavitation of valve sleeves effectively.

Keywords: streamline, cavitation, optimization, computational fluid dynamics

Procedia PDF Downloads 103
454 Pulmonary Embolism Indicative of Myxoma of the Right Atrium

Authors: A. Kherraf, M. Bouziane, A. Drighil, L. Azzouzi, R. Habbal

Abstract:

Objective: Myxomas are rare heart tumors most commonly found in the left atrium. The purpose of this observation is to report a rare case of myxoma of the right atrium revealed by pulmonary embolism. Observation: A 34-year-old patient with no history presented to the emergency room with sudden onset dyspnea. Clinical examination showed arterial pressure at 110/70mmHg, tachycardia at 110bpm, and 90% oxygen saturation. The ECG enrolled in incomplete right bundle branch block. The radio-thorax was normal. Echocardiography revealed the presence of a large homogeneous intra-OD mass, contiguous to the inter-atrial septum, prolapsing through the tricuspid valve, and causing mild tricuspid insufficiency, with dilation of the right ventricle and retained systolic function with PAPs estimated at 45mmHg. A chest scan was performed, revealing the presence of right segmental pulmonary embolism. The patient was put under anticoagulant and underwent surgical resection of the mass; its pathological examination concluded to a myxoma. The post-operative consequences were simple, without recurrence of the mass after one year follow-up. Discussion: Myxomas represent 50% of heart tumors. Most often, they originate in the left atrium, and more rarely in the right atrium or the ventricles. Myxoma of the right atrium can be responsible for life-threatening pulmonary embolism. The most predictive factor for embolization remains the morphology of the myxomas; papillary or villous myxomas are the most friable. Surgery is the standard treatment, with regular postoperative follow-up to detect recurrence. Conclusion: Myxomas of the right atrium are a rare location for these tumors. Pulmonary embolism is the main complication and should routinely involve careful study of the right chambers on echocardiography.

Keywords: pulmonary embolism, myxoma, right atrium, heart tumors

Procedia PDF Downloads 104
453 Investigation of Leakage, Cracking and Warpage Issues Observed on Composite Valve Cover in Development Phase through FEA Simulation

Authors: Ashwini Shripatwar, Mayur Biyani, Nikhil Rao, Rajendra Bodake, Sachin Sane

Abstract:

This paper documents the correlation of valve cover sealing, cracking, and warpage Finite Element Modelling with observations on engine test development. The valve cover is a component mounted on engine head with a gasket which provides sealing against oil which flows around camshaft, valves, rockers, and other overhead components. Material nonlinearity and contact nonlinearity characteristics are taken into consideration because the valve cover is made of a composite material having temperature dependent elastic-plastic properties and because the gasket load-deformation curve is also nonlinear. The leakage is observed between the valve cover and the engine head due to the insufficient contact pressure. The crack is observed on the valve cover due to force application at a region with insufficient stiffness and with elevated temperature. The valve cover shrinkage is observed during the disassembly process on hot exhaust side bolt holes after the engine has been running. In this paper, an analytical approach is developed to correlate a Finite Element Model with the observed failures and to address the design issues associated with the failure modes in question by making design changes in the model.

Keywords: cracking issue, gasket sealing analysis, nonlinearity of contact and material, valve cover

Procedia PDF Downloads 104
452 Anatomy of the Human Mitral Valve Leaflets: Implications for Transcatheter and Surgical Mitral Valve Repair Techniques

Authors: Agata Krawczyk-Ozog, Mateusz K. Holda, Mateusz Koziej, Danuta Sorysz, Zbigniew Siudak, Wieslawa Klimek-Piotrowska, Dariusz Dudek

Abstract:

Introduction: Rapid development of the surgical and less-invasive percutaneous mitral valve repair procedures greatly increase the interest of the mitral valve anatomy. The aim of this study was to characterize morphological variability of the mitral valve leaflets and to provide the size of their particular parts. Materials and Methods: In the study, we included 200 autopsied human hearts from Caucasian individuals (25% females) with mean age 47.5 (±17.9) without any valvular diseases. The morphology of the mitral valve was evaluated. The intercommissural and aorto-mural diameters of the mitral annulus were measured. All leaflets and their scallops were identified. The base and the height of the posteromedial commissure (PM-C), anterolateral commissure (AL-C), anterior leaflet (AL) and posterior leaflet (PL) with their scallops were measured. Results: The intercommissural diameter was 28.0±4.8 mm, the aorto-mural diameter 19.7±4.8 mm, circumference of the mitral annulus 89.9±12.6 mm and the area of the mitral valve 485.4±171.4 mm2. Classical mitral valves (AL+AL-C+PL(P1,P2,P3)+PM-C) were found in 141 (70.5%) specimens. In classical type, the mean AL base and height were 30.8±4.9 mm and 20.6±4.2 mm, while mean PL base and height 45.1±8.2 mm 12.9±2.8 mm respectively. The mean ratio of the AL base to PL base was 0.7±0.2. Variations in PL were found in 55 (27.5%) and in AL in 5 (2.5%) hearts. The most common variations were: valve with one accessory scallop (AcS) between P3 and PM-C (7%); AcS between P1 and AL-C (4%); connections of P2 and P3 scallops (4%); connections of P1 and P2 scallops (3%); AcS in AL (2.5%). All AcS were smaller than the main PL scallops. The mean intertrigonal distance was 21.9±3.8 mm. Conclusions: In all cases, the mitral valve is built by two main leaflets with possible variants in secondary to leaflets scallops (29.5%). The variations are largely associated with PL and are mostly related to the presence of AcS. Anatomically the AL is not divided into scallops, and it occupies 34.5% of the mitral annulus circumference. Understanding the anatomy of the mitral valve leaflets helps to planning and performing mitral valve repair procedures.

Keywords: accessory scallop, commissure, connected scallops, human heart, mitral leaflets, mitral valve

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451 A Theoretical to Conceptual Paper: The Use of Phosphodiesterase Inhibitors, Endothelin Receptor Antagonists and/or Prostacyclin Analogs in Acute Pulmonary Embolism

Authors: Ryan M. Monti, Bijal Mehta

Abstract:

In cases of massive pulmonary embolism, defined as acute pulmonary embolism presenting with systemic hypotension or right ventricular dysfunction and impending failure, there is indication that unconventional therapies, such as phosphodiesterase inhibitors, endothelin receptor antagonists, and/or prostacyclin analogs may decrease the morbidity and mortality. Based on the premise that dilating the pulmonary artery will decrease the pulmonary vascular pressure, while simultaneously decreasing the aggregation of platelets, it can be hypothesized that increased blood flow through the pulmonary artery will decrease right heart strain and subsequent morbidity and mortality. While this theory has yet to be formally studied, the recommendations for treating massive pulmonary embolism with phosphodiesterase inhibitors, endothelin receptor antagonists, and/or prostacyclin analogs in conjunction with the current standards of care in massive pulmonary embolism should be formally studied. In particular, patients with massive PE who are unable to undergo thrombolysis/surgical intervention may be the ideal population to study the use of these treatments to determine any decrease in mortality and morbidity (short term and long term).

Keywords: acute pulmonary thromboembolism, treatment of pulmonary embolism, use of phosphodiesterase inhibitors, endothelin receptor antagonists, prostacyclin analogs in PE

Procedia PDF Downloads 195
450 Advanced Techniques in Robotic Mitral Valve Repair

Authors: Abraham J. Rizkalla, Tristan D. Yan

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Purpose: Durable mitral valve repair is preferred to a replacement, avoiding the need for anticoagulation or re-intervention, with a reduced risk of endocarditis. Robotic mitral repair has been gaining favour globally as a safe, effective, and reproducible method of minimally invasive valve repair. In this work, we showcase the use of the Davinci© Xi robotic platform to perform several advanced techniques, working synergistically to achieve successful mitral repair in advanced mitral disease. Techniques: We present the case of a Barlow type mitral valve disease with a tall and redundant posterior leaflet resulting in severe mitral regurgitation and systolic anterior motion. Firstly, quadrangular resection of P2 is performed to remove the excess and redundant leaflet. Secondly, a sliding leaflet plasty of P1 and P3 is used to reconstruct the posterior leaflet. To anchor the newly formed posterior leaflet to the papillary muscle, CV-4 Goretex neochordae are fashioned using the innovative string, ruler, and bulldog technique. Finally, mitral valve annuloplasty and closure of a patent foramen ovale complete the repair. Results: There was no significant residual mitral regurgitation and complete resolution of the systolic anterior motion of the mitral valve on post operative transoesophageal echocardiography. Conclusion: This work highlights the robotic approach to complex repair techniques for advanced mitral valve disease. Familiarity with resection and sliding plasty, neochord implantation, and annuloplasty allows the modern cardiac surgeon to achieve a minimally-invasive and durable mitral valve repair when faced with complex mitral valve pathology.

Keywords: robotic mitral valve repair, Barlow's valve, sliding plasty, neochord, annuloplasty, quadrangular resection

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449 Impact of Pulmonary Rehabilitation on Respiratory Parameters in Interstitial Lung Disease Patients: A Tertiary Care Hospital Study

Authors: Vivek Ku, A. K. Janmeja, D. Aggarwal, R. Gupta

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Purpose: Pulmonary rehabilitation plays a key role in management of chronic lung diseases. However, pulmonary rehabilitation is an underused modality in the management of interstitial lung disease (ILD). This is because limited information is available in literature and no data is available from India on this issue so far. The study was carried out to evaluate the role of pulmonary rehabilitation on respiratory parameters in ILD patients. Methods: The present study was a prospective randomized non-blind case control study. Total of 40 ILD patients were randomized into 2 groups of 20 patients each viz ‘pulmonary rehabilitation group’ and ‘control group’. Pulmonary rehabilitation group underwent 8 weeks pulmonary rehabilitation (PR) along with medical management as per guidelines and the control group was advised only medical management. Results: Mean age in case group was 59.15 ± 10.39 years and in control group was 62.10 ± 14.54 years. The case and the control groups were matched for age and sex. Mean MRC grading at the end of 8 weeks showed significant improvement in the case group as compared to control group (p= 0.011 vs p = 0.655). Similarly, mean St. George Respiratory Questionnaire (SGRQ) score also showed significant improvement in pulmonary rehabilitation group at the end of the study (p= 0.001 vs p= 0.492). However, FEV1 and FVC had no significant change in the case and control group. Similarly, blood gases also did not show any significant difference in the group. Conclusion: Pulmonary rehabilitation improves breathlessness and thereby improves quality of life in the patients suffering from ILD. However, the pulmonary function values and blood gases are unaffected by pulmonary rehabilitation. Clinical Implications: Further large scale multicentre study is needed to ascertain the association.

Keywords: ILD, pulmonary rehabilitation, quality of life, pulmonary functions

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448 Improving the Flow Capacity (CV) of the Valves

Authors: Pradeep A. G, Gorantla Giridhar, Vijay Turaga, Vinod Srinivasa

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The major problem in the flow control valve is of lower Cv, which will reduce the overall efficiency of the flow circuit. Designers are continuously working to improve the Cv of the valve, but they need to validate the design ideas they have regarding the improvement of Cv. The traditional method of prototyping and testing takes a lot of time. That is where CFD comes into the picture with very quick and accurate validation along with visualization, which is not possible with the traditional testing method. We have developed a method to predict Cv value using CFD analysis by iterating on various Boundary conditions, solver settings and by carrying out grid convergence studies to establish the correlation between the CFD model and Test data. The present study investigates 3 different ideas put forward by the designers for improving the flow capacity of the valves, like reducing the cage thickness, changing the port position, and using the parabolic plug to guide the flow. Using CFD, we analyzed all design changes using the established methodology that we developed. We were able to evaluate the effect of these design changes on the Valve Cv. We optimized the wetted surface of the valve further by suggesting the design modification to the lower part of the valve to make the flow more streamlined. We could find that changing cage thickness and port position has little impact on the valve Cv. The combination of optimized wetted surface and introduction of parabolic plug improved the Flow capacity (Cv) of the valve significantly.

Keywords: flow control valves, flow capacity (Cv), CFD simulations, design validation

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447 The Role of Pulmonary Resection in Complicated Primary Pediatric Pulmonary Tuberculosis: An Evidence-Based Case Report

Authors: Hendra Wibowo, Suprayitno Wardoyo, Dhama Shinta

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Introduction: Pediatric pulmonary tuberculosis (TB) incidence was increasing, with many undetected cases. In complicated TB, treatment should consist of returning pulmonary function, preventing further complications, and eliminating bacteria. Complicated TB management was still controversial, and surgery was one of the treatments that should be evaluated in accordance with its role in the treatment of complicated TB. Method: This study was an evidence-based case report. The database used for the literature search were Cochrane, Medline, Proquest, and ScienceDirect. Keywords for the search were ‘primary pulmonary tuberculosis’, ‘surgery’, ‘lung resection’, and ‘children’. Inclusion criteria were studies in English or Indonesian, with children under 18 years old as subject, and full-text articles available. The assessment was done according to Oxford Centre for evidence-based medicine 2011. Results: Six cohort studies were analyzed. Surgery was indicated for patients with complicated TB that were unresponsive towards treatment. It should be noted that the experiments were done before the standard WHO antituberculosis therapy was applied; thus, the result may be different from the current application. Conclusion: Currently, there was no guideline on pulmonary resection. However, surgery yielded better mortality and morbidity in children with complicated pulmonary TB.

Keywords: pediatric, pulmonary, surgery, therapy, tuberculosis

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446 Gas Lift Optimization Using Smart Gas Lift Valve

Authors: Mohamed A. G. H. Abdalsadig, Amir Nourian, G. G. Nasr, M. Babaie

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Gas lift is one of the most common forms of artificial lift, particularly for offshore wells because of its relative down hole simplicity, flexibility, reliability, and ability to operate over a large range of rates and occupy very little space at the well head. Presently, petroleum industry is investing in exploration and development fields in offshore locations where oil and gas wells are being drilled thousands of feet below the ocean in high pressure and temperature conditions. Therefore, gas-lifted oil wells are capable of failure through gas lift valves which are considered as the heart of the gas lift system for controlling the amount of the gas inside the tubing string. The gas injection rate through gas lift valve must be controlled to be sufficient to obtain and maintain critical flow, also, gas lift valves must be designed not only to allow gas passage through it and prevent oil passage, but also for gas injection into wells to be started and stopped when needed. In this paper, smart gas lift valve has been used to investigate the effect of the valve port size, depth of injection and vertical lift performance on well productivity; all these aspects have been investigated using PROSPER simulator program coupled with experimental data. The results show that by using smart gas lift valve, the gas injection rate can be controlled which leads to improved flow performance.

Keywords: Effect of gas lift valve port size, effect water cut, vertical flow performance

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445 Numerical Investigation of Blood Flow around a Leaflet Valve through a Perforating Vein

Authors: Zohreh Sheidaei, Farhad Sadegh Moghanlou, Rahim Vesal

Abstract:

Diseases related to leg venous system are common worldwide. An incompetent vein with deformed wall and insufficient valves affects flow field of blood and disrupts the process of blood circulating system. Having enough knowledge about the flow field through veins will help find new ways to cure the related diseases. In the present study, blood flow around a leaflet valve of a perforating vein is investigated numerically by Finite Element Method. Flow behavior and vortexes, generated around the leaflet valves, are studied considering valve opening percentage. Obtained velocity and pressure fields show mechanical stresses on vein wall and these valves and consequently introduce the regions susceptible to deformation.

Keywords: fluid flow, leaflet valve, numerical investigation, perforating vein

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444 Structural Design of a Relief Valve Considering Strength

Authors: Nam-Hee Kim, Jang-Hoon Ko, Kwon-Hee Lee

Abstract:

A relief valve is a mechanical element to keep safety by controlling high pressure. Usually, the high pressure is relieved by using the spring force and letting the fluid to flow from another way out of system. When its normal pressure is reached, the relief valve can return to initial state. The relief valve in this study has been applied for pressure vessel, evaporator, piping line, etc. The relief valve should be designed for smooth operation and should satisfy the structural safety requirement under operating condition. In general, the structural analysis is performed by following fluid flow analysis. In this process, the FSI (Fluid-Structure Interaction) is required to input the force obtained from the output of the flow analysis. Firstly, this study predicts the velocity profile and the pressure distribution in the given system. In this study, the assumptions for flow analysis are as follows: • The flow is steady-state and three-dimensional. • The fluid is Newtonian and incompressible. • The walls of the pipe and valve are smooth. The flow characteristics in this relief valve does not induce any problem. The commercial software ANSYS/CFX is utilized for flow analysis. On the contrary, very high pressure may cause structural problem due to severe stress. The relief valve is made of body, bonnet, guide, piston and nozzle, and its material is stainless steel. To investigate its structural safety, the worst case loading is considered as the pressure of 700 bar. The load is applied to inside the valve, which is greater than the load obtained from FSI. The maximum stress is calculated as 378 MPa by performing the finite element analysis. However, the value is greater than its allowable value. Thus, an alternative design is suggested to improve the structural performance through case study. We found that the sensitive design variable to the strength is the shape of the nozzle. The case study is to vary the size of the nozzle. Finally, it can be seen that the suggested design satisfy the structural design requirement. The FE analysis is performed by using the commercial software ANSYS/Workbench.

Keywords: relief valve, structural analysis, structural design, strength, safety factor

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443 CT-Scan Transition of Pulmonary Edema Due to Water-Soluble Paint Inhalation

Authors: Masashi Kanazawa, Takaaki Nakano, Masaaki Takemoto, Tomonori Imamura, Mamiko Sugimura, Toshitaka Ito

Abstract:

Introduction: We experienced a massive disaster due to inhalation of water-soluble paint. Sixteen patients were brought to our emergency room, and pulmonary edema was revealed on the CT images of 12 cases. Purpose: Transition of chest CT-scan findings in cases with pulmonary edema was examined. Method: CT-scans were performed on the 1st, 2nd, 5th, and 19th days after the inhalation event. Patients whose pulmonary edema showed amelioration or exacerbation were classified into the improvement or the exacerbation group, respectively. Those with lung edema findings appearing at different sites after the second day were classified into the changing group. Results: Eight, one and three patients were in the improvement, exacerbation and changing groups, respectively. In all cases, the pulmonary edema had disappeared from CT images on the 19th day after the inhalation event. Conclusion: Inhalation of water-soluble paints is considered to be relatively safe. However, our observations in these emergency cases suggest that, even if pulmonary edema is not severe immediately after the exposure, new lesions may appear later and existing lesions may worsen. Follow-up imaging is thus necessary for about two weeks.

Keywords: CT scan, intoxication, pulmonary edema, water-soluble paint

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442 Congenital Malformations in Neonate Dogs in the Sao Paulo State University Veterinary Hospital, Botucatu, Sao Paulo, Brazil

Authors: Maria Lucia G. Lourenco, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

Abstract:

Congenital malformations are organ defects due to genetic or teratogenic causes, which can lead to high mortality in dog litters. This study assessed and described the congenital malformations in newborn dogs. The study included litters attend in the São Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil. One hundred seventy-eight litters and 803 newborns were evaluated. The occurrence of litters with malformations was 24.7%, and of newborns was 6.7%. Twenty-seven different malformations were registered: anasarca, anal atresia, cleft lip, cleft palate, duplicated right ribcage, equinovarus, exencephaly, gastroschisis, hydrocephaly, lissencephaly, macroglossia, microphthalmia, mitral valve dysplasia, omphalocele, eyelid agenesis, persistent urachus, polydactyly, pulmonary hypoplasia, pulmonary valve stenosis, rectovaginal fistula, agenesis of abdominal muscles, rib hypoplasia, scoliosis, segmental aplasia of the intestines, tricuspid valve dysplasia, unilateral kidney agenesis, and vaginal atresia. 68.7% of newborns died as a result of malformations. The pure breeds with the highest chances of manifesting malformations in contrast with mixed breeds were French Bulldog, Pug, English Bulldog, Rottweiler, German Spitz, Pinscher, Pitbull, Yorkshire Terrier, and Shih-Tzu. Significant values (P<0.05) occurred in races French Bulldogs and Pugs. The causes of congenital disabilities are possibly related to hereditary genetic factors considering that the highest incidence of malformations was observed among purebreds. There as one case of exposure to a teratogenic agent, but no other mothers were exposed to such agents during pregnancy. Two cases of consanguineal breeding between siblings were reported. The mortality rate was high. Genetic breeding programs for reproduction, avoiding consanguineous mating, care in choosing parents, and avoiding maternal exposure to teratogenic agents are of utmost importance in reducing dog malformations and consequent mortality.

Keywords: congenital defects, teratogenesis, canine neonatology, newborn puppy

Procedia PDF Downloads 103